A nurse in a community health clinic is preparing to administer the inactivated influenza vaccine to a group of clients. The nurse should recognize that this immunization is contraindicated for which of the following clients?

A young adult who has a febrile illness

A young adult who is pregnant

A child who has a hypersensitivity to amoxicillin

A child who has cerebral palsy

Answer and Explanation

The Correct Answer is A

A. A young adult who has a febrile illness: Receiving an inactivated influenza vaccine during an acute febrile illness can increase the risk of adverse reactions and may reduce the immune response. Vaccination should be postponed until the illness resolves.

B. A young adult who is pregnant: Inactivated influenza vaccines are safe during pregnancy and are recommended to protect both the mother and the fetus from influenza-related complications. Pregnancy is not a contraindication.

C. A child who has a hypersensitivity to amoxicillin: Hypersensitivity to antibiotics like amoxicillin does not contraindicate the influenza vaccine, as there is no cross-reactivity between amoxicillin and the vaccine components.

D. A child who has cerebral palsy: Cerebral palsy is a neurological condition and does not prevent administration of the inactivated influenza vaccine. Vaccination is encouraged in children with chronic conditions to reduce infection risk.

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Correct Answer is A

Explanation

A. Heart rate of 56/min: Propranolol is a beta-blocker that can lower heart rate. A heart rate below 60/min may indicate bradycardia, which can be dangerous and requires intervention before administering the next dose.

B. SaO2 95% on 2 L/min of oxygen: Oxygen saturation of 95% on supplemental oxygen is within an acceptable range and does not require immediate intervention.

C. Blood pressure 106/68 mm Hg: While slightly on the lower side, this blood pressure is generally considered acceptable for many adults and does not typically necessitate an immediate intervention.

D. Respirations 22/min: A respiratory rate of 22/min is mildly elevated but usually not critical. It does not require withholding propranolol or immediate intervention in a stable client.

A. Client reports starting to have mild headaches earlier this week. B. Also states, "Yesterday I was very nauseated and threw up before breakfast." C. When talking to client they have difficulty remembering the times they are taking their oxcarbazepine. D. Client reports using oral contraceptives as the only means of birth control. E. Hct 40% (37% to 47%) F. Hgb 13g/dL (12 to 16g/dL) G. Sodium 124 mEq/L (136 to 145 mEq/L) H. Temperature 36.3° C (97.4° F) I. Heart rate 86/min J. Blood pressure 110/66 mm Hg

Correct Answer is ["B","C","G"]

Explanation

Rationale for correct choices:

Sodium 124 mEq/L: The client’s serum sodium is critically low, indicating severe hyponatremia, a known serious adverse effect of oxcarbazepine. Hyponatremia can lead to confusion, seizures, and potentially life-threatening neurological complications, requiring immediate provider follow-up and possible medication adjustment or discontinuation.
Difficulty remembering medication times: Cognitive changes or confusion may indicate central nervous system effects of oxcarbazepine or complications from hyponatremia. This finding signals the need for urgent reassessment and intervention to prevent medication errors or toxicity.
Nausea/vomiting: Persistent nausea and vomiting, especially after a recent dose increase, may be a sign of drug intolerance, early hyponatremia symptoms, or central nervous system effects. Immediate follow-up is necessary to prevent further complications and dehydration.

Rationale for Incorrect Choices:

Mild headache: While headaches may occur with oxcarbazepine, the mild nature and recent onset are less urgent compared with severe hyponatremia and neurological symptoms.
Vital signs (HR 86, BP 110/66, Temp 36.3° C, RR 16): These are slightly lower than baseline but not immediately concerning. The priority is lab abnormality and neurological changes.
Hct 40%, Hgb 13 g/dL: These values remain within normal limits and do not require immediate intervention.
Use of oral contraceptives: This is important for counseling because oxcarbazepine can reduce contraceptive efficacy, but it is not an urgent clinical finding compared to hyponatremia.

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A nurse in a community health clinic is preparing to administer the inactivated influenza vaccine to a group of clients. The nurse should recognize that this immunization is contraindicated for which of the following clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has hypertension and is receiving propranolol. Which of the following findings require an intervention by the nurse?

Correct Answer is A

Explanation

Correct Answer is ["B","C","G"]

Explanation

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