A nurse practitioner (NP) is preparing to prescribe a medication for a 5-year-old child. To determine the correct dose for this child, the NP should:

Correct Answer: D

Rationale: The correct answer is D because manufacturer recommendations are the safest and most accurate for pediatric dosing. Choice A is incorrect as one-third is arbitrary. Choice B is wrong since BSA is less reliable than weight-based dosing. Choice C is inaccurate as dividing by weight alone isn’t standard.

Correct Answer: B

Rationale: Choice B is correct because digoxin's narrow therapeutic index means small dose increases can lead to type A ADRs (predictable, dose-related), like toxicity. Choice A is incorrect as idiosyncratic effects are type B, not A. Choice C is wrong because teratogenicity isn't a type A reaction—it's a specific harm. Choice D is incorrect since digoxin isn't a carcinogen; its ADRs are cardiovascular.

Correct Answer: D

Rationale: Choice D is correct because acetaminophen (high doses), NSAIDs (e.g., ibuprofen), and aminoglycosides (e.g., gentamicin) can impair renal function, worsened by age-related decline, per nephrology data. Choice A is incorrect alone as it's one risk. Choice B is wrong by itself because NSAIDs are just part. Choice C is incorrect solo since aminoglycosides are only one class.

Correct Answer: C

Rationale: Choice C is correct because corticosteroids (e.g., prednisone) increase bone resorption, raising osteoporosis risk, unlike the others. Choice A is incorrect as testosterone supports bone density. Choice B is wrong because estrogen prevents osteoporosis. Choice D is incorrect since only corticosteroids fit.

Correct Answer: B

Rationale: Choice B is correct because diphenhydramine (per Beers Criteria) is contraindicated in the elderly due to anticholinergic effects risking delirium and urinary retention. Choice A is incorrect as acetaminophen is safe. Choice C is wrong because amoxicillin is not contraindicated. Choice D is incorrect since only diphenhydramine applies.

Correct Answer: C

Rationale: The correct answer is C because a higher concentration (500 mg/5 mL) and bid dosing simplifies administration, enhancing compliance. Choice A is incorrect (lower concentration, less convenient). Choice B is wrong (tid less convenient). Choice D is inaccurate (tid and lower dose inconvenient).

Correct Answer: D

Rationale: Choice D is correct because off-label use lacks FDA approval (unregulated indication), risks ADRs (untested context), and may have limited evidence, per pharmacology concerns. Choice A is incorrect alone as it's one risk. Choice B is wrong by itself because ADRs are just part. Choice C is incorrect solo since evidence is only one issue.

Correct Answer: A

Rationale: The correct answer is A because the Physician Payment Review Commission in 1992 increased financial reimbursement for primary care providers, incentivizing medical schools to focus on training more primary care physicians to address shortages. Choice B is incorrect as competition from nonphysicians rose coincidentally, not as a primary driver. Choice C is wrong because monopolistic control isn’t a goal of medical education. Choice D is inaccurate since nonphysicians have shown increasing success in primary care, not variable success, but this wasn’t the main influence.

Correct Answer: D

Rationale: Choice D is correct because enteric-coated tablets need ample fluid (e.g., 8 ounces) to ensure proper passage and dissolution in the intestines, not stomach, for optimal effect. Choice A is incorrect as avoiding other drugs isn't a general rule unless specified. Choice B is wrong because dissolving enteric-coated tablets destroys their protective coating. Choice C is incorrect since crushing negates the coating's purpose.