Nokea
A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?
- A. A pregnant parent
- B. Receiving treatment for leukemia
- C. Taking acetaminophen for mild discomfort
- D. An allergy to eggs
Correct Answer: B
Rationale: The correct answer is B: Receiving treatment for leukemia. This is because individuals with leukemia have weakened immune systems, making them more susceptible to infections. Administering a live vaccine like varicella could potentially cause severe complications in these individuals.
Incorrect choices:
A: A pregnant parent - Pregnancy is not a contraindication for varicella vaccine.
C: Taking acetaminophen for mild discomfort - Acetaminophen does not interfere with varicella vaccine.
D: An allergy to eggs - Varicella vaccine is made using gelatin, not eggs, so egg allergy is not a contraindication.
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A nurse is reinforcing teaching with a client who is to start therapy with furosemide. The nurse determines that the teaching is effective when the client states he will increase intake of which of the following foods?
- A. Oatmeal
- B. Baked potatoes
- C. Brown rice
- D. Eggs
Correct Answer: B
Rationale: The correct answer is B: Baked potatoes. Furosemide is a loop diuretic that can lead to potassium depletion. Baked potatoes are high in potassium, which can help prevent hypokalemia associated with furosemide therapy. Oatmeal, brown rice, and eggs are not particularly high in potassium and would not be the best choice for increasing potassium intake. By choosing baked potatoes, the client can help maintain adequate potassium levels while on furosemide therapy.
A nurse is preparing to administer morphine 0.1 mg/kg IM to a school-age child who weighs 66 lb. What is the dose that the nurse should administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Correct Answer: 3
Rationale: The correct answer is 3. To calculate the dose, first convert the child's weight from lb to kg: 1 kg = 2.2 lb, so 66 lb ÷ 2.2 = 30 kg. Then, multiply the weight (30 kg) by the dose (0.1 mg/kg): 30 kg x 0.1 mg/kg = 3 mg. Since the question asks for the dose rounded to the nearest whole number, the nurse should administer 3 mg of morphine.
Choice A, B, C, D, E, F, and G are incorrect because they do not follow the correct calculation process. The correct dose is determined by the weight of the child and the prescribed dosage of 0.1 mg/kg, which yields 3 mg in this case.
A nurse is caring for a client who has cellulitis and is to begin antibiotic therapy. The client has a history of anaphylactic reaction to penicillin. Which of the following medications is contraindicated for this client?
- A. Fluconazole
- B. Tetracycline
- C. Acyclovir
- D. Cephalexin
Correct Answer: D
Rationale: The correct answer is D: Cephalexin. Cephalexin is a first-generation cephalosporin antibiotic, which shares a similar beta-lactam ring structure with penicillin. Due to the client's history of anaphylactic reaction to penicillin, there is a high risk of cross-reactivity and potential severe allergic reaction if cephalexin is administered. Therefore, it is contraindicated for this client.
Choice A: Fluconazole is an antifungal medication and does not have cross-reactivity with penicillin.
Choice B: Tetracycline is a broad-spectrum antibiotic that is not related to penicillin.
Choice C: Acyclovir is an antiviral drug and is not contraindicated in a client with a penicillin allergy.
A nurse is reinforcing teaching with a client who has a new prescription for digoxin. Which of the following herbal supplements should the nurse include as a contraindication for this medication?
- A. Glucosamine
- B. Garlic
- C. St. John's wort
- D. Ginkgo biloba
Correct Answer: C
Rationale: The correct answer is C: St. John's wort. St. John's wort can decrease the effectiveness of digoxin, leading to reduced therapeutic effects. This is due to St. John's wort inducing the enzymes that metabolize digoxin, resulting in lower drug levels in the body. Glucosamine (A), garlic (B), and ginkgo biloba (D) do not have significant interactions with digoxin. It is important to educate the client about potential herb-drug interactions to ensure the safety and effectiveness of their treatment.
A nurse is preparing to administer erythromycin PO to a client who has an infection. The nurse checks the client's medical record and notes that the client has a severe allergy to penicillin. Which of the following actions should the nurse take?
- A. Premedicate the client with diphenhydramine.
- B. Request a different route of administration from the provider.
- C. Administer the medication to the client.
- D. Request a different medication from the provider.
Correct Answer: C
Rationale: Rationale:
The correct action is to administer the medication to the client (Choice C) because erythromycin is not related to penicillin, and having a severe allergy to penicillin does not contraindicate the use of erythromycin. Premedicating with diphenhydramine (Choice A) is not necessary as there is no cross-reactivity between erythromycin and penicillin. Requesting a different route of administration (Choice B) is unnecessary as the oral route is appropriate for erythromycin. Requesting a different medication (Choice D) is not required, as erythromycin is safe to use in a client with a penicillin allergy.