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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Herbal products that may increase INR include:
- A. Ginkgo biloba
- B. St John's wort
- C. Valerian root
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because ginkgo biloba can increase INR by enhancing warfarin's effect through antiplatelet activity, risking bleeding. Choice B is incorrect as St John's wort induces CYP2C9, decreasing INR and warfarin efficacy. Choice C is wrong because valerian root doesn't significantly alter INR. Choice D is incorrect since only ginkgo biloba increases INR.
The parents of a 3-year-old child tell the primary care NP that their child is a very picky eater and they are worried about the child's nutrition. The NP should recommend:
- A. giving the child a daily multivitamin containing iron.
- B. providing small portions of a variety of foods at each meal.
- C. disciplining the child at mealtimes to ensure proper nutrition.
- D. making sure the child's cereals are fortified with vitamins and minerals.
Correct Answer: B
Rationale: The correct answer is B because offering variety in small portions balances nutrition over time for picky eaters. Choice A is incorrect (multivitamin if variety fails). Choice C is wrong (discipline ineffective). Choice D is inaccurate (fortified cereal not enough).
Drugs that are Pregnancy Category C:
- A. Have known fetal risks that outweigh the benefits
- B. Have no adequate studies in pregnant women
- C. Are proven safe in pregnancy
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because Category C drugs lack sufficient human studies, with animal studies showing risk or no data, used only if benefits justify, per FDA. Choice A is incorrect as that defines Category X, not C. Choice C is wrong because Category B, not C, indicates safety. Choice D is incorrect since only B fits Category C.
Upregulation or hypersensitization may lead to:
- A. Increased response to a drug
- B. Decreased response to a drug
- C. An exaggerated response if the drug is withdrawn
- D. Refractoriness or complete lack of response
Correct Answer: C
Rationale: Choice C is correct because upregulation (more receptors) or hypersensitization from chronic antagonist use can cause an exaggerated rebound response if withdrawn, as seen with beta blockers. Choice A is incorrect as increased response occurs during use, not withdrawal. Choice B is wrong because decreased response isn't typical of upregulation. Choice D is incorrect since refractoriness relates to agonists, not this scenario.
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.