A female patient who is 8 weeks pregnant is seen by a primary care nurse practitioner (NP) after a routine prenatal screen was positive for human immunodeficiency virus (HIV). A CD4 cell count is 750 cells/mm. The NP should:

Correct Answer: B

Rationale: The correct answer is B because antiretrovirals like zidovudine are recommended in pregnancy but avoided in the first trimester if possible. Choice A is incorrect (first trimester risk). Choice C is wrong (delay risks transmission). Choice D is inaccurate (CD4 threshold not applicable).

Correct Answer: A

Rationale: Choice A is correct because acetaminophen is safe and widely used in children for pain and fever, with a favorable safety profile per pediatric guidelines. Choice B is incorrect as aspirin is avoided in children due to Reye's syndrome risk. Choice C is wrong because codeine's variable metabolism (CYP2D6) can cause respiratory depression, leading to restrictions in kids. Choice D is incorrect since only acetaminophen is broadly safe.

Correct Answer: B

Rationale: The correct answer is B - Dry cough. Lisinopril is known to cause a persistent dry cough as a common side effect. This adverse reaction can be bothersome to the client and may necessitate discontinuation of the medication. Weight gain, hypokalemia, and increased appetite are not typically associated with lisinopril and would not be as concerning as a dry cough when assessing for adverse effects.

Correct Answer: B

Rationale: The correct answer is B because antiretrovirals like zidovudine are recommended in pregnancy but avoided in the first trimester if possible. Choice A is incorrect (first trimester risk). Choice C is wrong (delay risks transmission). Choice D is inaccurate (CD4 threshold not applicable).

Correct Answer: A

Rationale: Choice A is correct because lithium has a narrow therapeutic range, necessitating monitoring to maintain efficacy for bipolar disorder while avoiding toxicity, unlike the others. Choice B is incorrect as acetaminophen, used for pain, has a wider safety margin and doesn't require routine monitoring. Choice C is wrong because albuterol, a bronchodilator, acts locally with minimal systemic levels needing checks. Choice D is incorrect since only lithium among these requires therapeutic drug monitoring.

Correct Answer: C

Rationale: Choice C is correct because involving a family member improves adherence by providing support and reinforcing education, especially for complex regimens. Choice A is incorrect as assuming understanding risks miscommunication. Choice B is wrong because sixth-grade level may not suit all patients—tailoring is better. Choice D is incorrect since health literacy often differs from general literacy, requiring specific assessment.

Correct Answer: B

Rationale: The correct answer is B: Dry cough. A dry cough is a common side effect of enalapril that can indicate the development of angioedema or potentially life-threatening angioedema. An onset of dry cough should be reported to the provider promptly as it may require discontinuation of the medication to prevent further complications. Frequent urination, tremors, and dizziness are not typically associated with enalapril use and are less likely to be of immediate concern compared to a dry cough in this context.

Correct Answer: C

Rationale: Heat intolerance is a hallmark sign of levothyroxine toxicity. It indicates that the client may be receiving an excessive dose of levothyroxine, leading to hyperthyroid symptoms. This can happen when the dosage is too high, causing the body to have an excess of thyroid hormone. Weight loss is a common symptom of hyperthyroidism but alone does not specifically indicate levothyroxine toxicity. Insomnia can be related to hyperthyroidism but is not a specific sign of levothyroxine toxicity. Dry skin is more commonly associated with hypothyroidism rather than levothyroxine toxicity.

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).