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 with chronic kidney disease has a new prescription for epoetin alfa. The nurse should instruct the client to increase dietary intake of which of the following substances?

• A. Iron
• B. Protein
• C. Potassium
• D. Sodium

Correct answer: A

Rationale: Patients with chronic kidney disease are often prescribed epoetin alfa to treat anemia. Epoetin alfa stimulates red blood cell production, increasing the body's demand for iron to support this process. Therefore, clients taking epoetin alfa should be advised to increase their dietary intake of iron-rich foods to meet the increased demand and prevent iron deficiency anemia. Choices B, C, and D are incorrect because while protein is essential for overall health, potassium and sodium intake may need to be restricted in clients with chronic kidney disease to manage electrolyte balance and blood pressure.

3. Which of the following is considered a class IA Sodium Channel blocker?

• A. Mexiletine
• B. Amiodarone
• C. Quinidine
• D. Procainamide

Correct answer: D

Rationale: Procainamide is a class IA antiarrhythmic drug that acts as a sodium channel blocker by blocking fast sodium channels. Mexiletine is a class IB antiarrhythmic drug, not class IA. Amiodarone is a class III antiarrhythmic, and Quinidine is a class IA antiarrhythmic but not a sodium channel blocker.

4. A client has a new prescription for Prednisone. Which of the following instructions should be included in the discharge teaching?

• A. Increase your intake of potassium-rich foods.
• B. Avoid consuming grapefruit juice.
• C. Take this medication with food.
• D. Decrease your intake of sodium-rich foods.

Correct answer: A

Rationale: The correct answer is A: 'Increase your intake of potassium-rich foods.' Prednisone can lead to potassium depletion, making it important for clients to increase their intake of potassium-rich foods like bananas, oranges, and spinach to prevent potential complications. Choice B is incorrect because grapefruit juice can interact with certain medications, but it is not a specific concern with Prednisone. Choice C is incorrect as Prednisone can be taken with or without food. Choice D is also incorrect because there is no direct relationship between Prednisone and sodium-rich foods.

5. A patient with hypertension is taking an ACE inhibitor to lower blood pressure. What should the nurse advise the patient to avoid in their diet?

• A. Vinegar
• B. Apples
• C. Salt substitutes
• D. Tomatoes

Correct answer: C

Rationale: Patients taking ACE inhibitors should avoid salt substitutes as they often contain potassium, which can lead to hyperkalemia. Hyperkalemia is an elevated level of potassium in the blood that can be dangerous, especially for patients on ACE inhibitors. Vinegar, apples, and tomatoes do not pose a risk for patients taking ACE inhibitors. Therefore, the nurse should advise the patient to avoid salt substitutes to prevent potential complications.

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