Nokea
If the measles, mumps, rubella, and varicella (MMRV) combined vaccine is ordered to be given as the first MMR and varicella dose to a child the CDC recommends:
- A. Parents be informed of the increased risk of fever and febrile seizures over the MMR plus varicella two-shot regimen
- B. Patients must also receive MMRV as the second dose of MMR and varicella in order to build adequate immunity
- C. Patients be premedicated with acetaminophen 15 minutes before the vaccine is given
- D. Patients should not be around pregnant women for the first 48 hours after the vaccine is given
Correct Answer: A
Rationale: MMRV has higher fever/seizure risk vs. separate shots, per CDC; second dose isn't mandated as MMRV.
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The adverse event of thiazolidinedione's is:
- A. Water retention and edema
- B. Weight loss
- C. Facilitation of rhinitis and upper respiratory tract infection
- D. Pancreatitis
Correct Answer: A
Rationale: Thiazolidinediones like pioglitazone cause water retention and edema, increasing heart failure risk.
A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of dizzy spells and weakness. While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
- A. The impact of the placebo effect on the patients response.
- B. The accumulative effect of the drug if it has been taken for many years.
- C. The impact of the warmer environment on the patients physical status.
- D. Problems with patient compliance with the drug regimen while on vacation.
Correct Answer: C
Rationale: Antihypertensive drugs work to decrease the blood pressure. When a patient goes to a climate that is much warmer than usual, blood vessels dilate and the blood pressure falls. If a patient is taking an antihypertensive drug and moves to a warmer climate, there is a chance that the patients blood pressure will drop too low, resulting in dizziness and feelings of weakness. Even mild dehydration could exacerbate these effects. Most antihypertensives are metabolized and excreted and do not accumulate in the body. Patients must be very compliant with their drug regimen on vacation. After several years on an antihypertensive drug, the effects of that drug are known; therefore, the placebo effect should not be an issue.
Which of the following is natural mineralcorticoid:
- A. Methylprednisolone
- B. Betamethasone
- C. Triamcinolone
- D. Aldosterone
Correct Answer: D
Rationale: Aldosterone is the primary natural mineralocorticoid, regulating sodium and potassium balance.
A nurse is assessing a client who is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?
- A. Light yellow urine
- B. Report of tinnitus
- C. Productive cough
- D. Blue-gray skin discoloration
Correct Answer: C
Rationale: Productive cough may indicate pulmonary toxicity, a serious amiodarone side effect.
The nurse would expect to see an adjusted dosage in what patients? (Select one that does not apply.)
- A. Young adult women
- B. older adults
- C. Infants
- D. Neonates
Correct Answer: A
Rationale: Infants, neonates, and older adults require dosage adjustments due to differences in metabolism and organ function.