Nursing Elites

1. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The 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 who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

2. A healthcare professional is caring for a client who is prescribed Digoxin. Which of the following findings should the healthcare professional monitor to assess for potential toxicity?

• A. Bradycardia
• B. Hypertension
• C. Hypoglycemia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A: Bradycardia. Bradycardia is a common sign of Digoxin toxicity. Digoxin can cause bradycardia due to its effects on the heart's electrical conduction system. Monitoring the client's heart rate regularly is essential to detect and manage toxicity promptly. Choice B, Hypertension, is incorrect as Digoxin toxicity typically presents with bradycardia and not hypertension. Choices C and D, Hypoglycemia and Hypercalcemia, are also incorrect as they are not typically associated with Digoxin toxicity.

3. 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.

4. When teaching a client with a prescription for Cephalexin, which of the following instructions should the nurse include?

• A. Take the medication with an antacid.
• B. Avoid dairy products while taking this medication.
• C. Expect your stools to turn black.
• D. Complete the full course of medication.

Correct answer: D

Rationale: The correct instruction for a client prescribed with Cephalexin is to complete the full course of medication. This is crucial to ensure the infection is completely treated and to reduce the risk of antibiotic resistance. Choices A, B, and C are incorrect. Taking Cephalexin with an antacid is generally not recommended as it may reduce its effectiveness. While dairy products can interfere with certain antibiotics, they do not have a direct interaction with Cephalexin. Stools turning black is not an expected side effect of Cephalexin.

5. A client has a prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take furosemide in the morning.
• B. Eat a diet high in potassium.
• C. Avoid foods that are high in magnesium.
• D. Limit your fluid intake to 1 liter per day.

Correct answer: B

Rationale: The correct answer is to 'Eat a diet high in potassium.' Furosemide is a loop diuretic that can cause hypokalemia (low potassium levels). Instructing the client to eat a diet high in potassium can help counteract the potassium-wasting effect of furosemide and prevent hypokalemia. Choice A is incorrect because furosemide can be taken at different times of the day based on individual needs. Choice C is incorrect as furosemide does not directly interact with magnesium levels. Choice D is incorrect because while fluid intake may need to be monitored, a specific limit of 1 liter per day is not a general instruction for all clients taking furosemide.

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