Nursing Elites

1. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

2. A healthcare provider is caring for a group of individuals who are not immune to Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following individuals?

• 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 with essential hypertension. Individuals not immune to Varicella should receive the vaccine if they did not get two doses earlier. Essential hypertension is not a contraindication for the Varicella vaccine. Administering the vaccine to pregnant women, individuals with severe neomycin allergies, or infants is contraindicated. Pregnant women should not receive the Varicella vaccine due to the potential risk to the fetus. Severe neomycin allergies are a contraindication because neomycin is present in the vaccine. Infants under 12 months of age are generally not vaccinated against Varicella unless there are specific circumstances or recommendations.

3. A client is receiving spironolactone. Which of the following findings should the nurse report to the provider?

• A. Serum Sodium 144 mEq/L
• B. Urine output 120 mL in 4 hrs
• C. Serum Potassium 5.2 mEq/L
• D. Blood Pressure 140/90 mmHg

Correct answer: C

Rationale: A serum potassium level of 5.2 mEq/L indicates hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to potassium retention. The nurse should notify the provider and withhold the medication to prevent further elevation of potassium levels, which can result in serious cardiac complications. The other findings (Serum Sodium 144 mEq/L, Urine output 120 mL in 4 hrs, and Blood Pressure 140/90 mmHg) are within normal ranges and not directly related to spironolactone therapy.

4. When providing discharge instructions to a client with a new prescription for Levofloxacin, which of the following instructions should the nurse include?

• A. Take this medication with food.
• B. Avoid taking this medication with dairy products.
• C. Take this medication at bedtime.
• D. Increase your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to instruct the client to avoid taking Levofloxacin with dairy products. This is because calcium in dairy products can interfere with the absorption of the medication. Patients should be advised to take Levofloxacin either 1 hour before or 2 hours after consuming dairy products to ensure optimal effectiveness. Choice A is incorrect because Levofloxacin can be taken with or without food. Choice C is incorrect as the timing of Levofloxacin administration is not specified as at bedtime. Choice D is also incorrect as there is no need to increase intake of potassium-rich foods specifically for Levofloxacin administration.

5. A client presents in the Emergency Department with chest pain. Which of the following conditions is least likely to cause chest pain?

• A. Arthritis
• B. Peptic ulcer disease
• C. Myocardial infarction
• D. Gastric reflux

Correct answer: A

Rationale: Arthritis is a condition primarily affecting the joints and is not known to cause chest pain. Peptic ulcer disease, myocardial infarction, and gastric reflux are conditions that can present with chest pain due to various reasons such as inflammation, ischemia, or reflux of stomach acid into the esophagus, respectively.

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