A nurse in a clinic is assessing a 60-year-old client at an annual examination. The client asks the nurse about receiving a shingles vaccination. The nurse should identify that which of the following medications prescribed to the client is a contraindication for receiving this vaccine?

Metformin

Methotrexate

Esomeprazole

Estrogen

Answer and Explanation

The Correct Answer is B

A. Metformin is not a contraindication for receiving the shingles vaccine.

B.   Methotrexate, an immunosuppressant medication, can interfere with the efficacy of live vaccines such as the shingles vaccine, and it is generally contraindicated to administer live vaccines to individuals taking immunosuppressants.

C.   Esomeprazole, a proton pump inhibitor, is not a contraindication for receiving the shingles vaccine.
D.   Estrogen is not a contraindication for receiving the shingles vaccine.

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Correct Answer is C

Explanation

A. Hypomagnesemia: While lithium can affect magnesium levels, starting a new exercise program is not typically associated with hypomagnesemia. Hypomagnesemia may result in muscle weakness, tremors, and cardiac dysrhythmias.
B. Hypocalcemia: Starting a new exercise program is not typically associated with hypocalcemia. Hypocalcemia may present with muscle cramps, tetany, and seizures.
C. Hyponatremia: Starting a new exercise program may lead to dehydration and electrolyte imbalances, including hyponatremia (low sodium levels). This can have profound effects on patients taking lithium. Symptoms of hyponatremia include weakness, confusion, and seizures.
D. Hypokalemia is not a common occurrence among individuals doing exercise.

A. “Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose." B. "Plan to self-administer this medication for the next 6 months." C. "Lie down for 1 hour after administering the medication." D. "Administer the medication into one nostril once per week."

Correct Answer is D

Explanation

A. “Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose": This statement is not necessary for the administration of nasal cyanocobalamin. Nasal decongestants are not routinely recommended before administering nasal medications.
B. "Plan to self-administer this medication for the next 6 months": While the duration of treatment for pernicious anemia may vary, specifying a timeframe of 6 months for self- administration is not appropriate without considering individualized treatment plans.

C. "Lie down for 1 hour after administering the medication": There is no need for the client to lie down after administering nasal cyanocobalamin. This instruction is not necessary and may not be practical.
D. "Administer the medication into one nostril once per week": This is the correct instruction for administering nasal cyanocobalamin. It is typically given once weekly into one nostril. This
method provides a convenient and effective route for vitamin B12 supplementation in clients with pernicious anemia.

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A nurse in a clinic is assessing a 60-year-old client at an annual examination. The client asks the nurse about receiving a shingles vaccination. The nurse should identify that which of the following medications prescribed to the client is a contraindication for receiving this vaccine?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is taking lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?

Correct Answer is C

Explanation

A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Correct Answer is D

Explanation

A nurse is interviewing a client who was newly admitted prior to administering medications. The client tells the nurse. "I forgot to tell the doctor! take albuterol for asthma." For which of the following medications should the nurse withhold the dose and notify the provider?

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