Question 1

A child has wheat allergies and continues to have problems in spite of consuming
a diet without breads and cereals. What will the primary care pediatric nurse practitioner caution the parents to look for on product labels that may indicate wheat products are present in foods?
A. Casein
B. Malt
C. Miso
D. Whey

Malt

Accepted Answer

Malt is a sweetener made from barley which contains gluten, a protein found in wheat, barley, and rye, that can cause an allergic reaction in individuals with wheat allergy. It is important for the parents to read product labels and avoid any food items that contain malt. Casein and whey are milk proteins and do not contain gluten. Miso is a soybean paste and does not contain wheat.

Question 2

Which label on a CAM therapy product verifies that a product meets standards for
contamination, adulteration, manufacturing processes, and pharmacologic properties?
A. Generally Recognized as Safe (GRAS)
B. National Sanitation Foundation International (NSF)
C. Natural Products Association (NPA)
D. United States Pharmacopeia (USP)

United States Pharmacopeia (USP)

Accepted Answer

The United States Pharmacopeia (USP) sets standards for the quality, purity, strength, and consistency of medications, supplements, and CAM therapies. A label indicating compliance with USP standards verifies that the product meets specific criteria for contamination, adulteration, manufacturing processes, and pharmacologic properties. Therefore, the best choice is D.

Question 3

An adolescent will begin taking the combination oral contraceptive pill (OCP).
Which supplement will the primary care pediatric nurse practitioner caution the adolescent to avoid while taking OCPs?
A. Ginkgo
B. Kava
C. St. John's wort
D. Valerian

St. John's wort

Accepted Answer

St. John's wort can decrease the effectiveness of OCPs and increase the risk of breakthrough bleeding or unintended pregnancy. Therefore, it should be avoided while taking OCPs. Ginkgo, Kava, and Valerian do not interact with OCPs.

Question 4

The parent of a newborn reports using echinacea for family members to help
treat viral illnesses and feels that it is usually effective. What will the primary care pediatric nurse practitioner tell this parent?
A. That echinacea has no known therapeutic effects and should not be given
B. That the supplement should not be given to children under 2 years of age
C. To give half the recommended adult dose until the child is 5 years old
D. To wait until the infant is at least 1 month old before giving this product

Accepted Answer

The American Academy of Pediatrics (AAP) advises against the use of echinacea in children under the age of 2 due to lack of safety and efficacy data. Therefore, the primary care pediatric nurse practitioner should advise the parent not to give echinacea to children under 2 years of age.

Question 5

According to the 2007 NHIS analysis of the use of CAM therapy, use was higher among
A. families whose parent or parents had a college education.
B. Hispanic and AfricanAmerican populations.
C. persons who had not recently taken prescription medications.
D. those living in households earning less than $65,000.

Accepted Answer

The 2007 NHIS analysis found that CAM therapy use was higher among families whose parent or parents had a college education. This suggests that education levels may play a role in the decision to use CAM therapies.

Question 6

The primary care pediatric nurse practitioner is performing a medication history
on a child and learns that the child's parents use various complementary treatments and remedies for the child. According to the American Academy of Pediatrics standard for providers, what will the nurse practitioner do?
A. Evaluate the safety and efficacy of each product and monitor use.
B. Incorporate these therapies into standard care practices.
C. Recommend not using the products until the child is older.
D. Suggest that most of these treatments are not safe for children.

Accepted Answer

The American Academy of Pediatrics recommends that providers evaluate the safety and efficacy of complementary treatments and remedies and monitor their use in children. Incorporating these therapies into standard care practices should only be done after thorough evaluation and consideration. Simply recommending not using the products until the child is older or suggesting that most of these treatments are not safe for children may not be appropriate or evidence-based. A thorough assessment and monitoring of these treatments is recommended to ensure the safety and well-being of the child.

Question 7

The parent of a child who has numerous allergies reports using herbal remedies
to help treat the child because they are "natural" products. What will the primary care pediatric nurse practitioner suggest to this parent about using these products?
A. Brandname herbal products have been tested for efficacy.
B. Natural ingredients are usually safe for use in children.
C. There are few interactions between drugs and supplements.
D. Use singleherb supplements whenever possible.

Accepted Answer

Using single-herb supplements whenever possible can help minimize the risk of complications or interactions with other medications the child may be taking. While some herbal products may have been tested for efficacy, it is important to note that supplements and other natural remedies are not regulated in the same way that prescription medications are. Just because a product is "natural" does not necessarily mean it is safe, as many natural ingredients can cause adverse reactions or interact with other medications. It is also important to be aware of potential interactions between drugs and supplements.

Deck 43: Complementary Medicine