Nokea
Nurse practitioner prescriptive authority is regulated by:
- A. The National Council of State Boards of Nursing
- B. The U.S. Drug Enforcement Administration
- C. The State Board of Nursing for each state
- D. The State Board of Pharmacy
Correct Answer: C
Rationale: The correct answer is choice C, the State Board of Nursing for each state, because these boards establish the legal scope of practice for nurse practitioners, including prescriptive authority, which varies by state due to differing regulations. Choice A, the National Council of State Boards of Nursing, is incorrect as it provides guidelines and licensure standards but doesn't directly regulate state-specific authority. Choice B, the U.S. Drug Enforcement Administration, is wrong because it oversees controlled substances, not general prescribing rights. Choice D, the State Board of Pharmacy, is also incorrect since it governs pharmacists, not NPs, and has no jurisdiction over their prescriptive authority.
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The NP chooses to give cephalexin every 8 hours based on knowledge of the drug's:
- A. Propensity to go to the target receptor
- B. Biological half-life
- C. Pharmacodynamics
- D. Safety and side effects
Correct Answer: B
Rationale: Choice B is correct because dosing cephalexin every 8 hours aligns with its biological half-life, the time it takes for half the drug to be eliminated, ensuring steady therapeutic levels. Choice A is incorrect as ‘propensity to target receptor' isn't a standard pharmacokinetic term for dosing decisions. Choice C is wrong because pharmacodynamics (drug effects) informs efficacy, not timing. Choice D is incorrect since safety and side effects influence drug choice, not specifically the 8-hour interval.
Risk factors for drug abuse include:
- A. Family history of addiction
- B. Mental health disorders
- C. Peer pressure
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because family history (genetic predisposition), mental health issues (self-medication), and peer pressure (social influence) are all established risk factors, per SAMHSA. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because mental health is just part. Choice C is incorrect solo since pressure is only one element.
While assessing a client taking propranolol, which finding should the nurse report to the provider?
- A. Bradycardia
- B. Dry mouth
- C. Constipation
- D. Increased appetite
Correct Answer: A
Rationale: Bradycardia is a significant side effect of propranolol, a beta-blocker that slows the heart rate. It indicates potential cardiovascular complications and should be reported promptly to the healthcare provider for further evaluation and management. Dry mouth, constipation, and increased appetite are common side effects of various medications but are not directly associated with propranolol's mechanism of action.
Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Choice B is correct because azathioprine's type D ADR (delayed) relates to its carcinogenic potential, like leukemia, emerging years after use. Choice A is incorrect as teratogenicity is a separate risk, not type D's focus. Choice C is wrong because hypersensitivity is type B, not delayed. Choice D is incorrect since it suppresses immunity, not the HPA axis directly.
A client with a history of angina pectoris reports chest pain after climbing stairs. What should be the nurse's first action?
- A. Administer oxygen.
- B. Administer nitroglycerin.
- C. Sit the client down and rest.
- D. Check the client's blood pressure.
Correct Answer: C
Rationale: The correct action for a client experiencing anginal pain, like chest pain after climbing stairs, is to sit the client down and have them rest. Resting reduces myocardial oxygen demand, which can help relieve anginal pain. Administering oxygen or nitroglycerin may be appropriate interventions after the client has been seated and rested. Checking the client's blood pressure is important but not the immediate priority when a client is experiencing anginal pain. Therefore, the first action should be to sit the client down and allow them to rest.