Nokea
Drugs that may increase risk of erectile dysfunction include:
- A. Testosterone
- B. Beta blockers
- C. Alpha blockers
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because beta blockers (e.g., propranolol) can cause erectile dysfunction by reducing blood flow, a known side effect. Choice A is incorrect as testosterone improves erectile function. Choice C is wrong because alpha blockers often treat ED causes. Choice D is incorrect since only beta blockers fit.
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A patient who has HIV has been receiving a two-drug combination therapy for 6 months. At an annual physical examination, the primary care NP notes that the patient has a viral load of 60 copies/mL and a CD4 cell count of 350 cells/mm. The NP should contact the patient's infectious disease specialist to discuss:
- A. changing one of the medications.
- B. increasing the dose of both medications.
- C. discontinuing the medications for a short period.
- D. adding a third medication.
Correct Answer: B
Rationale: The correct answer is B because a high viral load and low CD4 suggest poor control, often needing dose adjustment. Choice A is incorrect (both should change if switching). Choice C is wrong (discontinuing risky). Choice D is inaccurate (text-based, not an option).
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).
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.
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.
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.