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: During pregnancy, it is safe for women to receive the inactivated influenza vaccine, which is recommended by healthcare providers to protect pregnant individuals from influenza. Vaccination with inactivated influenza vaccine during pregnancy not only provides protection to the pregnant individual but also confers passive immunity to the newborn during the vulnerable early months of life. The Varicella, Rubella, and Measles vaccines are live vaccines and are contraindicated during pregnancy due to the theoretical risk of transmission of the live virus to the fetus, which could potentially cause harm.

2. A client is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

• A. Take digoxin with your morning dose of colesevelam.
• B. Your sodium and potassium levels will be monitored periodically while taking colesevelam.
• C. Watch for bleeding or bruising while taking colesevelam.
• D. Take colesevelam with food and at least one glass of water.

Correct answer: D

Rationale: When taking colesevelam, it should be administered with food and at least 8 oz of water to ensure proper absorption and reduce the risk of gastrointestinal side effects. Taking colesevelam with food also helps in binding to bile acids efficiently. Options A, B, and C are incorrect because they do not provide the necessary instruction for taking colesevelam correctly or monitoring specific side effects associated with this medication.

3. A client with Schizophrenia is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

• A. Increase your intake of snacks to prevent weight loss.
• B. Notify the provider if you develop breast enlargement.
• C. Be aware of the possibility of mild seizures while taking this medication.
• D. Expect an increase in libido when taking this medication.

Correct answer: B

Rationale: The correct instruction the nurse should provide to the client taking Risperidone for Schizophrenia is to notify the provider if they develop breast enlargement. Risperidone can lead to an increase in prolactin levels, causing gynecomastia (breast enlargement) and galactorrhea. Therefore, it is crucial for the client to report these manifestations to the healthcare provider for appropriate management. Choices A, C, and D are incorrect. Increasing snack intake to prevent weight loss is not a specific concern related to Risperidone. Mild seizures are not a common side effect of Risperidone, so this instruction is unnecessary. Risperidone is more likely to cause sexual side effects like decreased libido rather than an increase.

4. When preparing to administer IV Acyclovir for Herpes Zoster, what action should the nurse take?

• A. Infuse the medication over 1 hour.
• B. Monitor the client's blood pressure every 15 minutes during infusion.
• C. Administer a stool softener.
• D. Monitor the client's blood glucose level every 4 hours during infusion.

Correct answer: A

Rationale: The correct action for the nurse is to infuse IV Acyclovir over at least 1 hour to prevent nephrotoxicity. Rapid infusion can lead to adverse effects, so a slow infusion rate is crucial for patient safety. Monitoring blood pressure, administering a stool softener, or monitoring blood glucose levels are not directly related to the administration of IV Acyclovir for Herpes Zoster.

5. Which adverse reaction poses the greatest life-threatening risk when taking Omeprazole?

• A. Chest pain
• B. Constipation
• C. Clostridium difficile-associated diarrhea
• D. Acute interstitial nephritis

Correct answer: C

Rationale: The most life-threatening adverse reaction associated with Omeprazole is Clostridium difficile-associated diarrhea. This condition can be severe and life-threatening due to the potential for dehydration, electrolyte imbalances, and complications such as toxic megacolon. Chest pain, constipation, and acute interstitial nephritis are potential side effects of Omeprazole but are not considered as life-threatening as Clostridium difficile-associated diarrhea. Monitoring for signs of this adverse reaction is crucial, and immediate medical attention should be sought if symptoms develop.

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