An NP prescribes an oral elixir medication for a child who is to take 1 tsp PO bid. When counseling the child's parents about administering this drug, the NP should tell them to:

Correct Answer: D

Rationale: The correct answer is D because a syringe ensures accurate dosing (teaspoons vary 2.5-7.8 mL). Choice A is incorrect (elixirs don’t need shaking). Choice B is wrong (mixing risks incomplete dosing). Choice C is inaccurate (empty stomach isn’t required).

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 because naproxen, highly protein-bound, can become toxic with low albumin from malnutrition, as seen in this patient’s weight loss. Choice A is incorrect as quinidine isn’t primarily protein-bound related. Choice C is wrong since calcium citrate isn’t affected this way. Choice D is inaccurate as calcium channel blockers have different concerns.

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: A

Rationale: Choice A is correct because the FDA requires generics to have the same active ingredient, strength, and efficacy as brand-name drugs, ensuring therapeutic equivalence. Choice B is incorrect as cost isn't FDA-regulated—it's market-driven. Choice C is wrong because color can vary. Choice D is incorrect since only A is FDA-enforced.

Correct Answer: C

Rationale: Choice C is correct because off-label prescribing—using a drug for an unapproved indication—is legal if supported by scientific evidence and clinical judgment, common in practice. Choice A is incorrect as the FDA doesn't regulate off-label use, just approval. Choice B is wrong because it's not illegal for NPs; it's allowed with justification. Choice D is incorrect since the DEA oversees controlled substances, not off-label prescribing.

Correct Answer: B

Rationale: The correct answer is B because protein-bound drugs compete for albumin, requiring monitoring to adjust dosing. Choice A is incorrect as increasing doses without monitoring is risky. Choice C is wrong since dietary protein doesn’t affect this. Choice D is inaccurate as staggering doesn’t resolve binding issues.

Correct Answer: D

Rationale: The correct answer is D: Bradycardia. Bradycardia is a significant finding associated with digoxin toxicity. Digoxin, a medication commonly used to treat heart conditions, can lead to bradycardia as a sign of toxicity. Bradycardia requires immediate attention and reporting to the healthcare provider for further evaluation and management to prevent serious complications. Choices A, B, and C are incorrect because weight gain, dry cough, and hypokalemia are not specific signs of digoxin toxicity. While weight gain can be a side effect of digoxin, it is not a classic sign of toxicity. Dry cough is more commonly associated with medications like ACE inhibitors, and hypokalemia can be a complication of digoxin therapy but is not a direct sign of toxicity.

Correct Answer: B

Rationale: Choice B is correct because oxycodone is a Schedule II controlled substance due to high abuse potential, per DEA classification. Choice A is incorrect as acetaminophen is not controlled. Choice C is wrong because ibuprofen is not a controlled substance. Choice D is incorrect since only oxycodone fits.