Nokea
The U.S. Drug Enforcement Administration:
- A. Registers manufacturers and prescribers of controlled substances
- B. Regulates NP prescribing at the state level
- C. Sanctions providers who prescribe drugs off-label
- D. Provides prescribers with a number they can use for insurance billing
Correct Answer: A
Rationale: Choice A is correct because the DEA registers those handling controlled substances, issuing numbers for tracking and prescribing, its primary role. Choice B is incorrect as state boards, not the DEA, regulate NP prescribing. Choice C is wrong because off-label prescribing isn't DEA-regulated. Choice D is incorrect since the DEA number is for controlled substances, not insurance billing.
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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).
The primary care NP sees a 5-year-old child for a prekindergarten physical examination. The child's parents do not have immunization records, and a local record search does not provide proof of vaccinations, although the parent thinks the child may have had some vaccines several years ago. The NP's initial action will be to:
- A. assume the child is unvaccinated and start the full series.
- B. check titers for all vaccine-preventable diseases.
- C. administer a single dose of each vaccine today.
- D. consult state immunization registry again.
Correct Answer: A
Rationale: The correct answer is A because without records, assuming unvaccinated and starting the series ensures protection. Choice B is incorrect (titers not practical initially). Choice C is wrong (single doses insufficient). Choice D is inaccurate (registry already checked).
Off-label use of drugs is:
- A. Illegal
- B. Regulated by the FDA
- C. Permitted with scientific evidence
- D. All of the above
Correct Answer: C
Rationale: Choice C is correct because off-label use is legal and common, permitted with scientific backing or clinical judgment, not FDA-regulated post-approval. Choice A is incorrect as it's not illegal. Choice B is wrong because FDA doesn't regulate off-label practice. Choice D is incorrect since only C applies.
An NP is caring for a 70-year-old patient who reports having seasonal allergies with severe rhinorrhea. Using the Beers criteria, which of the following medications should the NP recommend for this patient?
- A. Loratadine (Claritin)
- B. Hydroxyzine (Vistaril)
- C. Diphenhydramine (Benadryl)
- D. Chlorpheniramine maleate (Chlorphen 12)
Correct Answer: A
Rationale: The correct answer is A because loratadine is a nonsedating antihistamine, safer for elderly per Beers criteria, unlike the sedating options B, C, and D, which increase fall risk and cognitive impairment in older adults.
Drugs that may increase risk of erectile dysfunction include:
- A. Testosterone
- B. Beta blockers
- C. Alpha blockers
- D. All of the above
Correct Answer: B
Rationale: Choice B is correct because beta blockers (e.g., propranolol) can cause erectile dysfunction by reducing blood flow, a known side effect. Choice A is incorrect as testosterone improves erectile function. Choice C is wrong because alpha blockers often treat ED causes. Choice D is incorrect since only beta blockers fit.