Nursing Elites

1. The healthcare provider has prescribed an influenza vaccine for a 74-year-old client before discharge. Which client condition would prompt the practical nurse to consult with the charge nurse rather than administer the vaccine?

• A. History of congestive heart failure
• B. History of an egg allergy
• C. History of pneumococcal vaccination
• D. History of end-stage renal disease

Correct answer: B

Rationale: The correct answer is B: History of an egg allergy. The influenza vaccine may contain a small amount of egg protein. According to the CDC, individuals with a severe allergy to any component of the vaccine, including egg protein, should not receive the influenza vaccine. Therefore, if the client has a history of an allergy to eggs, the practical nurse should not administer the vaccine and consult with the charge nurse for further guidance, as it is a contraindication. The other conditions listed do not require consultation before administering the influenza vaccine.

2. A client has metoprolol prescribed. The nurse should reinforce instructions that this medication has which potential adverse effect?

• A. Anxiety
• B. Tachycardia
• C. Sexual dysfunction
• D. Acute renal failure

Correct answer: C

Rationale: The correct answer is C: Sexual dysfunction. Metoprolol, a beta-blocker, can cause sexual dysfunction as an adverse effect. It is important for the nurse to educate the client about this potential side effect. Choice A is incorrect because metoprolol can cause depression, not anxiety. Choice B is incorrect as tachycardia is not an adverse effect of metoprolol; instead, it can lead to bradycardia. Choice D is incorrect because acute renal failure is not typically associated with the use of beta-blockers.

3. A client with diabetes mellitus type 2 is prescribed linagliptin. Which instruction should the nurse include in the client's teaching plan?

• A. Report any signs of pancreatitis to the healthcare provider.
• B. Take this medication with meals.
• C. Avoid alcohol while taking this medication.
• D. Report any signs of heart failure to the healthcare provider.

Correct answer: A

Rationale: When a client is prescribed linagliptin, it is crucial to educate them to report any signs of pancreatitis to their healthcare provider. Linagliptin can lead to pancreatitis, making it essential for clients to be vigilant for symptoms such as severe abdominal pain, nausea, and vomiting. Timely reporting of these symptoms can aid in early intervention and management of pancreatitis.

4. A client has been diagnosed with open-angle glaucoma. The healthcare provider prescribes pilocarpine 1% eye drops. The nurse explains that which action of this drug makes it a useful treatment for the client's condition?

• A. The ciliary muscle contracts, increasing the outflow of aqueous humor in the eye.
• B. Ciliary muscles are paralyzed to decrease accommodation.
• C. Bilateral mydriasis with cycloplegia is accomplished.
• D. The production of aqueous humor in the eyes is decreased.

Correct answer: A

Rationale: Pilocarpine, a cholinergic agent, stimulates the ciliary muscle to contract, which opens the trabecular meshwork and facilitates the outflow of aqueous humor, reducing intraocular pressure. This mechanism helps in managing open-angle glaucoma by improving drainage and lowering pressure within the eye. Choice A is correct because the contraction of the ciliary muscle increases the outflow of aqueous humor, aiding in the treatment of open-angle glaucoma. Choices B, C, and D are incorrect because they do not describe the mechanism of action of pilocarpine in treating glaucoma.

5. A client with major depressive disorder is prescribed bupropion. Which statement by the client indicates the need for further teaching?

• A. This medication may cause weight gain.
• B. This medication may take several weeks to take effect.
• C. I should avoid alcohol while taking this medication.
• D. I should take this medication in the morning with food.

Correct answer: A

Rationale: The correct answer is A because bupropion is associated with weight loss rather than weight gain. It is important for the client to be aware of this potential side effect. Choice B is correct because bupropion may take several weeks to exhibit its full therapeutic effects. Choice C is also accurate as alcohol consumption should be avoided while taking bupropion due to the risk of seizures. Choice D is correct as taking bupropion in the morning with food can help reduce the risk of gastrointestinal side effects.

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