Nokea
Resources for patients with drug abuse issues include:
- A. Substance Abuse and Mental Health Services Administration (SAMHSA)
- B. National Institute on Drug Abuse (NIDA)
- C. Local support groups
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because SAMHSA (helpline), NIDA (research/support), and local groups (e.g., AA) provide comprehensive resources for drug abuse, per national frameworks. Choice A is incorrect alone as it's one resource. Choice B is wrong by itself because NIDA is just part. Choice C is incorrect solo since groups are only one option.
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A patient is taking drug A and drug B. The primary care NP notes increased effects of drug B. The NP should suspect that in this case drug A is a cytochrome P450 (CYP450) enzyme:
- A. inhibitor.
- B. substrate.
- C. inducer.
- D. metabolizer.
Correct Answer: A
Rationale: The correct answer is A because a CYP450 inhibitor (drug A) reduces metabolism of drug B, increasing its effects. Choice B is incorrect as a substrate is acted upon, not inhibiting. Choice C is wrong since an inducer increases metabolism, reducing effects. Choice D is inaccurate as 'metabolizer' isn’t a CYP450 role.
The point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the:
- A. Minimum adverse effect level
- B. Peak of action
- C. Onset of action
- D. Therapeutic range
Correct Answer: C
Rationale: Choice C is correct because the onset of action is when a drug first shows a therapeutic effect on the concentration curve, marking the start of its clinical impact. Choice A is incorrect as ‘minimum adverse effect level' isn't a standard term; it confuses with toxicity thresholds. Choice B is wrong because peak of action is the maximum effect, not the first sign. Choice D is incorrect since therapeutic range is the concentration window for efficacy, not a specific time point.
Drugs that are affected by genetic polymorphisms of UGT1A1 include:
- A. Warfarin
- B. Irinotecan
- C. Acetaminophen
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because irinotecan's active metabolite is glucuronidated by UGT1A1; poor function increases toxicity, requiring genetic consideration. Choice A is incorrect as warfarin's metabolism is via CYP2C9, not UGT1A1. Choice C is wrong because acetaminophen uses other UGT enzymes, not specifically UGT1A1 critically. Choice D is incorrect since only irinotecan is notably affected by UGT1A1 polymorphisms.
The current trend toward transitioning NP programs to the doctoral level will mean that:
- A. NPs licensed in one state may practice in other states.
- B. full prescriptive authority will be granted to all NPs with doctoral degrees.
- C. NPs will be better prepared to meet emerging health care needs of patients.
- D. requirements for physician supervision of NPs will be removed in all states.
Correct Answer: C
Rationale: The correct answer is C because doctoral programs aim to better prepare NPs for evolving healthcare needs, per the AACN. Choice A is incorrect as licensure remains state-specific. Choice B is wrong since prescriptive authority depends on state laws. Choice D is inaccurate as supervision rules vary by state.
A woman who is pregnant tells an NP that she has been taking sertraline for depression for several years but is worried about the effects of this drug on her fetus. The NP will consult with this patient's psychiatrist and will recommend that she:
- A. stop taking the sertraline now.
- B. continue taking the antidepressant.
- C. change to a different antidepressant.
- D. taper off the sertraline gradually.
Correct Answer: B
Rationale: The correct answer is B because continuing sertraline is often safer than untreated depression, with psychiatric consultation. Choice A is incorrect (abrupt stopping risky). Choice C is wrong (changing not first step). Choice D is inaccurate (tapering not indicated without specialist input).