Nursing Elites

1. A healthcare provider is educating a group of new parents about immunizations. The provider should instruct the parents that the series for which of the following vaccines is completed prior to the first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The series for the Rotavirus vaccine is completed prior to the first birthday as it is only administered to infants less than 8 months of age. This vaccine provides protection against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the series for these vaccines extends beyond the first birthday. Pneumococcal conjugate vaccine and Meningococcal conjugate vaccine are typically given in multiple doses up to 2 years of age, while the Varicella vaccine is usually administered between 12 to 15 months of age.

2. A client has a new prescription for Enalapril. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Dry cough.
• B. Hyperglycemia.
• C. Weight gain.
• D. Increased urination.

Correct answer: A

Rationale: The correct answer is A: Dry cough. A common adverse effect of Enalapril, an ACE inhibitor, is a persistent dry cough. This occurs due to the accumulation of bradykinin. It is essential for the client to monitor for this side effect and report it to their healthcare provider promptly. Choices B, C, and D are incorrect because hyperglycemia, weight gain, and increased urination are not typically associated with Enalapril use.

3. A client has been prescribed Aspirin for prevention of cardiovascular disease. Which of the following findings indicates the medication is effective?

• A. The client has a decrease in troponin levels.
• B. The client has a regular heart rhythm.
• C. The client experiences a decrease in episodes of angina.
• D. The client's blood pressure remains stable.

Correct answer: C

Rationale: The correct answer is C. A decrease in episodes of angina indicates that Aspirin is effectively preventing the formation of clots that could lead to cardiovascular events. Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle, usually due to coronary artery disease. Aspirin works by inhibiting platelet aggregation, thereby reducing the risk of clot formation in the arteries. Improvement in angina symptoms suggests that the medication is successfully preventing clot-related complications in the cardiovascular system. Monitoring and recognizing a decrease in angina episodes can be a valuable indicator of the medication's efficacy in preventing cardiovascular events. Choices A, B, and D are incorrect because a decrease in troponin levels, a regular heart rhythm, or stable blood pressure, while important parameters, do not directly reflect the effectiveness of Aspirin in preventing cardiovascular events through antiplatelet action.

4. What should a patient avoid while taking Angiotensin-converting enzymes?

• A. Salt substitutes
• B. Foods high in potassium
• C. Foods high in sodium
• D. All of the above

Correct answer: A

Rationale: Patients taking Angiotensin-converting enzyme (ACE) inhibitors should avoid salt substitutes because they can contain potassium chloride, which may lead to hyperkalemia. It is important to restrict potassium-rich foods while on ACE inhibitors, but the primary concern with salt substitutes is their potassium content.

5. A client informs the nurse that she has difficulty swallowing tablets and struggles with liquid or chewable medications due to taste. What medication should the nurse request a prescription for when preparing to administer Penicillin V to treat the client's streptococcal infection?

• A. Fosfomycin
• B. Amoxicillin
• C. Nafcillin
• D. Cefaclor

Correct answer: C

Rationale: Nafcillin is an appropriate alternative within the penicillin class for clients who have difficulty swallowing tablets or struggle with liquid or chewable medications. It is available for intramuscular (IM) or intravenous (IV) administration, offering options beyond oral formulations. Fosfomycin, Amoxicillin, and Cefaclor are not suitable alternatives for Penicillin V in this scenario as they belong to different classes of antibiotics and may not be as effective in treating streptococcal infections.

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