Nursing Elites

1. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler before using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist (such as albuterol) and an inhaled glucocorticoid (such as beclomethasone) for asthma control, the beta2-agonist should be administered first. Administering the beta2-agonist before the glucocorticoid helps promote bronchodilation and enhances the absorption of the glucocorticoid, maximizing its effectiveness in the lungs. Choice A is incorrect because albuterol is usually taken as needed for quick relief of asthma symptoms and not necessarily at the same time each day. Choice C is incorrect as beclomethasone is a controller medication used for long-term asthma management, not for acute episodes. Choice D is incorrect as shaking the beclomethasone inhaler before use helps ensure proper medication dispersion for effective inhalation.

2. A healthcare professional is preparing to administer Haloperidol 2 mg PO every 12 hr. The available medication is haloperidol 1 mg/tablet. How many tablets should the healthcare professional administer?

• A. 1 tablet
• B. 2 tablets
• C. 3 tablets
• D. 4 tablets

Correct answer: B

Rationale: To calculate the number of tablets needed, divide the desired dose by the dose per tablet. In this case, (2 mg / 1 mg/tablet) = 2 tablets required to administer the correct dosage of Haloperidol.

3. A client has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

• A. Somnolence
• B. Constipation
• C. Fluid retention
• D. Weight gain

Correct answer: A

Rationale: The correct answer is 'A: Somnolence.' Somnolence can indicate lactic acidosis, which is manifested by extreme drowsiness, hyperventilation, and muscle pain. It is a rare but very serious adverse effect caused by metformin and should be reported to the provider promptly to prevent further complications.

4. A client is prescribed Spironolactone. Which of the following laboratory findings should the nurse monitor and report to the provider?

• A. Sodium level of 138 mEq/L
• B. Potassium level of 5.2 mEq/L
• C. Chloride level of 100 mEq/L
• D. Calcium level of 9.5 mg/dL

Correct answer: B

Rationale: Spironolactone is a potassium-sparing diuretic, causing potassium retention, potentially leading to elevated potassium levels. A potassium level of 5.2 mEq/L is above the normal range (3.5-5.0 mEq/L), indicating hyperkalemia, a serious condition. Elevated potassium levels can lead to life-threatening cardiac arrhythmias. Monitoring and reporting high potassium levels promptly to the healthcare provider are crucial to prevent potential complications. Sodium, chloride, and calcium levels are not directly influenced by Spironolactone, making choices A, C, and D incorrect.

5. A client has a new prescription for Nitroglycerin to treat angina. Which of the following instructions should the nurse include?

• A. Take this medication only when chest pain occurs.
• B. Store the medication in a cool, dry place.
• C. Apply the patch to a different site each time.
• D. Avoid consuming alcohol while taking this medication.

Correct answer: C

Rationale: The correct instruction for the nurse to include is to advise the client to apply the Nitroglycerin patch to a different site each time. This is crucial to prevent skin irritation and ensure consistent absorption of the medication. Rotating application sites is important as it helps maintain the effectiveness of the treatment and reduces the risk of skin reactions. Choice A is incorrect because Nitroglycerin is often used prophylactically to prevent angina episodes rather than just for acute chest pain. Choice B is not relevant to the administration or effectiveness of the medication. Choice D, while generally a good recommendation, is not directly related to the administration of Nitroglycerin.

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