Nokea
Signs of tolerance include:
- A. Needing higher doses for the same effect
- B. Reduced side effects over time
- C. Increased sensitivity to the drug
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because tolerance is defined by needing more drug for the same effect due to body adaptation, per pharmacokinetic principles. Choice B is incorrect as reduced side effects may occur but aren't the definition. Choice C is wrong because sensitivity decreases, not increases. Choice D is incorrect since only A fits.
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Michael calls the clinic to ask about taking fish oil supplements with his simvastatin prescription. The NP's response is:
- A. Avoid fish oil as it will increase your risk of bleeding.
- B. There are no known interactions; it is safe to take fish oil with simvastatin.
- C. Avoid fish oil as it will decrease the effectiveness of the simvastatin.
- D. Fish oil should only be taken with simvastatin if prescribed by your cardiologist.
Correct Answer: B
Rationale: Choice B is correct because fish oil (omega-3s) and simvastatin both lower triglycerides with no significant interactions; studies show they're safe together, enhancing lipid benefits. Choice A is incorrect as fish oil's bleeding risk is minimal and not amplified by simvastatin. Choice C is wrong because fish oil doesn't reduce simvastatin's efficacy—they're complementary. Choice D is incorrect since no prescription is needed for this safe combination.
An NP is prescribing a medication for a 6-month-old infant. The medication comes in the following formulations. Which one should the NP select to improve absorption and distribution of the medication?
- A. Oral elixir
- B. Rectal suppository
- C. Lipid soluble compound
- D. Sustained-release capsule
Correct Answer: A
Rationale: The correct answer is A because oral elixirs ensure even drug distribution and good GI absorption in infants. Choice B is incorrect (rectal absorption is unreliable). Choice C is wrong (lipid solubility doesn’t ensure distribution). Choice D is inaccurate (sustained-release is poorly absorbed in infants).
Immunomodulators such as azathioprine may cause a delayed adverse drug reaction known as a type D reaction because they are known:
- A. Teratogens
- B. Carcinogens
- C. To cause hypersensitivity reactions
- D. Hypothalamus-pituitary-adrenal axis suppressants
Correct Answer: B
Rationale: Choice B is correct because azathioprine's type D ADR (delayed) relates to its carcinogenic potential, like leukemia, emerging years after use. Choice A is incorrect as teratogenicity is a separate risk, not type D's focus. Choice C is wrong because hypersensitivity is type B, not delayed. Choice D is incorrect since it suppresses immunity, not the HPA axis directly.
A client with atrial fibrillation is prescribed warfarin (Coumadin). Which instruction should the nurse give to the client regarding lifestyle changes?
- A. Avoid prolonged sitting or standing.
- B. Use an electric razor to prevent cuts.
- C. Take your medication with a full glass of water.
- D. Eat a diet low in protein.
Correct Answer: B
Rationale: The correct answer is B. Using an electric razor is advised to prevent cuts, which is crucial for individuals taking warfarin due to the increased risk of bleeding associated with this medication. Lifestyle changes related to warfarin therapy focus on minimizing the risk of bleeding, and using safety measures such as an electric razor is a practical recommendation to reduce the likelihood of injury. Choices A, C, and D are incorrect. Avoiding prolonged sitting or standing is more related to preventing blood clots than to the bleeding risk of warfarin. Taking warfarin with a full glass of water is not a specific lifestyle change associated with its use. Eating a diet low in protein is not a typical recommendation for individuals on warfarin therapy.
An adolescent girl has decided to become a vegetarian. The primary care NP should counsel her about iron intake and considering a vitamin containing:
- A. zinc.
- B. vitamin A.
- C. vitamin C.
- D. potassium.
Correct Answer: A
Rationale: The correct answer is A because vegetarians often lack zinc, critical alongside iron. Choice B is incorrect (vitamin A not primary). Choice C is wrong (vitamin C aids iron, not primary). Choice D is inaccurate (potassium unrelated).