The NP at the immunization clinic is reviewing the list of patients who are scheduled to receive the varicella vaccination. The NP will cancel all of the following patients except:

Correct Answer: C

Rationale: The correct answer is C because having asthma does not contraindicate receiving the varicella vaccination. Asthma is not a contraindication for the varicella vaccine, so the NP should not cancel the appointment for the 8-year-old patient with asthma. All the other choices have contraindications to receiving the varicella vaccine. A: Neomycin allergy is a contraindication as the vaccine may contain neomycin. B: Gelatin allergy is a contraindication as the varicella vaccine may contain gelatin. D: Pregnancy is a contraindication as live vaccines like varicella are generally not recommended during pregnancy due to theoretical risks to the fetus.

Correct Answer: C

Rationale: The correct answer is C: Initiate levothyroxine dose 0.1mg PO every morning and recheck her TSH in 6 weeks. Rationale: 1. The patient presents with symptoms of hypothyroidism (cold intolerance, fatigue, weight gain, heavy menstrual periods) and has elevated TSH levels, indicating primary hypothyroidism. 2. The recommended initial levothyroxine dose for adults with hypothyroidism is 1.6 mcg/kg/day, which translates to approximately 100 mcg (0.1mg) for a 60kg person. 3. Starting with a dose of 0.1mg PO every morning is appropriate to avoid rapid correction and potential adverse effects. 4. Rechecking TSH levels in 6 weeks allows for assessment of treatment response and adjustment of the levothyroxine dose if needed. Summary: A: Starting with 0.025 mg of levothyroxine is too low

Correct Answer: B

Rationale: The correct answer is B: If TSH high. In primary hypothyroidism, the thyroid gland fails to produce enough thyroid hormones, leading to elevated TSH levels as the body tries to stimulate the thyroid to produce more hormones. A high TSH is indicative of the pituitary gland's response to low thyroid hormone levels. Choices A, C, and D do not align with the typical hormonal profile seen in primary hypothyroidism. A high TSH is the key marker for suspecting primary hypothyroidism.

Correct Answer: C

Rationale: The correct answer is C: Beta blockers reduce effects. Beta blockers can mask the symptoms of hypoglycemia caused by glyburide or glipizide, leading to delayed recognition and treatment. This interaction is important for patients with diabetes as it can increase the risk of severe hypoglycemia. A: NSAIDs do not have a significant impact on the effectiveness of glyburide or glipizide. B: Statins do not interfere with the action of these medications. D: ACE inhibitors do not reduce the effects of glyburide or glipizide. In summary, beta blockers are a crucial consideration when taking glyburide or glipizide due to their potential to mask hypoglycemic symptoms, while NSAIDs, statins, and ACE inhibitors do not significantly affect the effectiveness of these medications.

Correct Answer: C

Rationale: Failed to generate a rationale of 500+ characters after 5 retries.