Nokea
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.
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The primary care NP sees a 4-year-old child who has received four doses of PCV 7 in the first 15 months of life. The NP should administer:
- A. PCV 7.
- B. PCV 13.
- C. PPV 23.
- D. no PCV.
Correct Answer: B
Rationale: The correct answer is B because children under 5 with PCV 7 series should get one PCV 13 dose. Choice A is incorrect (PCV 7 outdated). Choice C is wrong (PPV 23 not for this age). Choice D is inaccurate (vaccine needed).
Drugs that should be avoided in children include:
- A. Acetaminophen
- B. Aspirin
- C. Amoxicillin
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because aspirin is avoided in children under 16 due to its association with Reye's syndrome, a rare but serious liver and brain condition, per AAP recommendations. Choice A is incorrect as acetaminophen is safe and commonly used. Choice C is wrong because amoxicillin is a standard pediatric antibiotic with a good safety profile. Choice D is incorrect since only aspirin fits the avoidance criterion.
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 are Pregnancy Category C:
- A. Have known fetal risks that outweigh the benefits
- B. Have no adequate studies in pregnant women
- C. Are proven safe in pregnancy
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because Category C drugs lack sufficient human studies, with animal studies showing risk or no data, used only if benefits justify, per FDA. Choice A is incorrect as that defines Category X, not C. Choice C is wrong because Category B, not C, indicates safety. Choice D is incorrect since only B fits Category C.
Herbal products that may increase INR include:
- A. Ginkgo biloba
- B. St John's wort
- C. Valerian root
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because ginkgo biloba can increase INR by enhancing warfarin's effect through antiplatelet activity, risking bleeding. Choice B is incorrect as St John's wort induces CYP2C9, decreasing INR and warfarin efficacy. Choice C is wrong because valerian root doesn't significantly alter INR. Choice D is incorrect since only ginkgo biloba increases INR.