Nokea
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- C. An exaggerated response if the drug is withdrawn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(more receptors) or hypersensitization from chronic antagonist use can cause an exaggerated rebound response if withdrawn, as seen with beta blockers.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.
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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 Choice A is incorrect (PCV 7 outdated).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).
Women who are prescribed drugs that are known teratogens should:
- A. Use effective contraception
- B. Avoid breastfeeding
- C. Increase their vitamin intake
- D. All of the above
Correct Answer: A
Rationale: Choice A is correct because teratogenic drugs can harm a fetus, so effective contraception is essential to prevent pregnancy during treatment, per safety guidelines. Choice B is incorrect as breastfeeding avoidance applies post-delivery, not during prescribing. Choice C is wrong because increasing vitamins doesn't mitigate teratogenic risk. Choice D is incorrect since only contraception directly addresses the primary risk.
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.
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.
A patient is taking drug A and drug B. The primary care NP notes increased effects of drug B. The NP should suspect that in this case drug A is a cytochrome P450 (CYP450) enzyme:
- A. inhibitor.
- B. substrate.
- C. inducer.
- D. metabolizer.
Correct Answer: A
Rationale: The correct answer is A because a CYP450 inhibitor (drug A) reduces metabolism of drug B, increasing its effects. Choice B is incorrect as a substrate is acted upon, not inhibiting. Choice C is wrong since an inducer increases metabolism, reducing effects. Choice D is inaccurate as 'metabolizer' isn’t a CYP450 role.