Nokea
A nurse is assisting in the development of an in-service about the varicella vaccine. The nurse should include which of the following examples as a contraindication for receiving the vaccine?
- A. A client who is breastfeeding
- B. A client who has an allergy to latex
- C. A client who has a sinus infection
- D. A client who is pregnant
Correct Answer: D
Rationale: The correct answer is D: A client who is pregnant. Varicella vaccine is contraindicated during pregnancy due to potential risks to the fetus. Varicella vaccine is a live vaccine and can pose a risk of transmission to the fetus, potentially causing harm. Other choices are incorrect because: A: Breastfeeding is not a contraindication for varicella vaccine. B: Latex allergy is not a contraindication for varicella vaccine. C: Sinus infection is not a contraindication for varicella vaccine.
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A nurse is reinforcing teaching with a client who has a new prescription for benazepril. Which of the following instructions should the nurse include?
- A. Make sure to change positions slowly.
- B. Avoid drinking grapefruit juice with this medication.
- C. Discontinue this medication if you develop a cough.
- D. Use salt substitutes for cooking.
Correct Answer: A
Rationale: The correct answer is A: Make sure to change positions slowly. Benazepril is an ACE inhibitor that can cause orthostatic hypotension, leading to dizziness or fainting when changing positions quickly. Instructing the client to change positions slowly can help prevent this adverse effect. Choice B is incorrect because grapefruit juice does not interact with benazepril. Choice C is incorrect as a cough is a common side effect of ACE inhibitors, and discontinuing the medication without consulting a healthcare provider is not recommended. Choice D is incorrect because using salt substitutes can lead to high potassium levels when taking benazepril.
A nurse is assisting in the care of a client who is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?
- A. Ensure that the unit of packed RBCs is transfused within 6 hr.
- B. Obtain 0.9% sodium chloride solution for IV infusion.
- C. Use filterless IV tubing for the transfusion.
- D. Remain at the client's bedside for the first 5 min of the transfusion.
Correct Answer: B
Rationale: The correct answer is B because 0.9% sodium chloride solution is the appropriate IV solution to use when administering packed RBCs to prevent hemolysis. The sodium chloride solution is isotonic, which helps maintain the integrity of the RBCs during transfusion. Other choices are incorrect because: A: There is no specific time limit within which packed RBCs must be transfused. C: Using filterless IV tubing can increase the risk of air embolism and contamination. D: Remaining at the client's bedside for only 5 minutes is inadequate for monitoring potential adverse reactions during the transfusion.
A nurse is collecting data from a client who is taking lithium carbonate to treat bipolar disorder. For which of the following findings should the nurse monitor and report to the provider?
- A. Bruising
- B. Tremor
- C. Constipation
- D. Hypoglycemia
Correct Answer: B
Rationale: The correct answer is B: Tremor. Lithium carbonate is commonly associated with causing tremors as a side effect. The nurse should monitor and report any tremors in the client taking lithium as it could indicate lithium toxicity. Bruising (A), constipation (C), and hypoglycemia (D) are not typically associated with lithium carbonate use in treating bipolar disorder.
A nurse is talking with a client who takes NSAIDs routinely to treat osteoarthritis and has a new prescription for misoprostol. The client asks the nurse why he needs the second medication. Which of the following is an appropriate response?
- A. Misoprostol will help prevent stomach ulcers, which can develop from taking NSAIDs for a long time.
- B. Misoprostol helps protect you against the effects long-term NSAID use can have on your kidney function.
- C. Misoprostol will boost the effectiveness of the NSAIDs, so you can get the same pain relief with lower dosages.
- D. Misoprostol is a very effective antacid that will help reduce the stomach irritation you can get from NSAIDs.
Correct Answer: A
Rationale: The correct answer is A because misoprostol is often prescribed along with NSAIDs to help prevent stomach ulcers that can develop from long-term NSAID use. NSAIDs can irritate the stomach lining and increase the risk of ulcers. Misoprostol works by reducing the production of stomach acid and protecting the stomach lining. Choices B, C, and D are incorrect because misoprostol is specifically used to protect the stomach from NSAID-related ulcers, not to protect kidney function, boost NSAID effectiveness, or act as an antacid.
A nurse is collecting data from a client who is taking high doses of aspirin to treat rheumatoid arthritis. Which of the following findings indicates that the client has salicylism?
- A. Tinnitus
- B. Nuchal rigidity
- C. Pharyngitis
- D. Pruritus
Correct Answer: A
Rationale: The correct answer is A: Tinnitus. Salicylism is a toxic condition caused by high levels of salicylates, such as aspirin, in the body. Tinnitus is a common early sign of salicylism due to its ototoxic effects on the auditory nerve. Nuchal rigidity, pharyngitis, and pruritus are not typically associated with salicylism. Nuchal rigidity is more indicative of meningitis, pharyngitis suggests a throat infection, and pruritus is itching which is not specific to salicylism. Therefore, tinnitus is the most relevant finding in this context.