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 A

Explanation

A. Bleeding. Cefotetan, a second-generation cephalosporin, can interfere with vitamin K metabolism, leading to a decreased ability to form blood clots. When combined with NSAIDs, which have an antiplatelet effect, the risk of bleeding increases. Clients taking both medications should be monitored for bruising, prolonged bleeding, or signs of gastrointestinal hemorrhage such as black, tarry stools.

B. Dysrhythmias. Cefotetan and NSAIDs do not have significant cardiac effects that would lead to dysrhythmias. Some antibiotics, such as macrolides and fluoroquinolones, can cause QT prolongation, but cefotetan does not affect cardiac conduction.

C. Dizziness. While NSAIDs can sometimes cause dizziness as a side effect, this is not a significant interaction between cefotetan and NSAIDs. Cefotetan does not commonly cause dizziness unless associated with an allergic reaction or severe hypotension due to an adverse effect.

D. Jaundice. Cefotetan is metabolized by the liver, but it is not highly hepatotoxic and does not commonly cause jaundice. NSAIDs, when used long-term or in high doses, may contribute to liver dysfunction, but this is not a primary concern in the interaction between these two medications.

A. Orthostatic hypotension B. Hyperglycemia C. Paresthesia D. Jaundice

Correct Answer is B

Explanation

A. Orthostatic hypotension. Prednisone does not typically cause orthostatic hypotension. Instead, corticosteroids can lead to fluid retention and hypertension due to their effects on sodium and water balance. Orthostatic hypotension is more commonly associated with medications such as diuretics or antihypertensives.

B. Hyperglycemia. Prednisone is a glucocorticoid that increases blood glucose levels by enhancing gluconeogenesis and reducing insulin sensitivity. This effect can make blood sugar more difficult to control in clients who take insulin, potentially requiring higher insulin doses to maintain glycemic control. Clients with diabetes or those taking insulin should closely monitor their blood glucose levels while on prednisone.

C. Paresthesia. Paresthesia (numbness or tingling) is not a common adverse effect of prednisone or a direct interaction with insulin. While uncontrolled diabetes can cause diabetic neuropathy, prednisone does not typically cause neurological symptoms like tingling.

D. Jaundice. Prednisone is not commonly associated with hepatotoxicity or liver dysfunction leading to jaundice. However, long-term corticosteroid use may increase liver enzyme levels, but it does not typically cause direct liver damage or bile obstruction. Jaundice would require evaluation for other underlying liver conditions.

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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

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medication administration record of a client who has a wound infection. The client has prescriptions for cefotetan and an NSAID. The nurse should monitor for which of the following medication interactions?

Correct Answer is A

Explanation

A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

Correct Answer is B

Explanation

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