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A patient will begin taking two drugs that are both protein-bound. The primary care NP should:
- A. prescribe increased doses of both drugs.
- B. monitor drug levels, actions, and side effects.
- C. teach the patient to increase intake of protein.
- D. stagger the doses of drugs to be given 1 hour apart.
Correct Answer: B
Rationale: The correct answer is B because protein-bound drugs compete for albumin, requiring monitoring to adjust dosing. Choice A is incorrect as increasing doses without monitoring is risky. Choice C is wrong since dietary protein doesn’t affect this. Choice D is inaccurate as staggering doesn’t resolve binding issues.
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In every state, prescriptive authority for NPs includes the ability to write prescriptions:
- A. for controlled substances.
- B. for specified classifications of medications.
- C. without physician-mandated involvement.
- D. with full, independent prescriptive authority.
Correct Answer: B
Rationale: The correct answer is B because all states grant NPs some prescriptive authority, but it’s often limited to specific drug classes. Choice A is incorrect as not all states allow controlled substances. Choice C is wrong since physician involvement is required in many states. Choice D is inaccurate as full independence isn’t universal.
The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October. The child recently completed a 7-day course of oral steroids. The NP plans to give the child flu vaccine and should:
- A. administer LAIV today.
- B. administer 0.5 mg TIV today.
- C. wait 4 weeks and administer LAIV.
- D. wait 4 weeks and administer 0.5 mg TIV.
Correct Answer: B
Rationale: The correct answer is B because LAIV is contraindicated in asthmatic children aged 2-4; TIV is safe post-steroids. Choice A is incorrect (LAIV excluded). Choice C is wrong (waiting unnecessary). Choice D is inaccurate (waiting not needed).
A client has been prescribed ciprofloxacin and is receiving discharge teaching. Which of the following instructions should be included by the healthcare provider?
- A. Take the medication with milk.
- B. Avoid exposure to sunlight.
- C. Take the medication at bedtime.
- D. Increase your intake of vitamin K.
Correct Answer: B
Rationale: The correct answer is to instruct the client to avoid exposure to sunlight. Ciprofloxacin can increase the risk of photosensitivity, making it important to protect the skin from sunlight to prevent skin reactions. This precaution can help prevent skin damage and discomfort in individuals taking ciprofloxacin. Choices A, C, and D are incorrect. Taking ciprofloxacin with milk is not recommended as it may reduce the absorption of the medication. There is no specific instruction to take ciprofloxacin at bedtime. Increasing vitamin K intake is not directly related to ciprofloxacin therapy.
An NP prescribes an oral elixir medication for a child who is to take 1 tsp PO bid. When counseling the child's parents about administering this drug, the NP should tell them to:
- A. shake the medication well before giving each dose.
- B. mix the medication with cereal or applesauce to improve its taste.
- C. administer the medication on an empty stomach to enhance absorption.
- D. use a syringe purchased at the pharmacy to measure the medication accurately.
Correct Answer: D
Rationale: The correct answer is D because a syringe ensures accurate dosing (teaspoons vary 2.5-7.8 mL). Choice A is incorrect (elixirs don’t need shaking). Choice B is wrong (mixing risks incomplete dosing). Choice C is inaccurate (empty stomach isn’t required).
The benefits to the patient of having an Advanced Practice Registered Nurse (APRN) prescriber include:
- A. Nurses know more about Pharmacology than other prescribers because they take it both in their basic nursing program and in their APRN program.
- B. Nurses care for the patient from a holistic approach and include the patient in decision making regarding their care.
- C. APRNs are less likely to prescribe narcotics and other controlled substances.
- D. APRNs are able to prescribe independently in all states, whereas a physician's assistant needs to have a physician supervising their practice.
Correct Answer: B
Rationale: Choice B is correct because APRNs are trained to adopt a holistic approach, addressing physical, emotional, and social aspects of health, and often involve patients in care decisions, improving satisfaction and outcomes. Choice A is incorrect as it exaggerates pharmacology knowledge; APRNs study it extensively, but so do physicians, making superiority unproven. Choice C is wrong because APRNs' prescribing of narcotics varies by practice and isn't inherently less than others. Choice D is false since independent prescribing isn't universal—state laws differ, and some require oversight, similar to physician assistants.