Nursing Elites

1. A healthcare professional in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the healthcare professional administer safely to this client?

• A. Varicella vaccine
• B. Rubella vaccine
• C. Inactivated influenza vaccine
• D. Measles vaccine

Correct answer: C

Rationale: During pregnancy, it is safe for women to receive the inactivated influenza vaccine, which is recommended by healthcare providers to protect pregnant individuals from influenza. Vaccination with inactivated influenza vaccine during pregnancy not only provides protection to the pregnant individual but also confers passive immunity to the newborn during the vulnerable early months of life. The Varicella, Rubella, and Measles vaccines are live vaccines and are contraindicated during pregnancy due to the theoretical risk of transmission of the live virus to the fetus, which could potentially cause harm.

2. What is the classification for the drug valproate?

• A. Anti-diabetic
• B. Anti-convulsant
• C. Anti-ulcer agent
• D. Anti-hypertensive

Correct answer: B

Rationale: Valproate is classified as an anticonvulsant. It is commonly used to treat epilepsy and bipolar disorder by stabilizing electrical activity in the brain. Therefore, the correct classification for valproate is as an anticonvulsant. Options A, C, and D are incorrect because valproate is not used to treat diabetes, ulcers, or hypertension.

3. A client has a new prescription for nitroglycerin transdermal patches. Which of the following instructions should the nurse include?

• A. Apply the patch to a different location each day.
• B. Remove the patch every night before bedtime.
• C. Massage the patch area gently after application.
• D. Shave the area before applying the patch.

Correct answer: B

Rationale: The correct instruction for a client using nitroglycerin transdermal patches is to remove the patch every night before bedtime. This practice helps prevent tolerance to the medication's effects. Continuous exposure to nitroglycerin can result in the body becoming less responsive to its therapeutic effects over time, reducing its efficacy in managing the prescribed condition. Choices A, C, and D are incorrect. Applying the patch to a different location each day does not address the issue of tolerance. Massaging the patch area gently after application is not recommended as it may alter drug absorption. Shaving the area before applying the patch is unnecessary and may increase the risk of skin irritation.

4. A client has a new prescription for Docusate Sodium. Which of the following instructions should the nurse include?

• A. Take the medication with a full glass of water.
• B. Expect results within 30 minutes.
• C. Take this medication at bedtime.
• D. Avoid taking this medication with food.

Correct answer: A

Rationale: The correct instruction for a client prescribed Docusate Sodium is to take the medication with a full glass of water. Docusate sodium is a stool softener, and taking it with water helps to soften the stool and make bowel movements easier. Adequate fluid intake is crucial when taking stool softeners to prevent constipation. Choices B, C, and D are incorrect. B is incorrect because the effects of Docusate Sodium may not be immediate, and it may take a couple of days for the stool softener to work. Choice C is incorrect as there is no specific requirement to take this medication at bedtime. Choice D is incorrect because there is no instruction to avoid taking Docusate Sodium with food.

5. A client is to receive Tetracaine before a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

• A. Keep the client NPO until the pharyngeal response returns.
• B. Monitor the insertion site for a hematoma.
• C. Palpate the bladder to detect urinary retention.
• D. Maintain the client on bed rest for 12 hours following the procedure.

Correct answer: A

Rationale: The correct action for the nurse to include in the plan of care is to keep the client NPO until the pharyngeal response returns. Tetracaine can affect the gag reflex, so it is important to prevent aspiration by maintaining the client NPO until the pharyngeal response is normal, which typically takes about 1 hour. Monitoring for the return of the gag reflex is crucial to prevent complications from aspiration during the first oral intake after the procedure. Choices B, C, and D are incorrect because they are not directly related to the effects of Tetracaine or the bronchoscopy procedure.

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