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 U.S. Drug Enforcement Administration:
- A. Registers manufacturers and prescribers of controlled substances
- B. Regulates NP prescribing at the state level
- C. Sanctions providers who prescribe drugs off-label
- D. Provides prescribers with a number they can use for insurance billing
Correct Answer: A
Rationale: Choice A is correct because the DEA registers those handling controlled substances, issuing numbers for tracking and prescribing, its primary role. Choice B is incorrect as state boards, not the DEA, regulate NP prescribing. Choice C is wrong because off-label prescribing isn't DEA-regulated. Choice D is incorrect since the DEA number is for controlled substances, not insurance billing.
A patient is taking drug A and drug B. The primary care NP notes increased effects of drug B. The NP should suspect that in this case drug A is a cytochrome P450 (CYP450) enzyme:
- A. inhibitor.
- B. substrate.
- C. inducer.
- D. metabolizer.
Correct Answer: A
Rationale: The correct answer is A because a CYP450 inhibitor (drug A) reduces metabolism of drug B, increasing its effects. Choice B is incorrect as a substrate is acted upon, not inhibiting. Choice C is wrong since an inducer increases metabolism, reducing effects. Choice D is inaccurate as 'metabolizer' isn’t a CYP450 role.
Drugs that are affected by genetic polymorphisms of UGT1A1 include:
- A. Warfarin
- B. Irinotecan
- C. Acetaminophen
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because irinotecan's active metabolite is glucuronidated by UGT1A1; poor function increases toxicity, requiring genetic consideration. Choice A is incorrect as warfarin's metabolism is via CYP2C9, not UGT1A1. Choice C is wrong because acetaminophen uses other UGT enzymes, not specifically UGT1A1 critically. Choice D is incorrect since only irinotecan is notably affected by UGT1A1 polymorphisms.
The current trend toward transitioning NP programs to the doctoral level will mean that:
- A. NPs licensed in one state may practice in other states.
- B. full prescriptive authority will be granted to all NPs with doctoral degrees.
- C. NPs will be better prepared to meet emerging health care needs of patients.
- D. requirements for physician supervision of NPs will be removed in all states.
Correct Answer: C
Rationale: The correct answer is C because doctoral programs aim to better prepare NPs for evolving healthcare needs, per the AACN. Choice A is incorrect as licensure remains state-specific. Choice B is wrong since prescriptive authority depends on state laws. Choice D is inaccurate as supervision rules vary by state.
An NP is caring for a 70-year-old patient who reports having seasonal allergies with severe rhinorrhea. Using the Beers criteria, which of the following medications should the NP recommend for this patient?
- A. Loratadine (Claritin)
- B. Hydroxyzine (Vistaril)
- C. Diphenhydramine (Benadryl)
- D. Chlorpheniramine maleate (Chlorphen 12)
Correct Answer: A
Rationale: The correct answer is A because loratadine is a nonsedating antihistamine, safer for elderly per Beers criteria, unlike the sedating options B, C, and D, which increase fall risk and cognitive impairment in older adults.