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. A client with a diagnosis of bipolar disorder is prescribed lamotrigine. The nurse should monitor for which potential adverse effect?

• A. Rash
• B. Tremors
• C. Hair loss
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Rash. Lamotrigine can cause a rash, which may indicate a serious adverse effect like Stevens-Johnson syndrome. Monitoring for a rash is crucial in clients taking lamotrigine to promptly address any potential severe reactions.

3. A practical nurse (PN) is providing education to a client who is starting therapy with metformin for type 2 diabetes. What side effect should the client be instructed to report to the healthcare provider?

• A. Weight gain
• B. Hypoglycemia
• C. Muscle pain
• D. Nausea

Correct answer: D

Rationale: The correct answer is 'Nausea.' Nausea is a common side effect of metformin, especially when the medication is first started. It is essential for the client to report persistent or severe nausea to the healthcare provider for further evaluation and management. Weight gain (Choice A) is not a typical side effect of metformin; in fact, metformin is associated with weight loss or weight neutrality. Hypoglycemia (Choice B) is a potential side effect of some diabetes medications, but metformin does not typically cause hypoglycemia. Muscle pain (Choice C) is not a common side effect of metformin; it is more commonly associated with other medications like statins.

4. A client with a diagnosis of generalized anxiety disorder is prescribed alprazolam. The nurse should instruct the client that this medication may have which potential side effect?

• A. Drowsiness
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: The correct answer is A: Drowsiness. Alprazolam, a medication commonly used to treat anxiety disorders, can cause drowsiness as a common side effect. Clients should be advised not to drive or operate heavy machinery until they know how the medication affects them to ensure their safety.

5. What action should the nurse implement for a female client taking the bisphosphonate medication ibandronate for osteoporosis?

• A. Ask the client to describe how she takes the medication
• B. Reassure the client that the heartburn is temporary
• C. Explain that the use of antacids might be helpful
• D. Encourage the client to increase her calcium intake

Correct answer: A

Rationale: Ensuring correct administration of bisphosphonates, like ibandronate, is essential to maximize effectiveness and minimize potential side effects. By asking the client to describe how she takes the medication, the nurse can assess the client's understanding and adherence to the prescribed regimen, ultimately promoting optimal therapeutic outcomes.

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