Nokea
Patient education regarding prescribed medication includes:
- A. Instructions written at the high school reading level
- B. Discussion of expected adverse drug reactions
- C. How to store leftover medication such as antibiotics
- D. Verbal instructions always in English
Correct Answer: B
Rationale: Choice B is correct because educating patients about expected adverse reactions prepares them to manage side effects and seek help if needed, enhancing safety and adherence. Choice A is incorrect as reading level should match the patient's, not a fixed standard. Choice C is wrong because storing leftovers encourages misuse—antibiotics should be completed. Choice D is incorrect since language should suit the patient, not always English.
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Strategies to prevent drug abuse include:
- A. Education about risks
- B. Limiting access to abusable drugs
- C. Screening for risk factors
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because education (awareness), access limits (e.g., PDMPs), and screening (early intervention) all prevent abuse, per public health strategies. Choice A is incorrect alone as it's one method. Choice B is wrong by itself because access is just part. Choice C is incorrect solo since screening is only one approach.
Drugs that require therapeutic drug monitoring include:
- A. Lithium
- B. Acetaminophen
- C. Albuterol
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because lithium has a narrow therapeutic range, necessitating monitoring to maintain efficacy for bipolar disorder while avoiding toxicity, unlike the others. Choice B is incorrect as acetaminophen, used for pain, has a wider safety margin and doesn't require routine monitoring. Choice C is wrong because albuterol, a bronchodilator, acts locally with minimal systemic levels needing checks. Choice D is incorrect since only lithium among these requires therapeutic drug monitoring.
An adolescent girl reports having heavy menstrual periods. Her hemoglobin is consistently on the low end of the normal range. The primary care NP should prescribe:
- A. iron supplements.
- B. a folic acid supplement.
- C. oral contraceptive pills.
- D. increased red meats in her diet.
Correct Answer: C
Rationale: The correct answer is C because oral contraceptives reduce menstrual blood loss, preventing iron-deficiency anemia. Choice A is incorrect (iron for active anemia). Choice B is wrong (folic acid not preventive here). Choice D is inaccurate (diet insufficient).
Therapeutic drug levels are drawn when a drug reaches steady state. Drugs reach steady state:
- A. After the second dose
- B. After four to five half-lives
- C. When the patient feels the full effect of the drug
- D. One hour after IV administration
Correct Answer: B
Rationale: Choice B is correct because steady state is reached after four to five half-lives, when absorption equals elimination, stabilizing drug levels for therapeutic monitoring. Choice A is incorrect as the second dose is too early for steady state. Choice C is wrong because patient perception doesn't define pharmacokinetics. Choice D is incorrect since IV timing varies and doesn't inherently match steady state.
The process that clears the body of a drug is:
- A. Distribution
- B. Excretion
- C. Absorption
- D. Metabolism
Correct Answer: B
Rationale: Choice B is correct because excretion is the process by which the body eliminates a drug, primarily via the kidneys, completing its removal from the system. Choice A is incorrect as distribution moves the drug within the body, not out of it. Choice C is wrong because absorption brings the drug into the bloodstream, not clears it. Choice D is incorrect since metabolism transforms the drug, but excretion removes it.