A healthcare provider is caring for several clients who came to the clinic for a seasonal influenza immunization. The healthcare provider should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

Correct Answer: B

Rationale: In this scenario, the correct answer is option B, the 17-year-old with a hypersensitivity to Penicillin. This client is a candidate to receive the influenza vaccine via nasal spray rather than an injection due to their hypersensitivity to Penicillin, which could potentially complicate the injection site reaction. Option A, the 1-year-old with no health problems, is not a candidate for the nasal spray influenza vaccine as it is not recommended for children under 2 years of age. Option C, the 25-year-old who is pregnant, should not receive the nasal spray vaccine as it contains a live attenuated virus, which is contraindicated during pregnancy. Option D, the 52-year-old who takes a multivitamin supplement, does not have a specific condition that would make them a candidate for the nasal spray vaccine. Educationally, this question highlights the importance of considering individual patient factors and contraindications when determining the appropriate route of administration for vaccines. It also underscores the significance of understanding vaccine components and their implications for different patient populations.

Correct Answer: B

Rationale: The correct answer is B: Hot flashes. When initiating therapy with raloxifene, clients should be advised to monitor for hot flashes as they are a common adverse effect associated with this medication. Monitoring for this symptom can help in managing and addressing the side effects of raloxifene effectively.

Correct Answer: B

Rationale: In teaching a client starting therapy with rituximab, it is crucial for the nurse to instruct the client to report fever (Option B) among the listed findings. This is because rituximab, a biologic agent used to treat various conditions including autoimmune disorders and certain cancers, can suppress the immune system, making patients more susceptible to infections. Fever can indicate an infection, which can be severe in immunocompromised individuals on rituximab. The other options - dizziness (Option A), urinary frequency (Option C), and dry mouth (Option D) - are less likely to be directly related to rituximab therapy. While dizziness can occur as a side effect of rituximab, it is not as urgent or indicative of a serious complication as fever in this context. Urinary frequency and dry mouth are typically not associated with rituximab use and are less concerning compared to potential infections. From an educational perspective, understanding the side effects and potential complications of medications like rituximab is essential for nurses to provide safe and comprehensive care to their patients. In this scenario, emphasizing the importance of recognizing and promptly reporting signs of infection, such as fever, can help prevent serious consequences and improve patient outcomes.

Correct Answer: D

Rationale: In the context of pharmacology, specifically with cyclophosphamide use in a client with breast cancer, it is crucial for the nurse to monitor for potential adverse effects. The correct answer is D) Hemorrhagic cystitis. Cyclophosphamide, an alkylating agent, is known to cause hemorrhagic cystitis, which is characterized by bladder irritation leading to hematuria. Monitoring for this adverse effect is essential to prevent complications and provide timely interventions. Option A) Hypertension is incorrect because cyclophosphamide is not typically associated with hypertension as a side effect. Option B) Hyperglycemia is also incorrect as it is not a common adverse effect of cyclophosphamide. Option C) Ototoxicity is not associated with cyclophosphamide use, making it an incorrect choice. Educationally, understanding the side effects and monitoring parameters for specific medications is crucial for nurses to ensure patient safety and optimize outcomes. By knowing the expected side effects of medications like cyclophosphamide, nurses can implement proactive monitoring and interventions, enhancing the quality of care provided to patients undergoing cancer treatment.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Sore throat. When a client is starting therapy with topotecan, a topoisomerase inhibitor commonly used in chemotherapy, it is crucial for the nurse to instruct the client to report any signs of infection promptly. Topotecan can suppress the bone marrow, leading to decreased production of white blood cells, increasing the risk of infection. Therefore, a sore throat could be indicative of an infection that needs immediate attention to prevent complications. Option A) Hair loss is a common side effect of many chemotherapy drugs, including topotecan, but it is not typically a sign of an urgent or serious issue that requires immediate reporting. Option B) Fatigue is also a common side effect of chemotherapy but is not specific to topotecan. While it is important for the nurse to address fatigue, it is not the most critical finding to report immediately in this case. Option D) Red urine is a known side effect of topotecan due to its excretion pathway, but it is not typically a cause for immediate concern unless accompanied by other symptoms like pain or difficulty urinating. In an educational context, understanding the side effects and potential complications of chemotherapy drugs like topotecan is crucial for nurses to provide safe and effective care to clients undergoing cancer treatment. Teaching clients to recognize and report early signs of infection is vital in preventing serious complications and ensuring timely intervention.