Nursing Elites

1. A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?

• A. Varicella vaccine
• B. Rubella vaccine
• C. Inactivated influenza vaccine
• D. Measles vaccine

Correct answer: C

Rationale: The correct answer is C, the inactivated influenza vaccine. During pregnancy, the Centers for Disease Control and Prevention (CDC) recommend the inactivated influenza vaccine as safe for pregnant individuals. This vaccination is crucial to protect both the pregnant person and their developing baby from influenza-related complications. It is essential to avoid live vaccines, such as varicella (chickenpox), rubella, and measles vaccines during pregnancy due to the theoretical risk of harm to the fetus. Choices A, B, and D are incorrect because live vaccines are generally contraindicated during pregnancy.

2. A client is receiving discharge instructions for a new prescription of Warfarin. Which of the following over-the-counter medications should the client be instructed to avoid?

• A. Acetaminophen
• B. Ibuprofen
• C. Diphenhydramine
• D. Loratadine

Correct answer: B

Rationale: The correct answer is B: Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with Warfarin due to its antiplatelet effects. Patients on Warfarin should avoid NSAIDs like Ibuprofen and opt for alternative pain relief options to prevent potential complications such as an increased risk of bleeding. Acetaminophen (Choice A), Diphenhydramine (Choice C), and Loratadine (Choice D) are not known to significantly interact with Warfarin in terms of bleeding risk and are generally considered safe to use alongside Warfarin.

3. A client is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects?

• A. Increased TSH level
• B. Decreased ALT level
• C. Hypoglycemia
• D. Hyperlipidemia

Correct answer: D

Rationale: Hyperlipidemia, characterized by increased cholesterol and triglyceride levels, can occur as an adverse effect of Ritonavir. Monitoring lipid levels is essential to detect and manage this potential side effect in clients taking this medication for HIV infection.

4. A nurse is caring for a client who is receiving treatment with vincristine. Which of the following findings should the nurse monitor?

• A. Hyperkalemia
• B. Neurotoxicity
• C. Neutropenia
• D. Bradycardia

Correct answer: B

Rationale: The correct answer is B: Neurotoxicity. Vincristine is known to cause neurotoxicity as an adverse effect due to its impact on the nervous system. Monitoring for symptoms such as peripheral neuropathy, muscle weakness, and tingling sensations is crucial. Choices A, C, and D are incorrect because hyperkalemia, neutropenia, and bradycardia are not typically associated with vincristine therapy.

5. A client has a new prescription for Iron supplements. Which of the following instructions should be included?

• A. Take the medication with a glass of milk.
• B. Avoid taking the medication with orange juice.
• C. Increase fiber intake to prevent constipation.
• D. Expect stools to be bright red.

Correct answer: C

Rationale: The correct answer is C: 'Increase fiber intake to prevent constipation.' Iron supplements commonly cause constipation as a side effect. Increasing fiber intake can help alleviate this issue by promoting regular bowel movements and preventing constipation. Choice A is incorrect as iron absorption is hindered when taken with milk. Choice B is not directly related to iron supplements. Choice D is incorrect as iron supplements do not typically cause bright red stools.

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