Nursing Elites

1. A client is prescribed an inhaled corticosteroid for asthma management. Which instruction should the nurse provide to the client regarding the use of this medication?

• A. Rinse your mouth after using the inhaler
• B. Hold your breath for 5 seconds after inhaling the medication
• C. Use the inhaler during an acute asthma attack
• D. Take the medication only when symptoms occur

Correct answer: A

Rationale: The correct instruction for a client using an inhaled corticosteroid for asthma management is to rinse the mouth after using the inhaler. This helps prevent oral thrush, a common side effect of corticosteroid inhalers. Holding the breath for 5 seconds after inhaling the medication (Choice B) is not necessary for corticosteroid inhalers. Using the inhaler during an acute asthma attack (Choice C) is not the purpose of corticosteroids, which are used for long-term asthma management. Taking the medication only when symptoms occur (Choice D) is not correct as corticosteroids are typically used regularly to control asthma symptoms.

2. A male client with hypertension, who received new antihypertensive prescriptions at his last visit returns to the clinic two weeks later to evaluate his blood pressure (BP). His BP is 158/106, and he admits that he has not been taking the prescribed medication because the drugs make him feel bad. In explaining the need for hypertension control, the nurse should stress that an elevated BP places the client at risk for which pathophysiological condition?

• A. Stroke secondary to hemorrhage
• B. Myocardial infarction
• C. Heart failure
• D. Renal failure

Correct answer: A

Rationale: Stroke is a major complication of uncontrolled hypertension. Elevated BP, especially at levels like 158/106, can cause damage to blood vessels in the brain, leading to a hemorrhagic stroke. Controlling BP is essential to prevent such life-threatening events. Myocardial infarction (choice B) is more commonly associated with coronary artery disease, while heart failure (choice C) and renal failure (choice D) can be complications of uncontrolled hypertension but are not directly related to the elevated BP leading to a hemorrhagic stroke.

3. A young adult visits the clinic reporting symptoms associated with gastritis. Which information in the client's history is most important for the nurse to address in the teaching plan?

• A. Experiences occasional heartburn after eating spicy food
• B. Consumes 10 or more drinks of alcohol every weekend
• C. Reports frequent use of NSAIDs
• D. Has a history of peptic ulcers

Correct answer: B

Rationale: Excessive alcohol consumption is a major risk factor for gastritis and should be prioritized in the teaching plan. While spicy foods and NSAIDs can contribute to gastritis, alcohol consumption is the most significant factor that needs immediate lifestyle changes to prevent worsening of gastritis symptoms. Peptic ulcers, although relevant, are not as directly linked to exacerbating gastritis symptoms as alcohol consumption.

4. A client with diabetes mellitus is scheduled for surgery, and their blood glucose level is 280 mg/dL. What is the nurse's priority action?

• A. Administer insulin as prescribed.
• B. Delay surgery until the blood glucose is below 180 mg/dL.
• C. Check the client’s hemoglobin A1C level.
• D. Administer IV fluids to flush excess glucose.

Correct answer: A

Rationale: The correct answer is A: Administer insulin as prescribed. In clients with diabetes, high blood glucose levels can increase the risk of infection and impair healing after surgery. Administering insulin as prescribed helps reduce blood glucose to a safer level before surgery, preventing complications. Choice B is incorrect because delaying surgery without addressing the high blood glucose level does not address the immediate issue. Choice C is incorrect as checking the client's hemoglobin A1C level is not the priority when dealing with acute high blood glucose levels before surgery. Choice D is incorrect as administering IV fluids may help with hydration but does not directly address the high blood glucose level that needs immediate attention.

5. A client with severe dehydration is admitted to the hospital. Which assessment finding indicates that the client's condition is improving?

• A. The client reports feeling less thirsty
• B. Urine output increases to 40 mL/hour
• C. Heart rate decreases from 120 to 110 beats per minute
• D. Skin turgor returns to normal

Correct answer: B

Rationale: An increase in urine output is a reliable indicator that the client's hydration status is improving. This reflects adequate fluid replacement and improved kidney function. Choice A is subjective and may not always indicate improved hydration. Choice C, while a positive sign, may be influenced by other factors such as medications or pain. Choice D, skin turgor returning to normal, is a delayed indicator of hydration status and may take time to improve even after hydration is initiated.

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