Nokea
Clinical judgment in prescribing includes:
- A. Factoring in the cost to the patient of the medication prescribed
- B. Always prescribing the newest medication available for the disease process
- C. Handing out drug samples to poor patients
- D. Prescribing all generic medications to cut costs
Correct Answer: S
Rationale: Choice A is correct because clinical judgment involves balancing efficacy, safety, and cost to ensure patients can afford and adhere to treatment, which is critical for successful outcomes. Choice B is incorrect as always choosing the newest medication ignores evidence-based practice; newer drugs may lack long-term data or be unnecessarily expensive. Choice C is wrong because distributing samples isn't a sustainable prescribing strategy and may not meet ongoing needs. Choice D is also incorrect since mandating generics could compromise efficacy if a brand-name drug is clinically necessary.
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Strategies to improve adherence to medication regimes include:
- A. Assuming that the patient understands the directions on the prescription bottle
- B. Using pictograms or illustrations to explain how to take the medication
- C. Assuming that the patient's health literacy level is the same as their general literacy
- D. Using the patient's preferred language when there is a language barrier
Correct Answer: B
Rationale: Choice B is correct because pictograms clarify instructions visually, aiding comprehension and adherence, especially for low-literacy patients. Choice A is incorrect as assuming understanding can lead to errors. Choice C is wrong because health literacy varies from general literacy, needing specific attention. Choice D is incorrect here as it's a good strategy but not listed in this question's options correctly—B fits best.
Women who are prescribed drugs that are known teratogens should:
- A. Use effective contraception
- B. Avoid breastfeeding
- C. Increase their vitamin intake
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because teratogenic drugs can harm a fetus, so effective contraception is essential to prevent pregnancy during treatment, per safety guidelines. Choice B is incorrect as breastfeeding avoidance applies post-delivery, not during prescribing. Choice C is wrong because increasing vitamins doesn't mitigate teratogenic risk. Choice D is incorrect since only contraception directly addresses the primary risk.
Risks associated with polypharmacy include:
- A. Increased adverse drug reactions
- B. Drug-drug interactions
- C. Nonadherence
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because polypharmacy raises ADR risk (more drugs, more side effects), interactions (competing metabolism), and nonadherence (complex regimens), per geriatric studies. Choice A is incorrect alone as it's one risk. Choice B is wrong by itself because interactions are just part. Choice C is incorrect solo since nonadherence is only one issue.
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.
Risks associated with polypharmacy include:
- A. Increased adverse drug reactions
- B. Drug-drug interactions
- C. Nonadherence
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because polypharmacy raises ADR risk (more drugs, more side effects), interactions (competing metabolism), and nonadherence (complex regimens), per geriatric studies. Choice A is incorrect alone as it's one risk. Choice B is wrong by itself because interactions are just part. Choice C is incorrect solo since nonadherence is only one issue.