Food and Drug Administration labeling, Pregnancy Categories will be: 1. Strengthened with a new coding such as C or C- to discern when a drug is more or less toxic to the fetus 2. Changed to incorporate a pregnancy risk summary and clinical considerations on the drug label 3. Clarified to include information such as safe dosages in each trimester of pregnancy Chapter 4. Legal and Professional Issues in Prescribing Multiple Choice Identify the choice that best completes the statement or answers the question.
Food and Drug Administration regulates: 1. Prescribing of drugs by MDs and NPs 2. The official labeling for all prescription and over-the-counter drugs 3. Off-label recommendations for prescribing 4. Food and Drug Administration approval is required for: 1.
Medical devices, including artificial joints 2. Over-the-counter vitamins 3. An Investigational New Drug is filed with the U. Food and Drug Administration: 1. When the manufacturer has completed phase III trials 2. When a new drug is discovered 3. Prior to animal testing of any new drug entity 4. Phase IV clinical trials in the United States are also known as: 1. Human bioavailability trials 2.
Postmarketing research 3. Human safety and efficacy studies 4. Off-label prescribing is: 1. Regulated by the U. Food and Drug Administration 2.
Illegal by NPs in all states provinces 3. Legal if there is scientific evidence for the use 4. Drug Enforcement Administration: 1. Registers manufacturers and prescribers of controlled substances 2. Regulates NP prescribing at the state level 3. Sanctions providers who prescribe drugs off-label 4. Drugs that are designated Schedule II by the U.
Are known teratogens during pregnancy 2. May not be refilled; a new prescription must be written 3. Have a low abuse potential 4. Precautions that should be taken when prescribing controlled substances include: 1. Faxing the prescription for a Schedule II drug directly to the pharmacy 2.
Using tamper-proof paper for all prescriptions written for controlled drugs 3. Keeping any pre-signed prescription pads in a locked drawer in the clinic 4.
Strategies prescribers can use to prevent misuse of controlled prescription drugs include: 1. Use of chemical dependency screening tools 2.
Firm limit-setting regarding prescribing controlled substances 3. Behaviors predictive of addiction to controlled substances include: 1. Requiring increasing doses of opiates for pain associated with malignancy 3. Receiving refills of a Schedule II prescription on a regular basis 4.
Universally for all prescribing for chronic pain 2. For patients who have repeated requests for pain medication 3. When you suspect a patient is exhibiting drug-seeking behavior 4. A prescription needs to be written for: 1. Legend drugs 2. Most controlled drugs 3.
Medical devices 4. All of the above Chapter 6. A comprehensive assessment of a patient should be holistic when trying to determine competence in drug administration. Which of the following factors would the NP omit from this type of assessment? Financial status 2. Mobility 3. Social support 4. Which technique would be appropriate to use in teaching her about a new drug you have just prescribed?
Use correct medical terminology because Spanish has a Latin base. Use a family member who speaks more English to act as an interpreter. Use a professional interpreter or a reliable staff member who can act as an interpreter. Use careful, detailed explanations.
Rod, age 68, has hearing difficulty. Which of the following would NOT be helpful in assuring that he understands teaching about his drug? Stand facing him and speak slowly and clearly. Speak in low tones or find a provider who has a lower voice. Write down the instructions as well as speaking them. If he reads lips, exaggerate lips movements when pronouncing the vowel sounds.
Complexity of the drug regimen 2. Patient perception of the potential adverse effects of the drugs 3. The health-care delivery system itself can create barriers to adherence to a treatment regimen. Which of the following system variables creates such a barrier? Increasing copayments for care 2.
Unrestricted formularies for drugs, including brand names 3. Increasing the number of people who have access to care 4. The NP is concerned that he might not be adhering to his treatment regimen. Which of the following events would suggest that he might not be adherent? Ralph contacts his NP to discuss the need to increase the dosage.
Ralph consistently keeps his follow-up appointments to check his blood pressure. All of the above show that he is adherent to the drug regimen. Nonadherence is especially common in drugs that treat asymptomatic conditions, such as hypertension. One way to reduce the likelihood of nonadherence to these drugs is to prescribe a drug that: 1. Has a short half-life so that missing one dose has limited effect 2.
Requires several dosage titrations so that missed doses can be replaced with lower doses to keep costs down 3. Factors in chronic conditions that contribute to nonadherence include: 1.
The complexity of the treatment regimen 2. The length of time over which it must be taken 3. Breaks in the usual daily routine, such as vacations and weekends 4. While patient education about their drugs is important, information alone does not necessarily lead to adherence to a drug regimen.
Patients report greater adherence when: 1. The provider spent a lot of time discussing the drugs with them 2. Their concerns and specific area of knowledge deficit were addressed 3. They were given written material, such as pamphlets, about the drugs 4.
To improve adherence in this population, prescribe drugs: 1. With a longer half-life so that missed doses produce a longer taper on the drug curve 2. In oral formulations that are more easily taken 3. That do not require frequent monitoring 4. Many disorders require multiple drugs to treat them.
The more complex the drug regimen, the less likely the patient will adhere to it. Which of the following interventions will NOT improve adherence? Have the patient purchase a pill container with compartments for daily or multiple times-per-day dosing. Match the clinic appointment to the next time the drug is to be refilled.
Write prescriptions for new drugs with shorter times between refills. Give the patient a clear drug schedule that the provider devises to fit the characteristic of the drug. Pharmacologic interventions are costly. Older adults and those on fixed incomes 2. Patients with chronic illnesses 3. Patients with copayments for drugs on their insurance 4. Providers have a responsibility for determining the best plan of care, but patients also have responsibilities.
Patients the provider can be assured will carry through on these responsibilities include those who: 1. Are well-educated and affluent 2. Have chronic conditions 3. Self-monitor drug effects on their symptoms 4. Monitoring adherence can take several forms, including: 1. Patient reports from data in a drug diary 2.
Pill counts 3. Laboratory reports and other diagnostic markers 4. Factors that explain and predict medication adherence include: 1. Social 2. Financial 3. Health system 4. All of the above Chapter 7. Cultural and Ethnic Influences in Pharmacotherapeutics Multiple Choice Identify the choice that best completes the statement or answers the question.
Cultural factors that must be taken into account when prescribing include s : 1. Who the decision maker is in the family regarding health-care decisions 2. Attitudes regarding the use of drugs to treat illness 4. Ethnic differences have been found in drug: 1. Absorption 2. Hepatic metabolism 3. Filtration at the glomerulus 4. The National Standards of Culturally and Linguistically Appropriate Services are required to be implemented in all: 1.
Hospitals 2. Clinics that serve the poor 3. Organizations that receive federal funds 4. According to the National Standards of Culturally and Linguistically Appropriate Services, an interpreter for health care: 1. May be a bilingual family member 2. May be a bilingual nurse or other health-care provider 3.
Must be a professionally trained medical interpreter 4. According to the U. Office of Minority Health, poor health outcomes among African Americans are attributed to: 1. The belief among African Americans that prayer is more powerful than drugs 2. Poor compliance on the part of the African American patient 3. The genetic predisposition for illness found among African Americans 4. The racial difference in drug pharmacokinetics seen in American Indian or Alaskan Natives are: 1.
Increased CYP 2D6 activity, leading to rapid metabolism of some drugs 2. Largely unknown due to lack of studies of this population 3. Rapid metabolism of alcohol, leading to increased tolerance 4. Pharmacokinetics among Asians are universal to all the Asian ethnic groups. True 2. Alterations in drug metabolism among Asians may lead to: 1. Slower metabolism of antidepressants, requiring lower doses 2.
Faster metabolism of neuroleptics, requiring higher doses 3. Altered metabolism of omeprazole, requiring higher doses 4. Asians from Eastern Asia are known to be fast acetylators. Fast acetylators: 1. Require acetylization in order to metabolize drugs 2. Are unable to tolerate higher doses of some drugs that require acetylization 3. May have a toxic reaction to drugs that require acetylization 4. Hispanic native healers curanderas : 1.
Are not heavily utilized by Hispanics who immigrate to the United States 2. Use herbs and teas in their treatment of illness 3. Provide unsafe advice to Hispanics and should not be trusted 4.
Need to be licensed in their home country in order to practice in the United States Chapter 8. An Introduction to Pharmacogenomics Multiple Choice Identify the choice that best completes the statement or answers the question. Genetic polymorphisms account for differences in metabolism, including: 1.
Poor metabolizers, who lack a working enzyme 2. Intermediate metabolizers, who have one working, wild-type allele and one mutant allele 3. Extensive metabolizers, with two normally functioning alleles 4. A need to monitor drugs metabolized by 2D6 for toxicity 2. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake inhibitors 3.
Decreased conversion of codeine to morphine by CYP 2D6 4. Rifampin is a nonspecific CYP inducer that may: 1. Lead to toxic levels of rifampin and must be monitored closely 2.
Cause toxic levels of drugs, such as oral contraceptives, when coadministered 3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to: 1. Decreased therapeutic levels of quinidine 2. Increased therapeutic levels of quinidine 3. Decreased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination 4.
Toxic levels of warfarin building up 2. Decreased response to warfarin 3. Increased risk for significant drug interactions with warfarin 4.
Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to prescribing warfarin. Pharmacogenetic testing is required by the U. Food and Drug Administration prior to prescribing: 1. Erythromycin 2. Digoxin 3. Cetuximab 4. A genetic variation in how the metabolite of the cancer drug irinotecan SN is inactivated by the body may lead to: 1. Decreased effectiveness of irinotecan in the treatment of cancer 2.
Increased adverse drug reactions, such as neutropenia 3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN 4.
Patients who have a poor metabolism phenotype will have: 1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of prodrug 2. Accumulation of inactive metabolites of drugs 3. A need for increased dosages of medications 4. Ultra-rapid metabolizers of drugs may have: 1. To have dosages of drugs adjusted downward to prevent drug accumulation 2. Active drug rapidly metabolized into inactive metabolites, leading to potential therapeutic failure 3.
Increased elimination of active, nonmetabolized drug 4. A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer to: 1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen 2. Identify potential drug-drug interactions that may occur with tamoxifen 3. Reduce the likelihood of therapeutic failure with tamoxifen treatment 4. Identify poor metabolizers of tamoxifen Chapter Herbal Therapy and Nutritional Supplements Multiple Choice Identify the choice that best completes the statement or answers the question.
A potential harmful effect on patients who take some herbal medication is: 1. Constipation 2. Lead poisoning 3. Avast Free Security. WhatsApp Messenger. Talking Tom Cat. Clash of Clans. Subway Surfers. TubeMate 3. Google Play. Adele convinces Spotify to remove shuffle from all albums. PS5 restock updates.
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Normally a single exploit can only take advantage of a specific software vulnerability. Often, when an exploit is published, the vulnerability is fixed through a patch and the exploit becomes obsolete for newer versions of the software.
This is the reason why some blackhat hackers do not publish their exploits but keep them private to themselves or other crackers. A script kiddie is not looking to target specific information or a specific company but rather uses knowledge of a vulnerability to scan the entire Internet for a victim that possesses that vulnerability. These are people, usually kids, who are attracted by the seemingly magical powers that hacking gives them. One of the distinguishing features of script-kiddies is that they must have a lot of patience.
Because security holes are quickly found and repaired, most systems will resist most attacks. Therefore, if the script-kiddy is targeting a single system, they have to find a lot of scripts to try against the system before they find one that works.
More commonly, the script-kiddies downloads one of the most recently developed scripts and proceeds to run it against targets all throughout the Internet until they find someone who is vulnerable to that specific script.
Pastebin is a website where you can store text online for a set period of time. Pain Exist V3. Download the exploit by pressing the black download button above. Unzip the winzip archive to your desktop. Turn off all your antiviruses including 'windows defender - real time protection'.
There are ten paid tutorials on PainScience. The Respiration Connection — How dysfunctional breathing might be a root cause of a variety of common upper body pain problems and injuries.
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