Nokea
The employee health nurse is discussing hepatitis B vaccines with new employees. Which statement best describes the proper administration of the hepatitis B vaccine?
- A. The vaccine must be administered once a year.
- B. Two (2) mL of vaccine should be given in each hip.
- C. The vaccine is given in three (3) doses over a six (6)-month time period.
- D. The vaccine is administered intradermally into the deltoid muscle.
Correct Answer: C
Rationale: Hepatitis B vaccine is given in three IM doses (0, 1, 6 months), per CDC guidelines. Annual dosing, split doses, or intradermal routes are incorrect.
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The provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. The nurse instructs the client to discontinue the medication and contact the provider if which of the following symptoms occur?
- A. Infection of the gums
- B. Diarrhea for more than one day
- C. Numbness in the lower extremities
- D. Ringing in the ears
Correct Answer: D
Rationale: Ringing in the ears. Aspirin stimulates the central nervous system which may result in ringing in the ears.
An adult client is receiving lithium 600 mg PO tid for the treatment of bipolar disorder. The client should be taught that it is important to have adequate amounts of which substance?
- A. Potassium
- B. Sodium
- C. Calcium
- D. Magnesium
Correct Answer: B
Rationale: Adequate sodium intake is crucial with lithium to prevent toxicity, as low sodium levels increase lithium retention.
An adult client has pulmonary tuberculosis. He is receiving isoniazid (INH) 300 mg PO, ethambutol 1 g PO daily, and streptomycin 1 g IM three times a week. When he comes in for a checkup, he tells the nurse that he hates getting shots and his ears ring most of the time. What is the best interpretation for the nurse to make regarding the client's complaints?
- A. He may be receiving too much ethambutol.
- B. He should be evaluated for adverse reaction to streptomycin.
- C. Tuberculosis may have spread to the brain.
- D. He is experiencing a reaction commonly seen when INH and streptomycin are given at the same time.
Correct Answer: B
Rationale: Streptomycin is ototoxic, and ringing in the ears (tinnitus) is a sign of potential eighth cranial nerve damage, requiring evaluation.
The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the following conditions?
- A. Urinary incontinence
- B. Glaucoma
- C. Increased intracranial pressure
- D. Right sided heart failure
Correct Answer: B
Rationale: Glaucoma. Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation with an increase in aqueous humor, leading to a resultant increase in optic pressure.
A client is receiving erythromycin 500 mg IV every 6 hours to treat a pneumonia. Which of the following is the most common side effect of the medication?
- A. Blurred vision
- B. Nausea and vomiting
- C. Severe headache
- D. Insomnia
Correct Answer: B
Rationale: Nausea and vomiting. Nausea is a common side-effect of erythromycin in both oral and intravenous forms.