Nursing Elites

1. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

2. A client has a new prescription for Ferrous sulfate. Which of the following instructions should the nurse include?

• A. Take this medication with milk.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication with antacids.

Correct answer: B

Rationale: The correct answer is to take Ferrous sulfate on an empty stomach. This medication is best absorbed when taken 1 hour before or 2 hours after meals. Instructing the client to take it with milk, before bedtime, or with antacids can decrease its absorption and effectiveness. Taking it with milk can reduce the absorption of iron due to the calcium in milk. Taking it before bedtime is not necessary and may cause gastrointestinal upset. Taking it with antacids can interfere with the absorption of iron.

3. A client is to receive Pamidronate for bone pain related to cancer. What precaution should the nurse take during the administration of Pamidronate?

• A. Inspect the skin for redness and irritation around the injection site.
• B. Assess the IV site for thrombophlebitis frequently during administration.
• C. Instruct the client to lie down for 30 minutes after oral administration.
• D. Monitor for signs of anaphylaxis for 20 minutes after intramuscular injection.

Correct answer: B

Rationale: Pamidronate is typically administered through IV infusion, which can cause irritation to veins. The nurse should frequently assess the IV site for thrombophlebitis during the administration to promptly detect any potential complications related to the infusion. Inspecting the skin for redness and irritation around the injection site (Choice A) is not directly related to IV infusion. Instructing the client to lie down after oral administration (Choice C) is not necessary for IV administration. Monitoring for signs of anaphylaxis after an intramuscular injection (Choice D) is not relevant for an IV infusion of Pamidronate.

4. A client has a new prescription for Hydralazine. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Tachycardia
• B. Hyperglycemia
• C. Hyponatremia
• D. Constipation

Correct answer: A

Rationale: Corrected Rationale: Hydralazine is a vasodilator that can cause reflex tachycardia as an adverse effect. The client should monitor their pulse and report any significant increases, as tachycardia can indicate a severe adverse reaction to the medication. Choice B, Hyperglycemia, is not a common adverse effect of Hydralazine. Choice C, Hyponatremia, and Choice D, Constipation, are also not typically associated with Hydralazine use. Therefore, the correct answer is A: Tachycardia.

5. A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?

• A. Avoid consuming foods high in vitamin K.
• B. Monitor your blood pressure regularly.
• C. Increase your intake of green, leafy vegetables.
• D. Take the medication with a high-fat meal.

Correct answer: A

Rationale: The correct answer is to advise the client to avoid consuming foods high in vitamin K. Warfarin's effectiveness can be affected by vitamin K intake. Clients should maintain a consistent intake of vitamin K and avoid sudden increases in foods high in vitamin K to ensure the medication works properly and consistently. Choices B, C, and D are incorrect. Monitoring blood pressure, increasing intake of green, leafy vegetables, or taking the medication with a high-fat meal are not specific instructions related to Warfarin therapy.

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