Nokea
Genetic testing prior to prescribing which drug could prevent serious adverse drug reactions?
- A. Acetaminophen
- B. Codeine
- C. Albuterol
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because genetic testing for CYP2D6 variants can prevent ADRs with codeine; poor metabolizers get no pain relief, while ultrarapid metabolizers risk morphine toxicity. Choice A is incorrect as acetaminophen metabolism isn't strongly tied to genetic variants causing serious ADRs. Choice C is wrong because albuterol's inhaled use has minimal genetic metabolism risks. Choice D is incorrect since only codeine benefits significantly from pre-prescribing genetic testing.
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Upregulation or hypersensitization may lead to:
- A. Increased response to a drug
- B. Decreased response to a drug
- C. An exaggerated response if the drug is withdrawn
- D. Refractoriness or complete lack of response
Correct Answer: C
Rationale: Choice C is correct because upregulation (more receptors) or hypersensitization from chronic antagonist use can cause an exaggerated rebound response if withdrawn, as seen with beta blockers. Choice A is incorrect as increased response occurs during use, not withdrawal. Choice B is wrong because decreased response isn't typical of upregulation. Choice D is incorrect since refractoriness relates to agonists, not this scenario.
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.
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.
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.
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.