Nursing Elites

1. A client has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

• A. The vein for thrombophlebitis during IV administration.
• B. The subcutaneous site for redness following injection.
• C. The oral mucosa for ulceration after oral administration.
• D. The skin for irritation following removal of transdermal patch.

Correct answer: B

Rationale: Adalimumab is administered subcutaneously for Rheumatoid Arthritis. Injection-site reactions such as redness and swelling are common. Therefore, the nurse should monitor the subcutaneous site for redness following the injection to assess for potential adverse effects.

2. A client has a new prescription for Etravirine, an NNRTI. Which of the following statements should the nurse include in teaching the client?

• A. Take this medication with food.
• B. Take this medication on an empty stomach.
• C. Take this medication at the same time every day.
• D. Take this medication at bedtime to prevent drowsiness.

Correct answer: C

Rationale: The correct statement the nurse should include in teaching the client is to take Etravirine at the same time every day. This ensures consistent blood levels and effectiveness of the medication. Consistent timing is essential to achieve optimal therapeutic effects and avoid missing doses. Choices A and B are incorrect because Etravirine should not necessarily be taken with or without food; it is more important to take it consistently. Choice D is incorrect as there is no need to take Etravirine at bedtime to prevent drowsiness.

3. A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?

• A. NSAIDs
• B. Cardiac glycosides
• C. Beta blockers
• D. None of the above

Correct answer: C

Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.

4. 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.

5. 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.

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