Off-label prescribing is:
- A. Regulated by the U.S. Food and Drug Administration
- B. Illegal by NPs in all states (provinces)
- C. Legal if there is scientific evidence for the use
- D. Regulated by the Drug Enforcement Administration
Correct Answer: C
Rationale: Off-label prescribing is legal with scientific support , not FDA-regulated , universally illegal , or DEA-controlled .
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An order is written for oxazepam for a 6-year-old child. The nurse notices that there is no established dosage for children 6 to 12 years of age. Knowing that the usual adult dose is 10 mg t.i.d., what would the nurse calculate the appropriate dose to be?
- A. 0.03 mg t.i.d.
- B. 0.3 mg t.i.d.
- C. 1.8 mg t.i.d.
- D. 3.3 mg t.i.d.
Correct Answer: D
Rationale: Because the nurse only knows the child's age, the nurse would need to use Young's Rule to determine the appropriate dosage. Use the formula, child's dose equals the age of the child in years divided by the child's age plus 12 times the average adult dose to calculate the answer. Dose = (6/[6+12]) 10 mg (6/18 = 0.33 10 = 3.3).
Combined alpha-beta antagonists are used to reduce the progression of heart failure because they:
- A. Vasodilate the peripheral vasculature
- B. Decrease cardiac output
- C. Increase renal vascular resistance
- D. Reduce atherosclerosis secondary to elevated serum lipoproteins
Correct Answer: A
Rationale: Alpha-beta blockers (e.g., carvedilol) vasodilate, reducing afterload in heart failure.
A nurse is teaching a client who has OCD and has a new prescription for Paroxetine. Which of the following instructions should the nurse include?
- A. It can take several weeks before you feel like the medication is helping.
- B. Take the medication just before bedtime to promote sleep.
- C. I should take the medication for a new medical for a excessive urges.
- D. Monitor for weight gain while taking this medication.
Correct Answer: A
Rationale: Paroxetine, an SSRI, takes weeks for full effect , a key point for client expectations.
Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
- A. Erythromycin
- B. Digoxin
- C. Cetuximab
- D. Rifampin
Correct Answer: C
Rationale: FDA requires pharmacogenetic testing for cetuximab to check EGFR status, not for erythromycin, digoxin, or rifampin.
The factors contributing to the unequal distribution of drugs are all except:
- A. Heterogenesity of the drug
- B. Binding to plasma proteins
- C. Cellular binding
- D. Concentration in body fat
Correct Answer: A
Rationale: Unequal distribution is due to physiological factors like plasma protein binding, cellular binding, fat concentration, and barriers (e.g., blood-brain barrier), not drug heterogeneity.