Nokea
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.
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Signs of controlled substance misuse include:
- A. Requesting early refills
- B. Reporting lost prescriptions
- C. Using multiple prescribers
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because early refills, lost prescription claims, and multiple prescribers are classic misuse signs, per DEA and clinical red flags. Choice A is incorrect alone as it's one sign. Choice B is wrong by itself because lost reports are just part. Choice C is incorrect solo since multiple prescribers is only one indicator.
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.
Strategies to improve adherence to medication regimes include:
- A. Assuming that the patient understands the directions on the prescription bottle
- B. Using pictograms or illustrations to explain how to take the medication
- C. Assuming that the patient's health literacy level is the same as their general literacy
- D. Using the patient's preferred language when there is a language barrier
Correct Answer: B
Rationale: Choice B is correct because pictograms clarify instructions visually, aiding comprehension and adherence, especially for low-literacy patients. Choice A is incorrect as assuming understanding can lead to errors. Choice C is wrong because health literacy varies from general literacy, needing specific attention. Choice D is incorrect here as it's a good strategy but not listed in this question's options correctly—B fits best.
Drugs that may cause increased adverse effects in women include:
- A. Lipid-soluble drugs
- B. Water-soluble drugs
- C. Drugs that are highly protein bound
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because women's lower lean mass reduces the volume of distribution for water-soluble drugs, increasing concentrations and ADR risk. Choice A is incorrect as lipid-soluble drugs distribute more in fat, not necessarily causing more ADRs. Choice C is wrong because protein binding isn't sex-specific enough here. Choice D is incorrect since only water-soluble drugs align.
A patient who has HIV has been receiving a two-drug combination therapy for 6 months. At an annual physical examination, the primary care NP notes that the patient has a viral load of 60 copies/mL and a CD4 cell count of 350 cells/mm. The NP should contact the patient's infectious disease specialist to discuss:
- A. changing one of the medications.
- B. increasing the dose of both medications.
- C. discontinuing the medications for a short period.
- D. adding a third medication.
Correct Answer: B
Rationale: The correct answer is B because a high viral load and low CD4 suggest poor control, often needing dose adjustment. Choice A is incorrect (both should change if switching). Choice C is wrong (discontinuing risky). Choice D is inaccurate (text-based, not an option).