Nokea
Generic drugs may differ from brand-name drugs in:
- A. Active ingredient
- B. Inactive ingredients
- C. Therapeutic effect
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because generics may use different inactive ingredients (e.g., fillers, dyes) affecting appearance or tolerability, but not efficacy, per FDA rules. Choice A is incorrect as active ingredients must be identical. Choice C is wrong because therapeutic effects are equivalent. Choice D is incorrect since only inactive ingredients differ.
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Off-label use of drugs is:
- A. Illegal
- B. Regulated by the FDA
- C. Permitted with scientific evidence
- D. All of the above
Correct Answer: C
Rationale: Choice C is correct because off-label use is legal and common, permitted with scientific backing or clinical judgment, not FDA-regulated post-approval. Choice A is incorrect as it's not illegal. Choice B is wrong because FDA doesn't regulate off-label practice. Choice D is incorrect since only C applies.
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.
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.
Signs of controlled substance misuse include:
- A. Requesting early refills
- B. Reporting lost prescriptions
- C. Using multiple prescribers
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because early refills, lost prescription claims, and multiple prescribers are classic misuse signs, per DEA and clinical red flags. Choice A is incorrect alone as it's one sign. Choice B is wrong by itself because lost reports are just part. Choice C is incorrect solo since multiple prescribers is only one indicator.
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).