Nursing Elites

1. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The healthcare provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old with no health problems
• B. 17-year-old with a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: A 17-year-old can be immunized for influenza with the LAIV via nasal spray. A hypersensitivity to penicillin is not a contraindication for an influenza immunization. Nasal spray influenza vaccine is generally recommended for healthy individuals between 2 and 49 years old. Choices A, C, and D are not candidates for nasal spray influenza vaccine. A 1-year-old is too young, pregnant individuals should not receive the nasal spray, and age is a factor for the use of the nasal spray vaccine.

2. When educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia, which instruction should the nurse include?

• A. Take this medication in the morning.
• B. Avoid drinking grapefruit juice.
• C. Increase your intake of green, leafy vegetables.
• D. Expect your stools to turn clay-colored.

Correct answer: B

Rationale: The correct instruction for the nurse to include when educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia is to avoid drinking grapefruit juice. Grapefruit juice can increase the blood levels of atorvastatin, leading to an elevated risk of serious side effects such as liver damage and muscle problems. It is essential for the client to be aware of this potential interaction and to follow the nurse's advice to avoid grapefruit juice while taking Atorvastatin. Choices A, C, and D are incorrect. Taking Atorvastatin in the morning is a common recommendation but not the priority over avoiding grapefruit juice. Increasing intake of green, leafy vegetables is generally a healthy dietary choice but is not specific to the medication. Expecting stools to turn clay-colored is not a common side effect of Atorvastatin.

3. 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.

4. A healthcare provider is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?

• A. Bruising
• B. Report of metallic taste
• C. Muscle pain
• D. Report of anorexia

Correct answer: D

Rationale: The correct manifestation of digoxin toxicity is the report of anorexia. Anorexia, blurred vision, stomach pain, and diarrhea are common signs of digoxin toxicity. Bruising, metallic taste, and muscle pain are not typically associated with digoxin toxicity. Patients should promptly report symptoms of toxicity to their healthcare provider for further evaluation and management.

5. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?

• A. BUN
• B. Creatinine
• C. Hemoglobin
• D. White blood cell count

Correct answer: B

Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.

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