Nursing Elites

1. A healthcare provider is educating a group of new parents about immunizations. The provider should instruct the parents that the series for which of the following vaccines is completed prior to the first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The series for the Rotavirus vaccine is completed prior to the first birthday as it is only administered to infants less than 8 months of age. This vaccine provides protection against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the series for these vaccines extends beyond the first birthday. Pneumococcal conjugate vaccine and Meningococcal conjugate vaccine are typically given in multiple doses up to 2 years of age, while the Varicella vaccine is usually administered between 12 to 15 months of age.

2. A client is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects?

• A. Increased TSH level
• B. Decreased ALT level
• C. Hypoglycemia
• D. Hyperlipidemia

Correct answer: D

Rationale: Hyperlipidemia, characterized by increased cholesterol and triglyceride levels, can occur as an adverse effect of Ritonavir. Monitoring lipid levels is essential to detect and manage this potential side effect in clients taking this medication for HIV infection.

3. A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching?

• A. I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate.
• B. I will take this medication on an empty stomach.
• C. I'll let the doctor know if I develop sores in my mouth while taking this medication.
• D. I should stop taking oral contraceptives while I'm taking methotrexate.

Correct answer: C

Rationale: Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately.

4. A healthcare provider is teaching the parents of a school-age child about transdermal Methylphenidate. Which of the following instructions should the healthcare provider include?

• A. Apply one patch twice a day.
• B. Leave the patch on for 9 hours.
• C. Apply the patch to the child's waist.
• D. Use the opened tray within 6 months.

Correct answer: B

Rationale: When administering transdermal Methylphenidate, it is important to leave the patch on for 9 hours each day to ensure the medication is effective. This duration allows for proper absorption of the medication through the skin. It is crucial for parents to follow this instruction to achieve the desired therapeutic effect for their child.

5. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• 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 with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

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