Question

A nurse is preparing to administer vaccines to an 11-year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer?

Answer 1

Correct Answers:

Quadrivalent human papillomavirus

Rationale :

🔷 The quadrivalent HPV vaccine is recommended for preteens starting at age 11 or 12, ideally before the onset of sexual activity, to protect against HPV types that cause cervical, anal, and other cancers and genital warts.

🔷 The CDC immunization schedule advises that children at this age receive the HPV vaccine, along with Tdap (tetanus, diphtheria, pertussis) and meningococcal conjugate vaccine.

🔷 Hepatitis B, rotavirus, and pneumococcal conjugate (PCV13) are given during infancy and early childhood, and are not part of routine immunizations at age 11 if the child is already up to date.

🔷 Administering the HPV vaccine during preadolescence maximizes immune response and preventive benefit before any potential exposure.

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Answer 2

Correct Answers:

Decreased uric acid

Rationale :

💎 Allopurinol is a xanthine oxidase inhibitor used to lower serum uric acid levels, primarily in clients with gout or uric acid nephrolithiasis.

💎 The medication works by inhibiting the enzyme that converts xanthine to uric acid, thereby reducing uric acid production and preventing crystal formation in joints and kidneys.

💎 A decrease in serum uric acid is a clear indicator of therapeutic effectiveness and response to treatment with allopurinol.

💎 The other lab values—triglycerides, albumin, and potassium—are not direct indicators of allopurinol efficacy and would not be used to monitor its therapeutic outcome.

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Answer 3

Correct Answers:

Renal excretion time slows for medication.

Rationale :

🔶 Aging leads to a decline in renal function, including reduced glomerular filtration rate (GFR) and renal blood flow, which causes slower excretion of medications.

🔶 This change increases the half-life of renally-excreted drugs, raising the risk for drug accumulation and toxicity in older adults.

🔶 In contrast, brain receptors often become more sensitive, gastric emptying typically slows, and hepatic metabolism often declines rather than speeding up with age.

🔶 Nurses must consider these physiological changes when calculating dosages, choosing medications, and monitoring for adverse effects in the elderly.

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Answer 4

Correct Answers:

Sedation

Rationale :

🔹 Oxycodone is an opioid analgesic that can cause central nervous system (CNS) depression when taken in excess, leading to sedation, lethargy, or unresponsiveness.

🔹 Opioid overdose is typically associated with the classic triad: sedation (or coma), respiratory depression, and pinpoint pupils (not dilation).

🔹 Bradycardia and hypoventilation (not tachycardia or tachypnea) are more common in opioid toxicity due to its depressive effects on the brainstem.

🔹 Sedation is one of the earliest and most noticeable signs, requiring immediate intervention to prevent progression to respiratory failure.

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Answer 5

Correct Answers:

Lithium carbonate

Rationale :

✴️ Furosemide is a loop diuretic that promotes significant sodium and water loss. When used with lithium carbonate, there is a high risk of lithium toxicity because sodium depletion enhances renal reabsorption of lithium, raising serum levels.

✴️ Clients on both medications require close monitoring of lithium levels and often a dose adjustment.

✴️ The other medications listed — albuterol (a bronchodilator), levothyroxine (thyroid hormone), and cetirizine (antihistamine) — do not have a direct contraindication with furosemide, though general monitoring is still necessary.

✴️ Combining lithium with diuretics like furosemide is potentially dangerous and typically avoided unless essential and closely managed.

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Answer 6

Correct Answers:

Monitor for gingival hyperplasia.

Rationale :

✔️ Phenytoin, an anticonvulsant used to manage tonic-clonic seizures, commonly causes gingival hyperplasia (overgrowth of gum tissue), especially with long-term use.

✔️ Clients should be advised to maintain good oral hygiene, use a soft-bristled toothbrush, and have regular dental checkups to minimize this effect.

✔️ Phenytoin does not lower potassium levels; its primary concern is with folic acid and calcium/vitamin D metabolism.

✔️ Ginkgo biloba may reduce phenytoin's effectiveness—not increase it—due to potential interactions affecting drug metabolism.

✔️ Sunlight sensitivity is not a typical adverse effect associated with phenytoin.

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Answer 7

Correct Answers:

"I will avoid eating fatty foods while I take this medication."

Rationale :

♦️ Sildenafil is best taken on an empty stomach or with a light meal, as high-fat meals can delay absorption and reduce its effectiveness.

♦️ The medication is typically taken once daily as needed, about 30–60 minutes before sexual activity, not twice daily.

♦️ Sildenafil does not provide protection against sexually transmitted infections (STIs), so barrier protection like condoms is still necessary.

♦️ Constipation is not a known or common adverse effect of sildenafil; more typical side effects include headache, flushing, nasal congestion, and dizziness.

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Answer 8

Correct Answers:

Reduced bronchial inflammation

Rationale :

🟢 Montelukast is a leukotriene receptor antagonist used for long-term control of asthma and allergic rhinitis by blocking leukotrienes, which are inflammatory mediators.

🟢 This action leads to reduced bronchial inflammation, decreased mucus production, and improved airway function, helping prevent asthma attacks and nighttime symptoms.

🟢 It is not used for gastric acid, vascular effects, or to increase WBC count—its role is strictly related to airway inflammation control in respiratory conditions.

🟢 It is especially beneficial for clients with exercise-induced bronchospasm or chronic allergic responses.

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Answer 9

Correct Answers:

Select an injection site that is free of scar tissue. B.

Rationale :

🟣 The tuberculin skin test (TST), also known as the Mantoux test, must be administered intradermally in an area that allows for accurate reading of induration, typically on the inner forearm.

🟣 Scar tissue can interfere with the immune response and the nurse's ability to accurately interpret the results, so a site free of scars, rashes, or other skin abnormalities should be selected.

🟣 The correct technique involves holding the needle at a 5–15° angle, injecting 0.1 mL of purified protein derivative (PPD), not 0.3–0.5 mL, and not massaging the site to avoid dispersing the solution.

🟣 A proper wheal should form to indicate the injection was made into the intradermal layer.

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Answer 10

Correct Answers:

"I will increase my daily intake of fiber and fluid."

Rationale :

🟢 Verapamil, a calcium channel blocker, often causes constipation as a common side effect, especially in older adults. Increasing fiber and fluid intake helps to minimize this gastrointestinal effect.

🟢 The medication should be swallowed whole—not crushed, as it is sustained-release and designed for slow absorption to avoid toxicity.

🟢 Sitting upright for 30 minutes is recommended for medications like bisphosphonates, not verapamil.

🟢 There is no routine requirement for monthly anemia labs with verapamil use; it is not known to significantly affect red blood cell production.

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QLexNursing

1 :
A nurse is preparing to administer vaccines to an 11-year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer?

2 :
A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?

3 :
A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?

4 :
A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect?

5 :
A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?

6 :
A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching?

7 :
A nurse is reinforcing teaching with a client who has a prescription for sildenafil to treat erectile dysfunction. Which of the following statements by the client indicates an understanding of the teaching?

8 :
A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?

9 :
A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?

10 :
A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching?

QLexNursing

1 : A nurse is preparing to administer vaccines to an 11-year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer?

2 : A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?

3 : A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?

4 : A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect?

5 : A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?

6 : A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching?

7 : A nurse is reinforcing teaching with a client who has a prescription for sildenafil to treat erectile dysfunction. Which of the following statements by the client indicates an understanding of the teaching?

8 : A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?

9 : A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?

10 : A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching?

1 :
A nurse is preparing to administer vaccines to an 11-year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer?

2 :
A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?

3 :
A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?

4 :
A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect?

5 :
A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?

6 :
A nurse is reinforcing teaching about phenytoin with a client who had a tonic-clonic seizure. Which of the following information should the nurse include in the teaching?

7 :
A nurse is reinforcing teaching with a client who has a prescription for sildenafil to treat erectile dysfunction. Which of the following statements by the client indicates an understanding of the teaching?

8 :
A nurse working in an urgent care clinic is collecting data from a client who takes montelukast. Which of the following is an expected therapeutic effect of this medication?

9 :
A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?

10 :
A nurse is reinforcing teaching with a client who has a new prescription for sustained-release verapamil. Which of the following statements by the client indicates an understanding of the teaching?