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 receiving chemotherapy reports nausea and vomiting. Which of the following medications should the nurse anticipate administering?

• A. Ondansetron
• B. Metoclopramide
• C. Promethazine
• D. Lorazepam

Correct answer: A

Rationale: The correct answer is A: Ondansetron. Ondansetron is a commonly used antiemetic for managing nausea and vomiting in clients undergoing chemotherapy. It works by blocking serotonin to reduce these symptoms effectively. Metoclopramide (choice B) is another antiemetic but is more commonly used for gastric motility disorders. Promethazine (choice C) is an antihistamine with antiemetic properties, but ondansetron is often preferred for chemotherapy-induced nausea and vomiting due to its efficacy and fewer side effects. Lorazepam (choice D) is a benzodiazepine used for anxiety and insomnia, not typically for managing nausea and vomiting in this context.

3. Which of the following is not an effect of the drug isoflurane?

• A. Elevated lipid levels
• B. Nausea
• C. Increased blood flow to the brain
• D. Decreased respiratory function

Correct answer: A

Rationale: Isoflurane is not known to cause elevated lipid levels. Common effects of isoflurane include nausea, increased blood flow to the brain, and decreased respiratory function. Elevated lipid levels are not typically associated with the administration of isoflurane, making choice A the correct answer.

4. A client with a history of migraine headaches is starting prophylaxis therapy with Propranolol. Which of the following findings in the client history should be reported to the provider by the nurse?

• A. The client had a prior myocardial infarction.
• B. The client takes warfarin for atrial fibrillation.
• C. The client takes an SSRI for depression.
• D. An ECG indicates a first-degree heart block.

Correct answer: D

Rationale: Propranolol is contraindicated in clients with a first-degree heart block due to its negative chronotropic properties that can further slow the heart rate. This can worsen conduction through the atrioventricular node, potentially leading to heart block progression. Therefore, the nurse should report the finding of a first-degree heart block to the provider before initiating Propranolol therapy. Choices A, B, and C are not contraindications for Propranolol therapy. A prior myocardial infarction, taking warfarin for atrial fibrillation, or using an SSRI for depression do not directly impact the initiation of Propranolol therapy in a client with a history of migraine headaches.

5. A client has a new prescription for Metronidazole. Which of the following instructions should be included in the discharge teaching?

• A. Avoid drinking alcohol while taking this medication.
• B. Take this medication on an empty stomach.
• C. Avoid dairy products while taking this medication.
• D. Take this medication with antacids.

Correct answer: A

Rationale: The correct instruction to include in the discharge teaching for a client prescribed Metronidazole is to avoid drinking alcohol while taking this medication. Drinking alcohol with Metronidazole can result in a disulfiram-like reaction, leading to symptoms such as nausea, vomiting, and flushing. Therefore, it is crucial for the client to abstain from alcohol consumption during the course of treatment with Metronidazole.

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