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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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.
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.
A patient who has HIV has been receiving a two-drug combination therapy for 6 months. At an annual physical examination, the primary care NP notes that the patient has a viral load of 60 copies/mL and a CD4 cell count of 350 cells/mm. The NP should contact the patient's infectious disease specialist to discuss:
- A. changing one of the medications.
- B. increasing the dose of both medications.
- C. discontinuing the medications for a short period.
- D. adding a third medication.
Correct Answer: B
Rationale: The correct answer is B because a high viral load and low CD4 suggest poor control, often needing dose adjustment. Choice A is incorrect (both should change if switching). Choice C is wrong (discontinuing risky). Choice D is inaccurate (text-based, not an option).
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.
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.