Rosenthal: Lehne's Pharmacotherapeutics for Advanced Practice Providers, 1st Ed. Chapter 1: Prescriptive Authority

A 11-year-old boy received all childhood immunizations before attending school as a kindergartner. Which vaccines are recommended for this child at his current age? a. DTaP, MCV4, Varivax b. PCV-23, Td, MMR c. Tdap, MCV4, HPV d. Tdap, Varivax, hepatitis B - ANS: C At age 11, both males and females should receive a booster of diphtheria, tetanus, and pertussis (Tdap); the Menactra vaccine against meningitis (MCV4); and the human papillomavirus (HPV) vaccine. A Varivax booster is not recommended at this age. The PCV-23 vaccine is indicated only in high-risk patients. The Tdap can be given, but a vaccine with a pertussis component is preferred. The MMR is not given at this age. The hepatitis B vaccine is not given at this age.DIF: Cognitive Level: ApplicationREF: p. 583TOP: Nursing Process: Implementation MSC: NCLEX Client Needs Category: Physiologic Integrity: Health Promotion and Maintenance . A nurse is reviewing an older adult patient's chart before giving medications. Which patient information is of most concern? a. Chronic constipation b. Increased body fat c. Low serum albumin d. Low serum creatinine - ANS: C Low serum albumin reduces protein binding of drugs and can cause levels of free drug to rise, increasing the risk of toxicity. Altered gastrointestinal (GI) absorption is not a major factor in drug sensitivity in the older adult, although delayed gastric emptying can delay drug responses. Increased body fat can alter drug distribution, causing reduced responses in lipid-soluble drugs, however, it is not the finding of greatest concern to the nurse. Low serum creatinine is a function of decreased lean muscle mass in older patients and does not reflect kidney function or drug excretion.DIF: Cognitive Level: ApplicationREF: p. 69TOP: Nursing Process: Diagnosis MSC: NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation 2. A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse discuss with the child's provider? a. 250 mg/5 mL to 375 mg PO twice daily b. 250 mg/5 mL to 250 mg PO three times daily