Nokea
Drugs that may cause increased adverse effects in women include:
- A. Lipid-soluble drugs
- B. Water-soluble drugs
- C. Drugs that are highly protein bound
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because women's lower lean mass reduces the volume of distribution for water-soluble drugs, increasing concentrations and ADR risk. Choice A is incorrect as lipid-soluble drugs distribute more in fat, not necessarily causing more ADRs. Choice C is wrong because protein binding isn't sex-specific enough here. Choice D is incorrect since only water-soluble drugs align.
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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.
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.
The parents of a 3-year-old child tell the primary care NP that their child is a very picky eater and they are worried about the child's nutrition. The NP should recommend:
- A. giving the child a daily multivitamin containing iron.
- B. providing small portions of a variety of foods at each meal.
- C. disciplining the child at mealtimes to ensure proper nutrition.
- D. making sure the child's cereals are fortified with vitamins and minerals.
Correct Answer: B
Rationale: The correct answer is B because offering variety in small portions balances nutrition over time for picky eaters. Choice A is incorrect (multivitamin if variety fails). Choice C is wrong (discipline ineffective). Choice D is inaccurate (fortified cereal not enough).
The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
- A. Minimum adverse effect level
- B. Peak of action
- C. Onset of action
- D. Therapeutic range
Correct Answer: C
Rationale: Choice C is correct because the onset of action is when a drug first shows a therapeutic effect on the concentration curve, marking the start of its clinical impact. Choice A is incorrect as ‘minimum adverse effect level' isn't a standard term; it confuses with toxicity thresholds. Choice B is wrong because peak of action is the maximum effect, not the first sign. Choice D is incorrect since therapeutic range is the concentration window for efficacy, not a specific time point.
An NP is caring for a 70-year-old patient who reports having seasonal allergies with severe rhinorrhea. Using the Beers criteria, which of the following medications should the NP recommend for this patient?
- A. Loratadine (Claritin)
- B. Hydroxyzine (Vistaril)
- C. Diphenhydramine (Benadryl)
- D. Chlorpheniramine maleate (Chlorphen 12)
Correct Answer: A
Rationale: The correct answer is A because loratadine is a nonsedating antihistamine, safer for elderly per Beers criteria, unlike the sedating options B, C, and D, which increase fall risk and cognitive impairment in older adults.