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 client with arthritis is self-medicating with aspirin, a nonsteroidal anti-inflammatory medication. Which complication should the nurse discuss with the client?
- A. Tinnitus.
- B. Diarrhea.
- C. Tetany.
- D. Paresthesia.
Correct Answer: A
Rationale: High-dose aspirin can cause tinnitus, an early sign of salicylate toxicity, requiring education. Diarrhea, tetany, or paresthesia are less common.
The nurse is administering carbidopa/levodopa (Sinemet) to the client. Which assessment should the nurse perform to determine if the medication is effective?
- A. Assess the client's muscle strength.
- B. Assess for cogwheel movements.
- C. Assess the carbidopa serum level.
- D. Assess the client's blood pressure.
Correct Answer: B
Rationale: Carbidopa/levodopa reduces Parkinson’s symptoms like cogwheel rigidity; decreased cogwheel movements indicate effectiveness. Strength, levels, or BP are less specific.
A 66 year-old client is admitted for mitral valve replacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis since her teenage years. During the admission assessment, the nurse should ask the client if as a child she had
- A. measles
- B. rheumatic fever
- C. hay fever
- D. encephalitis
Correct Answer: B
Rationale: rheumatic fever. Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.
The client is receiving the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec). When would the nurse question administering this medication?
- A. The client is not receiving potassium supplements.
- B. The client complains of a persistent irritating cough.
- C. The blood pressure for two (2) consecutive readings is 110/70.
- D. The client's urinary output is 400 mL for the last eight (8) hours.
Correct Answer: B
Rationale: A persistent cough is a common ACE inhibitor side effect, warranting discontinuation or HCP evaluation. Potassium, BP, or urine output are less critical.
The nurse is assessing a 7 year-old after several days of treatment for a documented strep throat. Which of the following statements suggests that further teaching is needed?
- A. Sometimes I take my medicine with fruit juice.'
- B. My mother makes me take my medicine right after school.'
- C. Sometimes I take the pills in the morning and other times at night.'
- D. I am feeling much better than I did last week.'
Correct Answer: C
Rationale: Sometimes I take the pills in the morning and other times at night.' Inconsistency in taking the prescribed medication indicates more teaching is needed.