Nursing Elites

1. 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.

2. A client has a new prescription for Nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet every 15 minutes until pain is relieved.
• B. Take one tablet every 5 minutes, up to three doses.
• C. Take one tablet at bedtime.
• D. Take one tablet on an empty stomach.

Correct answer: B

Rationale: The correct administration of Nitroglycerin sublingual tablets involves taking one tablet at the onset of chest pain and repeating every 5 minutes for up to three doses. This protocol helps in managing angina episodes effectively. Choice A suggests taking a tablet every 15 minutes until pain relief, which may delay appropriate intervention. Choice C, taking a tablet at bedtime, is not suitable for immediate relief during angina attacks. Choice D, taking a tablet on an empty stomach, is unrelated to the correct administration of Nitroglycerin sublingual tablets.

3. When should a blood sample be obtained for a peak serum level of gentamicin when administered by IV infusion for 1 hour at 0900?

• A. 1000
• B. 1030
• C. 1100
• D. 1130

Correct answer: B

Rationale: The nurse should obtain the blood sample for the peak serum level at 1030. This timing allows for 30 minutes to elapse after the completion of the 1-hour IV infusion, which is the recommended window for obtaining the peak serum level of gentamicin.

4. A client with Depression has a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)

• A. Cough
• B. Dizziness
• C. Decreased libido
• D. B and C

Correct answer: D

Rationale: The correct answer is D: 'B and C.' Venlafaxine, a medication used to treat depression, can lead to adverse effects like dizziness and decreased libido. It is important for the nurse to monitor the client for these potential side effects. Cough and alopecia are not typically associated with Venlafaxine. Therefore, choices A (Cough) and C (Decreased libido) are incorrect. Dizziness and decreased libido are the adverse effects that the nurse should focus on when monitoring a client on Venlafaxine treatment.

5. A client is starting therapy with raloxifene. Which adverse effect should the client monitor for as instructed by the nurse?

• A. Leg cramps
• B. Hot flashes
• C. Urinary frequency
• D. Hair loss

Correct answer: B

Rationale: Hot flashes are a common adverse effect associated with raloxifene therapy. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent and treat osteoporosis in postmenopausal women. Hot flashes are a well-known side effect of SERMs due to their estrogen-like effects on the body. Leg cramps, urinary frequency, and hair loss are not typically associated with raloxifene therapy. Therefore, the nurse should instruct the client to monitor for hot flashes as part of the medication education.

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