Nursing Elites

1. A public health nurse is planning a vaccination clinic for a rural community. Which vaccine should the nurse prioritize for adults in this area?

• A. hepatitis A
• B. influenza
• C. varicella
• D. measles, mumps, rubella (MMR)

Correct answer: B

Rationale: The correct answer is 'B: influenza.' Influenza vaccination is crucial for adults, particularly in rural areas where access to healthcare may be limited. Influenza can cause serious illness and complications, and vaccination helps protect individuals and prevent the spread of the virus. While vaccines for hepatitis A, varicella, and measles, mumps, rubella (MMR) are important, prioritizing influenza vaccination in this scenario is essential due to its seasonal prevalence and potential impact on public health. Hepatitis A and varicella vaccines are also important but may not be as immediately critical for this population. MMR vaccine is typically administered in childhood, so it is not the priority for adults in this scenario.

2. A client with a history of myocardial infarction is prescribed aspirin therapy. Which instruction should the nurse include in the client's teaching plan?

• A. Take aspirin with food.
• B. Take aspirin at the same time every day.
• C. Avoid taking aspirin with alcohol.
• D. Discontinue aspirin if you experience ringing in your ears.

Correct answer: C

Rationale: The correct instruction for the nurse to include in the client's teaching plan is to avoid taking aspirin with alcohol. Combining aspirin with alcohol can increase the risk of gastrointestinal bleeding and other complications. Taking aspirin with food helps reduce stomach upset, but it is not the most crucial instruction in this scenario. While taking aspirin at the same time every day can help with consistency, it is not as critical as avoiding alcohol. Discontinuing aspirin if experiencing ringing in the ears is important to address potential side effects, but it is not directly related to preventing complications when combining with alcohol.

3. A client with asthma receives a prescription for high blood pressure during a clinic visit. Which prescription should the nurse anticipate the client to receive that is least likely to exacerbate asthma?

• A. Pindolol (Visken)
• B. Carteolol (Ocupress)
• C. Metoprolol tartrate (Lopressor)
• D. Propranolol hydrochloride (Inderal)

Correct answer: C

Rationale: The correct answer is C, Metoprolol tartrate (Lopressor). Metoprolol is a beta2 blocking agent that is cardioselective and less likely to cause bronchoconstriction, making it a suitable antihypertensive option for clients with asthma. Choices A, B, and D are non-selective beta-blockers which can potentially exacerbate asthma symptoms by causing bronchoconstriction.

4. Which client has the highest risk for developing community-acquired pneumonia?

• A. a 40-year-old first-grade teacher who works with underprivileged children
• B. a 75-year-old retired secretary with exercise-induced wheezing
• C. a 60-year-old homeless person who is an alcoholic and smokes
• D. a 35-year-old aerobics instructor who skips meals and eats only vegetables

Correct answer: C

Rationale: The correct answer is C, a 60-year-old homeless person who is an alcoholic and smokes. This client has the highest risk of developing community-acquired pneumonia due to multiple factors such as homelessness, substance abuse, and smoking. Homelessness can lead to poor living conditions and limited access to healthcare, increasing susceptibility to infections. Alcoholism and smoking weaken the immune system, making individuals more vulnerable to respiratory infections like pneumonia. Choices A, B, and D do not present the same level of risk factors for pneumonia compared to choice C.

5. A client with a history of hypertension is admitted with a blood pressure of 200/120 mm Hg. Which medication should the nurse prepare to administer?

• A. Metoprolol (Lopressor).
• B. Furosemide (Lasix).
• C. Lisinopril (Zestril).
• D. Nitroprusside (Nipride).

Correct answer: D

Rationale: The correct answer is D, Nitroprusside (Nipride). In this scenario of severe hypertension (200/120 mm Hg), a hypertensive emergency is present, requiring rapid reduction of blood pressure. Nitroprusside is a vasodilator that acts quickly to lower blood pressure in such emergencies. Options A, B, and C are incorrect: A) Metoprolol is a beta-blocker that lowers blood pressure but is not indicated for hypertensive emergencies requiring rapid reduction. B) Furosemide is a diuretic that helps with fluid retention but does not rapidly lower blood pressure. C) Lisinopril is an ACE inhibitor used for long-term management of hypertension, not for immediate reduction in hypertensive emergencies.

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