A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient’s:

Choice A Reason:

Primary prevention involves measures taken to prevent the onset of a disease before it occurs. This includes lifestyle interventions such as a healthy diet, regular physical activity, and vaccinations. Mammograms, however, are not used to prevent breast cancer from occurring but to detect it early.

Choice B Reason:

Secondary prevention aims to detect and address a disease early in its course to prevent progression. Mammograms are a classic example of secondary prevention because they are used to screen for breast cancer in women who do not yet show symptoms2. Early detection through mammograms can lead to earlier treatment, which can significantly improve outcomes and reduce mortality rates.

Choice C Reason:

Disease treatment refers to the direct management of a diagnosed condition. For breast cancer, this could include surgery, chemotherapy, radiation therapy, and other medical interventions. Mammograms are not a treatment but a diagnostic tool used to detect the presence of cancer.

Choice D Reason:

Tertiary prevention focuses on managing and mitigating the complications of an existing disease to prevent further deterioration. For breast cancer, this might involve rehabilitation, ongoing treatment to prevent recurrence, and palliative care. Mammograms are used for early detection, not for managing complications of already diagnosed cancer.

Choice A Reason:

Boxed warnings, also known as black box warnings, are the strictest warnings put in the labeling of prescription drugs by the FDA when there is reasonable evidence of an association of a serious hazard with the drug. However, they do not necessarily indicate that a drug should only be given in life-threatening circumstances. Instead, they highlight the potential for serious or life-threatening risks and advise on how to use the drug safely.

Choice B Reason:

While some boxed warnings may include information about teratogenic effects (effects that can cause birth defects), this is not their primary purpose. Boxed warnings are broader and can apply to various serious risks, not just teratogenicity. Therefore, this choice is too narrow to be correct.

Choice C Reason:

This is the correct answer. Boxed warnings are designed to alert prescribers to serious or life-threatening risks associated with a drug and provide guidance on how to mitigate these risks. This can include recommendations for monitoring, dosage adjustments, or avoiding certain populations. The goal is to ensure that prescribers are fully aware of the risks and can take appropriate measures to minimize harm to patients.

Choice D Reason:

Boxed warnings do not typically provide information about antidotes for toxicity. While managing toxicity is an important aspect of drug safety, boxed warnings focus on alerting prescribers to serious risks and how to mitigate them, rather than detailing specific antidotes.