Nursing Elites

1. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• 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 who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

2. A client is receiving treatment with bevacizumab. Which of the following findings should the nurse monitor?

• A. Hypertension
• B. Hypokalemia
• C. Hyperglycemia
• D. Hypocalcemia

Correct answer: A

Rationale: Correct Answer: A. Bevacizumab is known to cause hypertension as a common adverse effect. The nurse should closely monitor the client's blood pressure to detect and manage this potential side effect promptly. Choice B, hypokalemia, is not typically associated with bevacizumab treatment. Choice C, hyperglycemia, is not a common adverse effect of bevacizumab. Choice D, hypocalcemia, is not a recognized side effect of bevacizumab.

3. 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: The correct instruction for taking Colesevelam is to take it with food and at least one glass of water. This helps to ensure proper absorption and reduce the risk of gastrointestinal side effects. Option A is incorrect because Digoxin and Colesevelam should not be taken together. Option B is irrelevant to the administration of Colesevelam. Option C is unrelated to the specific instructions for taking Colesevelam.

4. A client is starting a new prescription for verapamil. Which of the following instructions should be included?

• A. Take the medication with a full glass of water.
• B. Avoid grapefruit juice.
• C. Monitor blood pressure regularly.
• D. Monitor heart rate daily.

Correct answer: B

Rationale: Clients prescribed verapamil should be advised to avoid grapefruit juice as it can potentiate the drug's effects, leading to adverse reactions. Grapefruit juice can inhibit the metabolism of verapamil, resulting in higher blood levels of the medication and an increased risk of side effects. Instructions such as taking the medication with a full glass of water (Choice A) are not specific to verapamil and are generally recommended. While monitoring blood pressure regularly (Choice C) is important for clients on antihypertensive medications, it is not a direct concern related to verapamil. Monitoring heart rate daily (Choice D) is not a primary consideration when starting verapamil, as it is more commonly used for its effects on blood pressure and arrhythmias rather than heart rate.

5. A client is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements by the client requires further discussion?

• A. I signed up for a swimming class.
• B. I've been taking an antacid to help with indigestion.
• C. I've lost 2 pounds since my appointment 2 weeks ago.
• D. The naproxen is easier to take when I crush it and put it in applesauce.

Correct answer: B

Rationale: The client stating that they have been taking an antacid to help with indigestion while on naproxen requires further discussion. This statement suggests potential gastrointestinal distress or interactions between the medications. Antacids can affect the absorption of naproxen or lead to other complications. Therefore, the nurse should address this statement with the client to ensure safe and effective medication management. Choices A, C, and D do not raise immediate concerns related to the client's medication regimen and can be considered positive health behaviors or side effects of treatment that do not require immediate intervention.

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