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 healthcare professional is preparing to administer Spironolactone to a client. Which of the following laboratory results should the professional review before administering this medication?

• A. Serum potassium.
• B. Serum sodium.
• C. Serum chloride.
• D. Serum calcium.

Correct answer: A

Rationale: When administering Spironolactone, it is essential to monitor the client's serum potassium levels because Spironolactone is a potassium-sparing diuretic. Monitoring potassium levels helps to detect hyperkalemia, a potential adverse effect of the medication.

3. During transfusion of a unit of whole blood, a nurse is assessing a client who develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: The client's symptoms indicate circulatory overload, which can occur during blood transfusions. Furosemide, a loop diuretic, is commonly prescribed in such cases to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Epinephrine is used for severe allergic reactions, lorazepam for anxiety or seizures, and diphenhydramine for mild allergic reactions or as a sedative. Therefore, the correct choice is Furosemide (C) to manage circulatory overload during a blood transfusion.

4. When teaching a client about a new prescription for Celecoxib, which of the following information should the nurse include?

• A. Increases the risk for a myocardial infarction
• B. Decreases the risk of stroke
• C. Inhibits COX-1
• D. Increases platelet aggregation

Correct answer: A

Rationale: The nurse should educate the client that taking Celecoxib increases the risk of a myocardial infarction due to its suppression of vasodilation. Celecoxib belongs to the class of NSAIDs known to have cardiovascular risks, including an increased risk of heart attacks. Choice B is incorrect because Celecoxib does not decrease the risk of stroke. Choice C is incorrect because Celecoxib selectively inhibits COX-2 rather than COX-1. Choice D is incorrect because Celecoxib does not increase platelet aggregation; in fact, it inhibits platelet aggregation.

5. When educating a patient on taking levothyroxine, a drug used to balance thyroid activity, what should you include in their education?

• A. Don't disregard side effects and consult your healthcare professionals
• B. Take this at the same time every day
• C. Thyroid tests are necessary while taking this drug
• D. It is not recommended to take this drug if you have recently had a myocardial infarction

Correct answer: B

Rationale: The correct answer is to take levothyroxine at the same time every day. Consistent timing helps maintain stable thyroid levels, ensuring the effectiveness of the medication. It is important to establish a routine to optimize its therapeutic benefits. Choice A is incorrect as patients should not ignore side effects but should consult healthcare professionals if they experience any. Choice C is incorrect because thyroid tests may still be necessary to monitor thyroid function while on levothyroxine. Choice D is incorrect as it is not advisable to take levothyroxine if the patient has recently had a myocardial infarction without consulting their healthcare provider.

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