Nokea
A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient's psychiatrist and will recommend that she:
- A. stop taking the sertraline now.
- B. continue taking the antidepressant.
- C. change to a different antidepressant.
- D. taper off the sertraline gradually.
Correct Answer: B
Rationale: The correct answer is B because continuing sertraline is often safer than untreated depression, with psychiatric consultation. Choice A is incorrect (abrupt stopping risky). Choice C is wrong (changing not first step). Choice D is inaccurate (tapering not indicated without specialist input).
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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.
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).
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.
Drugs that may interact with vaccines include:
- A. Immunosuppressants
- B. Antibiotics
- C. Antihistamines
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because immunosuppressants (e.g., prednisone) reduce vaccine efficacy by weakening immune response, per CDC guidelines. Choice B is incorrect as antibiotics don't typically affect vaccines. Choice C is wrong because antihistamines lack vaccine interactions. Choice D is incorrect since only immunosuppressants apply.
An agonist activates a receptor and stimulates a response. When given frequently over time, the body may:
- A. Upregulate the total number of receptors
- B. Block the receptor with a partial agonist
- C. Alter the drug's metabolism
- D. Downregulate the numbers of that specific receptor
Correct Answer: D
Rationale: Choice D is correct because frequent agonist use can cause the body to downregulate receptors, reducing sensitivity to overstimulation as a compensatory mechanism. Choice A is incorrect as upregulation occurs with antagonists, not agonists. Choice B is wrong because partial agonists compete, not result from frequent use. Choice C is incorrect since metabolism changes aren't the primary receptor response.