Nokea
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.
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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.
The elderly are at high risk of ADRs due to:
- A. Having greater muscle mass than younger adults, leading to higher volume of distribution
- B. The extensive studies that have been conducted on drug safety in this age group
- C. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect
- D. Age-related decrease in renal function
Correct Answer: D
Rationale: Choice D is correct because an age-related decline in renal function slows drug excretion, increasing ADR risk as drugs accumulate. Choice A is incorrect as muscle mass decreases with age, not increases. Choice B is wrong because studies are often limited in the elderly, not extensive. Choice C is incorrect since the blood-brain barrier's permeability doesn't typically lessen, and higher doses aren't standard.
Genetic testing prior to prescribing which drug could prevent serious adverse drug reactions?
- A. Acetaminophen
- B. Codeine
- C. Albuterol
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because genetic testing for CYP2D6 variants can prevent ADRs with codeine; poor metabolizers get no pain relief, while ultrarapid metabolizers risk morphine toxicity. Choice A is incorrect as acetaminophen metabolism isn't strongly tied to genetic variants causing serious ADRs. Choice C is wrong because albuterol's inhaled use has minimal genetic metabolism risks. Choice D is incorrect since only codeine benefits significantly from pre-prescribing genetic testing.
The elderly are at high risk of ADRs due to:
- A. Having greater muscle mass than younger adults, leading to higher volume of distribution
- B. The extensive studies that have been conducted on drug safety in this age group
- C. The blood-brain barrier being less permeable, requiring higher doses to achieve therapeutic effect
- D. Age-related decrease in renal function
Correct Answer: D
Rationale: Choice D is correct because an age-related decline in renal function slows drug excretion, increasing ADR risk as drugs accumulate. Choice A is incorrect as muscle mass decreases with age, not increases. Choice B is wrong because studies are often limited in the elderly, not extensive. Choice C is incorrect since the blood-brain barrier's permeability doesn't typically lessen, and higher doses aren't standard.
The primary care NP sees a 4-year-old child who has received four doses of PCV 7 in the first 15 months of life. The NP should administer:
- A. PCV 7.
- B. PCV 13.
- C. PPV 23.
- D. no PCV.
Correct Answer: B
Rationale: The correct answer is B because children under 5 with PCV 7 series should get one PCV 13 dose. Choice A is incorrect (PCV 7 outdated). Choice C is wrong (PPV 23 not for this age). Choice D is inaccurate (vaccine needed).