A nurse in a clinic is preparing to administer the measles, mumps, rubella (MMR) vaccine to a client. Which of the following findings should indicate to the nurse that the client has a contraindication for the MMR vaccine?

The client had a local reaction from a previous immunization

The client reports having diarrhea this morning

The client is at 9 weeks of gestation

The client reports an allergy to penicillin.

Answer and Explanation

The Correct Answer is C

A. The client had a local reaction from a previous immunization. A mild local reaction, such as redness or swelling at the injection site, is not a contraindication to receiving the MMR vaccine. These reactions are common and typically resolve without complications. Only severe allergic reactions, such as anaphylaxis, would warrant withholding the vaccine.

B. The client reports having diarrhea this morning. Mild illnesses, such as diarrhea or the common cold, do not contraindicate vaccination. The MMR vaccine can be safely administered as long as the client does not have a moderate to severe illness with fever. Delaying immunization due to minor illnesses could lead to unnecessary gaps in vaccine coverage.

C. The client is at 9 weeks of gestation. The MMR vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the theoretical risk of fetal harm. Pregnant individuals should wait until after delivery to receive the vaccine. If a client of childbearing age is vaccinated, they should be advised to avoid pregnancy for at least 4 weeks following immunization to reduce the risk of congenital rubella syndrome.

D. The client reports an allergy to penicillin. A penicillin allergy is not a contraindication for the MMR vaccine. The MMR vaccine does not contain penicillin or related antibiotics. Severe allergic reactions to vaccine components, such as neomycin or gelatin, would be more relevant contraindications. Clients with a penicillin allergy can safely receive the MMR vaccine without concern.

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Correct Answer is B

Explanation

A. Oatmeal. Oatmeal is a healthy carbohydrate and fiber source, but it is not a significant source of potassium, which is essential for clients taking furosemide. While beneficial for overall health, oatmeal will not help counteract potassium loss caused by diuretic therapy.

B. Baked potatoes. Baked potatoes are rich in potassium, which is frequently lost due to furosemide’s potassium-wasting effects. Furosemide is a loop diuretic that increases urine output and depletes electrolytes, particularly potassium, which can lead to hypokalemia (low potassium levels). To help maintain electrolyte balance, clients should consume potassium-rich foods like potatoes, bananas, oranges, and spinach.

C. Brown rice. Brown rice is a good source of fiber and complex carbohydrates, but it contains only small amounts of potassium. While it provides sustained energy, it does not significantly contribute to potassium replacement, making it less beneficial for clients on furosemide.

D. Eggs. Eggs are high in protein and essential nutrients but are not a significant source of potassium. While eggs are beneficial for overall health, they do not help replenish potassium lost due to diuretic therapy.

A. Anorexia B. Jaw pain C. Insomnia D. Bruising

Correct Answer is B

Explanation

A. Anorexia. While gastrointestinal side effects such as nausea and esophageal irritation can occur with alendronate, anorexia is not a common adverse effect. If severe nausea leads to decreased appetite, the client should report this to their provider, but it is not a primary concern compared to more serious side effects.

B. Jaw pain. Jaw pain can indicate osteonecrosis of the jaw (ONJ), a rare but serious adverse effect associated with long-term bisphosphonate use. This condition involves poor bone healing, especially after dental procedures, and can lead to bone deterioration. Clients taking alendronate should report any persistent jaw pain and undergo regular dental exams to monitor bone health.

C. Insomnia. Alendronate does not typically cause insomnia. While some medications, such as corticosteroids and stimulants, are linked to sleep disturbances, alendronate does not affect the central nervous system in a way that would disrupt sleep patterns.

D. Bruising. Alendronate does not interfere with platelet function or coagulation, making bruising an unlikely adverse effect. Clients who experience unexplained bruising should be evaluated for other underlying causes, such as blood disorders or medication interactions.

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A nurse in a clinic is preparing to administer the measles, mumps, rubella (MMR) vaccine to a client. Which of the following findings should indicate to the nurse that the client has a contraindication for the MMR vaccine?

Nursing Test Bank

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Explanation

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Correct Answer is B

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