Nursing Elites

1. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

2. A client is taking oral Oxycodone and Ibuprofen. The nurse should identify that an interaction between these two medications will cause which of the following findings?

• A. A decrease in serum levels of ibuprofen, possibly leading to a need for increased doses of this medication.
• B. A decrease in serum levels of oxycodone, possibly leading to a need for increased doses of this medication.
• C. An increase in the expected therapeutic effect of both medications.
• D. An increase in expected adverse effects for both medications.

Correct answer: C

Rationale: The interaction between oxycodone and ibuprofen results in an increase in the expected therapeutic effect of both medications. Oxycodone is a narcotic analgesic, while ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). They work through different mechanisms but complement each other in pain management. When taken together, they can enhance the pain-relieving effects of each other, providing better pain relief for the client.

3. What is levothyroxine's pharmacologic classification?

• A. Thyroid Preparations
• B. Metabolic Inhibitors
• C. Analgesic
• D. Loop Diuretic

Correct answer: A

Rationale: Levothyroxine is classified as a thyroid preparation because it is a synthetic form of the thyroid hormone thyroxine. It is primarily used to treat hypothyroidism by supplementing or replacing the natural thyroid hormones in the body, helping to regulate metabolism and energy levels. Choice B, Metabolic Inhibitors, is incorrect because levothyroxine does not inhibit metabolism but rather helps regulate it. Choice C, Analgesic, is incorrect as levothyroxine is not used for pain relief but for thyroid hormone replacement therapy. Choice D, Loop Diuretic, is also incorrect as loop diuretics are medications that act on the kidneys to increase urine production and are not related to thyroid hormone replacement therapy.

4. A client receives a local anesthetic of Lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?

• A. Seizures
• B. Tachycardia
• C. Hypertension
• D. Fever

Correct answer: A

Rationale: Seizures are a potential adverse reaction to local anesthetics like Lidocaine. Lidocaine can affect the central nervous system and, in some cases, lead to seizure activity. Therefore, it is important for the nurse to monitor the client for any signs of seizures during and after the administration of Lidocaine.

5. A client is taking Furosemide for heart failure. Which of the following findings is a priority to report to the provider?

• A. Weight loss of 1 kg in 24 hours
• B. Blood pressure of 104/60 mm Hg
• C. Potassium level of 3.5 mEq/L
• D. Urine output of 200 mL in 8 hours

Correct answer: D

Rationale: A urine output of 200 mL in 8 hours indicates decreased kidney function, potentially due to Furosemide therapy. This finding can suggest inadequate renal perfusion and impaired drug clearance, necessitating immediate reporting to prevent further complications like electrolyte imbalances and worsening heart failure. Choice A: Weight loss may be expected in heart failure patients due to fluid retention, but it is not an immediate concern. Choice B: A blood pressure of 104/60 mm Hg is slightly low but not a priority compared to the indication of kidney dysfunction. Choice C: A potassium level of 3.5 mEq/L is within the normal range, so it does not require immediate reporting.

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