Nursing Elites

1. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The healthcare provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old with no health problems
• B. 17-year-old with a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: A 17-year-old can be immunized for influenza with the LAIV via nasal spray. A hypersensitivity to penicillin is not a contraindication for an influenza immunization. Nasal spray influenza vaccine is generally recommended for healthy individuals between 2 and 49 years old. Choices A, C, and D are not candidates for nasal spray influenza vaccine. A 1-year-old is too young, pregnant individuals should not receive the nasal spray, and age is a factor for the use of the nasal spray vaccine.

2. A client is receiving heparin therapy. Which laboratory value should be monitored by the nurse to evaluate the effectiveness of the therapy?

• A. PT
• B. aPTT
• C. INR
• D. Platelet count

Correct answer: B

Rationale: The activated partial thromboplastin time (aPTT) is specifically used to monitor the effectiveness of heparin therapy. It should be maintained at 1.5 to 2 times the normal level. Monitoring aPTT helps ensure that the therapeutic range of heparin is achieved to prevent clot formation while minimizing the risk of bleeding complications. Choice A (PT) is incorrect as it is used to monitor warfarin therapy, not heparin. Choice C (INR) is also incorrect as it is primarily used to monitor warfarin therapy. Choice D (Platelet count) is not directly related to monitoring the effectiveness of heparin therapy.

3. A client reports taking Aspirin four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

• A. Digoxin
• B. Metformin
• C. Warfarin
• D. Nitroglycerin

Correct answer: C

Rationale: Aspirin inhibits platelet aggregation, which can increase the effect of anticoagulants like warfarin, leading to an elevated risk of bleeding. Therefore, the concurrent use of aspirin and warfarin is generally contraindicated due to this potential interaction. Digoxin is not contraindicated with aspirin in most cases. Metformin and nitroglycerin do not have significant interactions with aspirin, making them less likely to be contraindicated in this scenario.

4. When teaching a client with a new prescription for nitroglycerin patches, which of the following instructions should the nurse include?

• A. Apply the patch at the same time every day.
• B. Rotate the application site daily.
• C. Remove the patch for 12 hours each day.
• D. Cut the patch in half if needed.

Correct answer: B

Rationale: The correct instruction for a client with a new prescription for nitroglycerin patches is to rotate the application site daily. This is important to prevent skin irritation and ensure optimal absorption of the medication. Applying the patch at the same time every day (Choice A) is not necessary for nitroglycerin patches. Removing the patch for 12 hours each day (Choice C) would disrupt the continuous delivery of medication. Cutting the patch in half (Choice D) can alter the dose and is not recommended unless directed by a healthcare provider.

5. Which of the following medications is a bronchodilator?

• A. Albuterol
• B. Omeprazole
• C. Ondansetron
• D. Senna

Correct answer: A

Rationale: Albuterol is classified as a bronchodilator, which is commonly used to treat conditions like asthma by relaxing the muscles in the airways and increasing airflow to the lungs. Omeprazole is a proton pump inhibitor used to reduce stomach acid production, while ondansetron is an anti-nausea medication, and senna is a laxative.

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