Nokea
Over-the-counter drugs that should be avoided in patients with hypertension include:
- A. Acetaminophen
- B. Pseudoephedrine
- C. Ibuprofen
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because pseudoephedrine, a decongestant, raises blood pressure via vasoconstriction, risky in hypertension, per guidelines. Choice A is incorrect as acetaminophen doesn't affect BP. Choice C is wrong because ibuprofen's BP effect is milder and not absolute avoidance. Choice D is incorrect since only pseudoephedrine is key.
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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.
Which of the following statements about the major distribution barriers (blood-brain or fetal-placental) is true?
- A. Water soluble and ionized drugs cross these barriers rapidly.
- B. The blood-brain barrier slows the entry of many drugs into and from brain cells.
- C. The fetal-placental barrier protects the fetus from drugs taken by the mother.
- D. Lipid-soluble drugs do not pass these barriers and are safe for pregnant women.
Correct Answer: B
Rationale: Choice B is correct because the blood-brain barrier, with its tight junctions, slows entry of many drugs, especially water-soluble ones, protecting the brain. Choice A is incorrect as water-soluble, ionized drugs cross poorly due to barrier selectivity. Choice C is wrong because the fetal-placental barrier doesn't fully block drugs—many cross and affect the fetus. Choice D is incorrect since lipid-soluble drugs readily pass these barriers, posing risks in pregnancy.
Drugs that should be avoided in children include:
- A. Acetaminophen
- B. Aspirin
- C. Amoxicillin
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because aspirin is avoided in children under 16 due to its association with Reye's syndrome, a rare but serious liver and brain condition, per AAP recommendations. Choice A is incorrect as acetaminophen is safe and commonly used. Choice C is wrong because amoxicillin is a standard pediatric antibiotic with a good safety profile. Choice D is incorrect since only aspirin fits the avoidance criterion.
Passive monitoring of drug effectiveness includes:
- A. Therapeutic drug levels
- B. Adding or subtracting medications from the treatment regimen
- C. Ongoing provider visits
- D. Instructing the patient to report if the drug is not effective
Correct Answer: D
Rationale: Choice D is correct because passive monitoring relies on patient feedback, like reporting ineffectiveness, rather than active measures like lab tests. Choice A is incorrect as therapeutic levels are active monitoring. Choice B is wrong because adjusting medications is an intervention, not monitoring. Choice C is incorrect since provider visits are active engagement, not passive.
An NP is caring for a 70-year-old patient who reports having seasonal allergies with severe rhinorrhea. Using the Beers criteria, which of the following medications should the NP recommend for this patient?
- A. Loratadine (Claritin)
- B. Hydroxyzine (Vistaril)
- C. Diphenhydramine (Benadryl)
- D. Chlorpheniramine maleate (Chlorphen 12)
Correct Answer: A
Rationale: The correct answer is A because loratadine is a nonsedating antihistamine, safer for elderly per Beers criteria, unlike the sedating options B, C, and D, which increase fall risk and cognitive impairment in older adults.