Nursing Elites

1. A nurse is preparing to administer a measles, mumps, rubella (MMR) immunization to a child. Which is a contraindication for this vaccine?

• A. Recent blood transfusion
• B. Allergy to penicillin
• C. Minor acute illness
• D. Low-grade fever

Correct answer: A

Rationale: The correct answer is A: Recent blood transfusion. A recent blood transfusion can interfere with the effectiveness of the MMR vaccine, making it a contraindication. Choice B, allergy to penicillin, is not a contraindication for the MMR vaccine. Choice C, minor acute illness, is not a contraindication unless the child has a moderate to severe illness. Choice D, low-grade fever, is not a contraindication as long as the child does not have a moderate to severe febrile illness.

2. A nurse is caring for a client with chronic pain. Which of the following interventions should the nurse prioritize?

• A. Administer pain medications as prescribed
• B. Encourage physical activity
• C. Monitor for depression
• D. Educate about alternative therapies

Correct answer: A

Rationale: Administering pain medications as prescribed is a priority to manage chronic pain effectively. Pain medications help alleviate the client's discomfort and improve their quality of life. Encouraging physical activity, monitoring for depression, and educating about alternative therapies are important interventions but may not directly address the immediate need for pain relief in a client with chronic pain. Physical activity and alternative therapies can be beneficial as part of a holistic pain management plan, but addressing the pain directly should be the initial priority.

3. A nurse is caring for a client receiving anticoagulation therapy. Which of the following should the nurse monitor?

• A. INR levels
• B. Blood glucose
• C. Serum creatinine
• D. Liver function

Correct answer: A

Rationale: Corrected Rationale: When caring for a client receiving anticoagulation therapy, the nurse should monitor the INR levels. INR (International Normalized Ratio) reflects the blood's ability to clot properly. It is crucial to monitor INR levels to ensure the anticoagulation therapy is within the therapeutic range and to prevent bleeding complications. Monitoring blood glucose levels (Choice B) is more relevant for clients with diabetes or those on medications affecting blood sugar. Serum creatinine (Choice C) is typically monitored to assess kidney function. Liver function (Choice D) is assessed through tests like AST, ALT, and bilirubin levels, and it is more relevant for assessing liver health rather than monitoring anticoagulation therapy.

4. A client who has osteoporosis is being discharged with a new prescription for alendronate. Which of the following instructions should the nurse provide?

• A. Take the medication at bedtime.
• B. Take the medication with a full glass of water.
• C. Take the medication with food.
• D. Lie down for 30 minutes after taking the medication.

Correct answer: B

Rationale: The correct answer is to take the medication with a full glass of water. Alendronate should be taken with a full glass of water to prevent esophageal irritation. Additionally, the client should remain upright for 30 minutes after taking it to prevent potential adverse effects. Choice A is incorrect because alendronate should not be taken at bedtime, but rather in the morning on an empty stomach. Choice C is incorrect because alendronate should be taken on an empty stomach, not with food. Choice D is incorrect because the client should remain upright, not lie down, for 30 minutes after taking the medication.

5. A client is prescribed digoxin for heart failure. Which of the following should the nurse monitor to evaluate the effectiveness of the medication?

• A. Respiratory rate
• B. Blood pressure
• C. Apical pulse
• D. Urine output

Correct answer: C

Rationale: The correct answer is C: Apical pulse. Digoxin's primary effect is to strengthen the force of the heart's contractions and slow the heart rate. Monitoring the apical pulse is crucial in evaluating the effectiveness of digoxin as it helps assess the medication's impact on the heart's function. Option A, respiratory rate, is not directly related to digoxin's mechanism of action and is not the most appropriate parameter to monitor for this medication. Option B, blood pressure, while important, may not be as sensitive as the apical pulse in assessing the effectiveness of digoxin. Option D, urine output, is more indicative of kidney function and fluid balance, rather than the direct effectiveness of digoxin in heart failure.

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