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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.
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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.
The primary care NP sees a 5-year-old child for a prekindergarten physical examination. The child's parents do not have immunization records, and a local record search does not provide proof of vaccinations, although the parent thinks the child may have had some vaccines several years ago. The NP's initial action will be to:
- A. assume the child is unvaccinated and start the full series.
- B. check titers for all vaccine-preventable diseases.
- C. administer a single dose of each vaccine today.
- D. consult state immunization registry again.
Correct Answer: A
Rationale: The correct answer is A because without records, assuming unvaccinated and starting the series ensures protection. Choice B is incorrect (titers not practical initially). Choice C is wrong (single doses insufficient). Choice D is inaccurate (registry already checked).
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.
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.