Nokea
A client can receive the mumps, measles, rubella (MMR) vaccine if he or she:
- A. is pregnant.
- B. is immunocompromised.
- C. is allergic to neomycin.
- D. has a cold.
Correct Answer: D
Rationale: A simple cold without fever does not preclude vaccination. Choices 1 and 2 are incorrect because pregnant women and immunocompromised individuals cannot have the MMR vaccine because the rubella component is a live virus and might cause birth defects and/or disease. Choice 3 is incorrect because the American Academy of Pediatrics states, 'Persons who have experienced anaphylactic reactions to topically or systemically administered neomycin should not receive measles vaccine.'
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Mr. Lee comes to the clinic with thick green drainage around his eyelids. The nurse examiner takes his history and performs a physical examination, beginning with an eye history. General information the nurse should seek is:
- A. type of employment.
- B. burning or itchy sensation in the eyes.
- C. position of the eyelids.
- D. existence of floaters.
Correct Answer: A
Rationale: Data belonging in a general health history of the eye includes employment, activities, allergies, medications, lenses, and protective devices used.
When teaching a woman about possible side effects of hormone replacement therapy, the nurse should include information about all of the following except:
- A. Hypoglycemia in diabetic women.
- B. The possible return of monthly menses when taking combination hormones.
- C. Increased risk of gallbladder disease.
- D. Increased risk of breast, cervical, and ovarian cancer with long-term use.
Correct Answer: A
Rationale: When taking estrogen, there is an increased risk of diabetes or hyperglycemia due to lowered glucose tolerance. It is true that monthly menses might return when taking combination hormones. The progestin is responsible for this. There is also a risk of gallbladder disease. It is also true that there is an increased risk of breast, cervical, and ovarian cancer with long-term hormone replacement therapy.
In infants and children, the side effects of first-generation over-the-counter (OTC) antihistamines, such as diphenhydramine (Benedryl) and hydroxyzine (Atarax), can include:
- A. Reye's syndrome.
- B. cholinergic effects.
- C. paradoxical CNS stimulation.
- D. nausea and diarrhea.
Correct Answer: C
Rationale: Typically, first-generation OTC antihistamines have a sedating effect because of passage into the CNS. However, in some individuals, especially infants and children, paradoxical CNS stimulation occurs and is manifested by excitement, euphoria, restlessness, and confusion. For this reason, use of first-generation OTC antihistamines has declined and second-generation product use has increased. Reye's syndrome is a systemic response to a virus. First-generation OTC antihistamines do not exhibit a cholinergic effect. Nausea and diarrhea are uncommon with first-generation OTC antihistamines.
If a client has chronic renal failure, which of the following sexual complications is the client at risk of developing?
- A. retrograde ejaculation
- B. decreased plasma testosterone
- C. hypertrophy of testicles
- D. state of euphoria
Correct Answer: B
Rationale: Untreated chronic renal failure causes decreased testosterone levels, atrophy of testicles, and decreased spermatogenesis. Retrograde ejaculation is not a complication of chronic renal failure. It is a complication of transurethral resection of the prostate. In chronic renal failure, the testicles atrophy; they do not hypertrophy. Chronic renal failure produces a state of depression, not euphoria.
A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS. Which of the following side effects should the patient specifically watch out for?
- A. Weakness and SOB
- B. Fever and anemia
- C. Hypertension and SOB
- D. Fever and hypertension
Correct Answer: B
Rationale: Anemia and fever are associated with Zidovudine's side effects.