Nokea
Infants and young children are at higher risk of ADRs due to:
- A. Immature renal function in school-age children
- B. Lack of safety and efficacy studies in the pediatric population
- C. Children's skin being thicker than adults, requiring higher doses of topical medication
- D. Infant boys having a higher proportion of muscle mass, leading to a higher volume of distribution
Correct Answer: B
Rationale: Choice B is correct because limited pediatric studies mean less data on safety and efficacy, increasing ADR risk due to untested dosing and effects. Choice A is incorrect as immature renal function applies to infants, not school-age children specifically. Choice C is wrong because children's skin is thinner, not thicker, and this isn't the primary risk. Choice D is incorrect since infant muscle mass is lower, not higher, and not the key factor.
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Signs that a drug may be counterfeit include:
- A. Unusual packaging
- B. Lower than expected cost
- C. Different taste or texture
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because unusual packaging (e.g., misspellings), suspiciously low cost (too good to be true), and odd taste/texture (formulation issues) are all counterfeit indicators, per FDA warnings. Choice A is incorrect alone as it's one sign. Choice B is wrong by itself because cost is just part. Choice C is incorrect solo since taste/texture is only one clue.
Risk factors for misuse of controlled substances include:
- A. History of substance abuse
- B. Young age
- C. Mental health disorders
- D. All of the above
Correct Answer: D
Rationale: Choice D is correct because prior substance abuse, young age (impulsivity), and mental health issues (self-medication) are all established risk factors for misuse, per addiction research. Choice A is incorrect alone as it's one factor. Choice B is wrong by itself because age is just part. Choice C is incorrect solo since mental health is only one aspect.
The primary care NP sees a 4-year-old child who has persistent asthma episodes for a well-child visit in October. The child recently completed a 7-day course of oral steroids. The NP plans to give the child flu vaccine and should:
- A. administer LAIV today.
- B. administer 0.5 mg TIV today.
- C. wait 4 weeks and administer LAIV.
- D. wait 4 weeks and administer 0.5 mg TIV.
Correct Answer: B
Rationale: The correct answer is B because LAIV is contraindicated in asthmatic children aged 2-4; TIV is safe post-steroids. Choice A is incorrect (LAIV excluded). Choice C is wrong (waiting unnecessary). Choice D is inaccurate (waiting not needed).
A patient has been taking trimethoprim-sulfamethoxazole (TMP/SMX) for 14 days. The patient calls the primary care nurse practitioner (NP) to report fever, rash, and enlarged lymph nodes. The NP should suspect:
- A. serum sickness reaction.
- B. immediate sensitivity reaction.
- C. cytotoxic hypersensitivity reaction.
- D. cell-mediated hypersensitivity reaction.
Correct Answer: A
Rationale: The correct answer is A because serum sickness (fever, rash, lymphadenopathy) occurs days to weeks after TMP/SMX. Choice B is incorrect (immediate within 30 minutes). Choice C is wrong (blood-related, 7-14 days). Choice D is inaccurate (rash syndromes, 48-72 hours).
A client has a new prescription for sertraline. Which of the following instructions should the nurse include?
- A. Take the medication in the morning.
- B. Avoid consuming grapefruit juice.
- C. Take the medication with a full glass of water.
- D. Monitor for signs of weight gain.
Correct Answer: B
Rationale: The correct instruction for the nurse to include is to 'Avoid consuming grapefruit juice.' Grapefruit juice can increase sertraline levels, leading to an elevated risk of side effects. Instructing the client to avoid grapefruit juice is crucial to prevent potential interactions that could impact the effectiveness and safety of the medication. The other options are not directly related to sertraline administration. Taking the medication in the morning may vary depending on individual preferences or the prescriber's directions. Taking the medication with a full glass of water is a general instruction for many medications and not specific to sertraline. Monitoring for signs of weight gain is important but not a direct instruction related to taking sertraline.