Nokea
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).
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An example of a first-dose reaction that may occur includes:
- A. Orthostatic hypotension that does not occur with repeated doses
- B. Purple glove syndrome with phenytoin use
- C. Hemolytic anemia from ceftriaxone use
- D. Contact dermatitis from neomycin use
Correct Answer: A
Rationale: Choice A is correct because orthostatic hypotension can occur with a first dose of drugs like antihypertensives, subsiding as the body adjusts, a classic first-dose reaction. Choice B is incorrect as purple glove syndrome is a rare phenytoin effect, not first-dose specific. Choice C is wrong because hemolytic anemia is a type II reaction, not first-dose. Choice D is incorrect since contact dermatitis is a delayed, not first-dose, reaction.
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.
Drugs that should be avoided in children include:
- A. Acetaminophen
- B. Aspirin
- C. Amoxicillin
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because aspirin is avoided in children under 16 due to its association with Reye's syndrome, a rare but serious liver and brain condition, per AAP recommendations. Choice A is incorrect as acetaminophen is safe and commonly used. Choice C is wrong because amoxicillin is a standard pediatric antibiotic with a good safety profile. Choice D is incorrect since only aspirin fits the avoidance criterion.
Over-the-counter drugs that should be avoided in patients with hypertension include:
- A. Acetaminophen
- B. Pseudoephedrine
- C. Ibuprofen
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because pseudoephedrine, a decongestant, raises blood pressure via vasoconstriction, risky in hypertension, per guidelines. Choice A is incorrect as acetaminophen doesn't affect BP. Choice C is wrong because ibuprofen's BP effect is milder and not absolute avoidance. Choice D is incorrect since only pseudoephedrine is key.
Schedule II drugs are characterized by:
- A. High potential for abuse
- B. Low potential for abuse
- C. No accepted medical use
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because Schedule II drugs (e.g., oxycodone) have a high abuse potential with accepted medical use, per DEA rules. Choice B is incorrect as low potential is Schedule IV/V. Choice C is wrong because no medical use is Schedule I. Choice D is incorrect since only A applies.