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 with hypertension is prescribed clonidine. The nurse should monitor the client for which potential side effect?

• A. Hypotension
• B. Tachycardia
• C. Dizziness
• D. Hyperglycemia

Correct answer: A

Rationale: The correct answer is A: Hypotension. Clonidine, a medication used to treat hypertension, can cause a lowering of blood pressure leading to hypotension as a potential side effect. Monitoring for hypotension is essential to prevent complications such as dizziness, fainting, or falls. Option B, Tachycardia, is incorrect as clonidine typically causes bradycardia or a decreased heart rate. Option C, Dizziness, can occur due to hypotension caused by clonidine. Option D, Hyperglycemia, is not a common side effect associated with clonidine use.

3. The nurse is preparing a client with chronic obstructive pulmonary disease, which medication should the nurse review with the client to manage this?

• A. Guaifenesin
• B. Prednisone
• C. Salmeterol
• D. Tiotropium

Correct answer: D

Rationale: Tiotropium is commonly used for COPD management.

4. A client with a diagnosis of generalized anxiety disorder is prescribed escitalopram. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct potential side effect of escitalopram is drowsiness. Escitalopram is known to cause sedation, so clients should be advised to avoid activities that require mental alertness, such as driving, until they know how the medication affects them. Dry mouth, nausea, and headache are also common side effects of various medications but are not specifically associated with escitalopram.

5. A client with chronic pain is prescribed oxycodone. What instruction should the practical nurse (PN) include in the client's teaching plan?

• A. Take the medication with meals to avoid gastrointestinal upset.
• B. Avoid taking the medication with alcohol.
• C. Increase fluid intake to avoid constipation.
• D. Report any signs of respiratory depression to the healthcare provider.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking oxycodone with alcohol. Mixing oxycodone with alcohol can lead to serious side effects, including respiratory depression. Taking the medication with meals may not always be necessary, and instructions about fluid intake to avoid constipation are important but not the priority when considering the immediate risks associated with oxycodone. While reporting signs of respiratory depression is crucial, preventing it by avoiding alcohol is key in the client's safety.

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