Nokea
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.
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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.
A 4-month-old infant has a viral illness with high fever and cough. The infant's parent asks the NP about what to give the infant to help with symptoms. The NP should prescribe which of the following?
- A. Aspirin to treat the fever
- B. Acetaminophen as needed
- C. Dextromethorphan for coughing
- D. An antibiotic to prevent increased infection
Correct Answer: B
Rationale: The correct answer is B because acetaminophen is safe for infants to reduce fever. Choice A is incorrect (aspirin risks Reye’s syndrome). Choice C is wrong (dextromethorphan risks respiratory depression). Choice D is inaccurate (antibiotics don’t treat viral illness).
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.
Drugs that require refrigeration include:
- A. Insulin
- B. Amoxicillin suspension
- C. Vaccines
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because insulin (protein stability), amoxicillin suspension (post-reconstitution), and vaccines (biological potency) require refrigeration to maintain efficacy, per storage guidelines. Choice A is incorrect alone as it's one drug. Choice B is wrong by itself because amoxicillin is just part. Choice C is incorrect solo since vaccines are only one group.
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).