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 has a new prescription for Losartan. Which of the following instructions should be included?

• A. Avoid drinking grapefruit juice.
• B. Take this medication with a full glass of water.
• C. Take this medication on an empty stomach.
• D. Monitor for signs of dehydration.

Correct answer: D

Rationale: The correct instruction for a client prescribed Losartan is to monitor for signs of dehydration. Losartan can lead to dehydration, so it is essential for the client to be vigilant for symptoms such as dry mouth, increased thirst, and decreased urine output. Providing the instruction to monitor for signs of dehydration ensures the client's safety and helps in early identification of any potential issues related to dehydration. Choices A, B, and C are incorrect as Losartan does not interact with grapefruit juice, does not require specific instructions regarding water intake, and does not need to be taken on an empty stomach.

3. Which statement is true about food and drug precautions?

• A. Limiting certain types of food or administering certain types of drugs is necessary.
• B. Certain combinations of food and drugs can cause adverse reactions.
• C. Precautions may involve limiting certain types of food or administering drugs rather than restricting the drug itself.
• D. When one drug alters the way another drug affects the body.

Correct answer: B

Rationale: The correct answer is B. Certain combinations of food and drugs can indeed lead to adverse reactions. It is important to be cautious with the simultaneous intake of food and drugs as interactions between them can affect their efficacy and safety. Choices A, C, and D are incorrect because they do not accurately reflect the potential risks associated with the combination of food and drugs.

4. A healthcare professional is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. How many gtt/min should the healthcare professional adjust the manual IV infusion to deliver?

• A. 22 gtt/min
• B. 24 gtt/min
• C. 20 gtt/min
• D. 18 gtt/min

Correct answer: A

Rationale: To calculate the flow rate, use the formula: (Volume in mL x Drop factor) / Time in minutes = Flow rate in gtt/min. In this case, (100 mL x 10 gtt/mL) / 45 min = 22 gtt/min. Thus, the healthcare professional should adjust the manual IV infusion to deliver 22 gtt/min. Choice B, 24 gtt/min, is incorrect because it miscalculates the flow rate. Choices C and D, 20 gtt/min and 18 gtt/min, are also incorrect as they do not accurately calculate the flow rate based on the given information.

5. A client is receiving Morphine IV for pain management. Which of the following actions should the nurse take to monitor for adverse effects?

• A. Monitor the client's respiratory rate every 15 minutes.
• B. Monitor the client's blood pressure every 30 minutes.
• C. Monitor the client's oxygen saturation every hour.
• D. Monitor the client's heart rate every 5 minutes.

Correct answer: A

Rationale: The correct action for the nurse to monitor for adverse effects of Morphine IV is to check the client's respiratory rate every 15 minutes. Respiratory depression is a potentially life-threatening adverse effect of Morphine. Monitoring the respiratory rate frequently allows for early detection and intervention if needed. Monitoring blood pressure, oxygen saturation, or heart rate alone may not provide early signs of respiratory depression, which is a critical adverse effect of Morphine IV.

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