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 is prescribed an IM dose of penicillin. She reports developing a rash after taking penicillin 3 years ago. What action should the healthcare professional take?

• A. Administer the prescribed dose.
• B. Withhold the medication.
• C. Ask the provider to change the prescription to an oral form.
• D. Administer an oral antihistamine at the same time.

Correct answer: B

Rationale: The healthcare professional should withhold the medication and notify the provider of the client's previous reaction to penicillin. It is crucial to report any past allergic reactions to medications, as this information guides the provider in prescribing a safe alternative. Administering the prescribed dose without considering the client's history of developing a rash can lead to potentially severe adverse reactions. Changing the prescription to an oral form or administering an oral antihistamine does not address the risk of an allergic reaction to penicillin in this case.

3. A client is starting therapy with paclitaxel. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Bradycardia
• B. Diarrhea
• C. Neutropenia
• D. Urinary retention

Correct answer: C

Rationale: Neutropenia is a common adverse effect of paclitaxel due to bone marrow suppression. Clients should be instructed to monitor for signs of infection and report any symptoms such as fever, chills, or sore throat immediately to their healthcare provider.

4. When educating a client with early Parkinson's disease about pramipexole, what adverse effect should the nurse advise the client to monitor for?

• A. Hallucinations
• B. Increased salivation
• C. Diarrhea
• D. Discoloration of urine

Correct answer: A

Rationale: The correct answer is A: Hallucinations. Pramipexole can lead to hallucinations, especially within 9 months of starting the medication, and may necessitate discontinuation. Hallucinations are a serious adverse effect that the client should be aware of and report promptly to their healthcare provider for evaluation and management. Increased salivation (choice B), diarrhea (choice C), and discoloration of urine (choice D) are not common adverse effects associated with pramipexole and are not typically emphasized in client education for this medication.

5. Which of the following is not directly related to drug toxicity of Nitroglycerin?

• A. Headaches
• B. Tachycardia
• C. Dizziness
• D. Projectile vomiting

Correct answer: D

Rationale: Headaches, tachycardia, and dizziness are common side effects of nitroglycerin due to its vasodilatory properties. Projectile vomiting is not typically associated with nitroglycerin toxicity, making it the correct answer. Therefore, option D is the correct choice.

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