Nursing Elites

1. A healthy 68-year-old client asks the practical nurse (PN) whether they should take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?

• A. The vaccine is given annually before the flu season to those older than 50 years.
• B. The immunization is recommended for children younger than 2 years old and all adults 65 years or older.
• C. The vaccine is for all ages and is given primarily to those traveling overseas to areas of infection.
• D. The vaccine will prevent the occurrence of pneumococcal pneumonia for up to 5 years.

Correct answer: B

Rationale: The correct answer is B because it is usually recommended that children younger than 2 years old and adults 65 years or older get vaccinated against pneumococcal disease. This is because these age groups are more susceptible to severe complications from the infection. While the vaccine may be recommended for certain individuals with specific medical conditions at any age, the primary target groups are as mentioned in option B. Option A is incorrect as the pneumococcal vaccine is not given annually like the flu vaccine. Option C is incorrect because the vaccine is not primarily for travelers but for certain age groups and individuals with medical conditions at risk. Option D is incorrect as the vaccine's duration of protection can vary, and it is not guaranteed to prevent pneumococcal pneumonia for up to 5 years.

2. When should a client receiving insulin lispro administer this medication?

• A. Before meals
• B. After meals
• C. At bedtime
• D. Before sleep

Correct answer: A

Rationale: Insulin lispro is a rapid-acting insulin that should be administered shortly before meals. This timing helps to synchronize the peak action of insulin with the rise in blood glucose levels after eating, effectively managing blood glucose levels in the body.

3. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

4. The client is being instructed on the correct technique for using... what to provide the client?

• A. Angle the tip of the inhaler upwards while spraying
• B. Hold one nostril closed while spraying the other nostril
• C. Avoid shaking the inhaler immediately before using
• D. Use the inhaler when first awakening in the morning

Correct answer: B

Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.

5. A client with a history of heart failure is prescribed carvedilol. The nurse should monitor the client for which adverse effect?

• A. Dizziness upon standing
• B. Weight loss
• C. Bradycardia
• D. Hypotension

Correct answer: D

Rationale: The correct answer is D: Hypotension. Carvedilol, a beta-blocker, can lead to hypotension by blocking the effects of adrenaline, which can cause blood vessels to dilate and reduce blood pressure. While dizziness upon standing is a potential adverse effect of carvedilol, it is more specifically related to orthostatic hypotension, which is a form of hypotension that occurs when a person stands up from a sitting or lying position. Weight loss and bradycardia are not typically associated with carvedilol use. Therefore, the nurse should primarily monitor for hypotension in a client taking carvedilol.

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