Nursing Elites

1. A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

• A. 1-year-old who has no health problems
• B. 17-year-old who has a hypersensitivity to Penicillin
• C. 25-year-old who is pregnant
• D. 52-year-old who takes a multivitamin supplement

Correct answer: B

Rationale: The correct answer is B. A 17-year-old can receive the influenza vaccine via nasal spray even if they have a hypersensitivity to penicillin, as this is not a contraindication for the influenza immunization. The nasal spray vaccine (LAIV) is a live attenuated vaccine that is suitable for healthy individuals aged 2-49 years. Pregnancy (choice C) is a contraindication for the nasal spray influenza vaccine. Children under 2 years of age (choice A) are also not candidates for the nasal spray. Taking a multivitamin supplement (choice D) is not a determining factor for the type of influenza vaccine a person should receive.

2. A client is receiving vancomycin. Which of the following laboratory results should be monitored to evaluate the therapeutic effect of this medication?

• A. BUN
• B. Creatinine
• C. Hemoglobin
• D. White blood cell count

Correct answer: B

Rationale: Corrected Rationale: Creatinine levels should be monitored to evaluate vancomycin's effect on kidney function. Vancomycin can be nephrotoxic, so monitoring creatinine levels helps assess renal function and ensure that the medication is not causing harm to the kidneys. Monitoring BUN (choice A) is important for assessing kidney function but is not as specific as monitoring creatinine levels. Hemoglobin (choice C) and white blood cell count (choice D) are not directly related to evaluating the therapeutic effect of vancomycin.

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

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Take this medication on an empty stomach in the morning.
• D. Take this medication with an antacid.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance its absorption. This timing allows for optimal absorption and effectiveness of the medication. Taking it with food, at bedtime, or with an antacid may interfere with its absorption and reduce its efficacy.

4. A healthcare professional is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the healthcare professional prepare to transfuse?

• A. Whole blood
• B. Platelets
• C. Fresh frozen plasma
• D. Packed red blood cells

Correct answer: C

Rationale: Fresh frozen plasma is the correct choice for a client with an elevated aPTT because it contains essential coagulation factors that can help correct coagulopathy and prevent bleeding. It is rich in clotting factors like fibrinogen, factors V and VIII, which are crucial in maintaining proper blood clotting function. Whole blood (Choice A) is not typically used to correct coagulopathy and is more suitable for situations requiring both volume and oxygen-carrying capacity. Platelets (Choice B) are indicated for thrombocytopenia, not for correcting coagulation factors. Packed red blood cells (Choice D) are used to increase oxygen-carrying capacity in cases of anemia, not for correcting coagulopathy.

5. The client makes which statement about lifestyle changes to reduce the development and progression of coronary artery disease that indicates the need for further teaching?

• A. “I will check my weight regularly for any gain or loss.”
• B. “I’ll make sure to take my high blood pressure medications.”
• C. “I am attending a smoking cessation class.”
• D. “As long as I exercise, stress at my job will not bother me.”

Correct answer: D

Rationale: The client stating, 'As long as I exercise, stress at my job will not bother me,' indicates a misunderstanding of the relationship between exercise and stress management. It is important to clarify that while exercise can help reduce stress, it may not eliminate all stressors, especially those related to work. Further teaching is needed to ensure the client understands the multifactorial approach required to address stress and its impact on coronary artery disease.

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