Nokea
A 4-month-old infant has a viral illness with high fever and cough. The infant's parent asks the NP about what to give the infant to help with symptoms. The NP should prescribe which of the following?
- A. Aspirin to treat the fever
- B. Acetaminophen as needed
- C. Dextromethorphan for coughing
- D. An antibiotic to prevent increased infection
Correct Answer: B
Rationale: The correct answer is B because acetaminophen is safe for infants to reduce fever. Choice A is incorrect (aspirin risks Reye’s syndrome). Choice C is wrong (dextromethorphan risks respiratory depression). Choice D is inaccurate (antibiotics don’t treat viral illness).
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The elderly are at high risk of ADRs due to:
- A. Having greater muscle mass than younger adults, leading to higher volume of distribution
- B. The extensive studies that have been conducted on drug safety in this age group
- C. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect
- D. Age-related decrease in renal function
Correct Answer: D
Rationale: Choice D is correct because an age-related decline in renal function slows drug excretion, increasing ADR risk as drugs accumulate. Choice A is incorrect as muscle mass decreases with age, not increases. Choice B is wrong because studies are often limited in the elderly, not extensive. Choice C is incorrect since the blood-brain barrier's permeability doesn't typically lessen, and higher doses aren't standard.
Generic drugs may differ from brand-name drugs in:
- A. Active ingredient
- B. Inactive ingredients
- C. Therapeutic effect
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because generics may use different inactive ingredients (e.g., fillers, dyes) affecting appearance or tolerability, but not efficacy, per FDA rules. Choice A is incorrect as active ingredients must be identical. Choice C is wrong because therapeutic effects are equivalent. Choice D is incorrect since only inactive ingredients differ.
Genetic testing prior to prescribing which drug could prevent serious adverse drug reactions?
- A. Acetaminophen
- B. Codeine
- C. Albuterol
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because genetic testing for CYP2D6 variants can prevent ADRs with codeine; poor metabolizers get no pain relief, while ultrarapid metabolizers risk morphine toxicity. Choice A is incorrect as acetaminophen metabolism isn't strongly tied to genetic variants causing serious ADRs. Choice C is wrong because albuterol's inhaled use has minimal genetic metabolism risks. Choice D is incorrect since only codeine benefits significantly from pre-prescribing genetic testing.
The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
- A. Minimum adverse effect level
- B. Peak of action
- C. Onset of action
- D. Therapeutic range
Correct Answer: C
Rationale: Choice C is correct because the onset of action is when a drug first shows a therapeutic effect on the concentration curve, marking the start of its clinical impact. Choice A is incorrect as ‘minimum adverse effect level' isn't a standard term; it confuses with toxicity thresholds. Choice B is wrong because peak of action is the maximum effect, not the first sign. Choice D is incorrect since therapeutic range is the concentration window for efficacy, not a specific time point.
Drugs that may cause sedation in the elderly include:
- A. Benzodiazepines
- B. Antihistamines
- C. Opioids
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because benzodiazepines (e.g., lorazepam), antihistamines (e.g., diphenhydramine), and opioids (e.g., oxycodone) all cause sedation, increasing fall risk in the elderly, per Beers Criteria. Choice A is incorrect alone as it's one class. Choice B is wrong by itself because antihistamines are just part. Choice C is incorrect solo since opioids are only one group.