Nursing Elites

1. A client with asthma is prescribed a corticosteroid inhaler. What instruction should the nurse give about the inhaler?

• A. Use it only during asthma attacks
• B. Rinse the mouth after each use to prevent oral thrush
• C. It will provide immediate relief during an asthma attack
• D. Increase the dose if breathing does not improve

Correct answer: B

Rationale: The correct instruction for a client using a corticosteroid inhaler is to rinse the mouth after each use to prevent the development of oral thrush, a common side effect of these inhalers. Choice A is incorrect as corticosteroid inhalers are often used regularly as a maintenance treatment, not just during asthma attacks. Choice C is incorrect because corticosteroid inhalers provide long-term control of asthma symptoms, not immediate relief during an attack. Choice D is incorrect and potentially dangerous advice as increasing the dose without medical guidance can lead to adverse effects.

2. A client with a history of seizures is being discharged home. Which instruction is most important for the nurse to provide?

• A. Take your medication as prescribed.
• B. Avoid driving until your condition is stable.
• C. Keep a seizure diary.
• D. Avoid alcohol consumption.

Correct answer: A

Rationale: The most important instruction for a client with a history of seizures being discharged home is to take their medication as prescribed. Consistent and timely intake of anti-seizure medication is vital in managing seizures and preventing episodes. While instructions like avoiding driving until the condition is stable, keeping a seizure diary, and avoiding alcohol consumption are important, none are as critical as ensuring proper medication adherence to control seizures effectively. Failure to take prescribed medications can lead to breakthrough seizures, compromising the patient's safety and seizure control.

3. A client with a diagnosis of rheumatoid arthritis is prescribed methotrexate. What is the primary action of this medication?

• A. Increases joint lubrication
• B. Reduces inflammation by suppressing the immune system
• C. Enhances bone density
• D. Stimulates cartilage regeneration

Correct answer: B

Rationale: The correct answer is B: Methotrexate is an immunosuppressant that works by suppressing the immune system, thereby reducing inflammation in rheumatoid arthritis. Methotrexate does not directly increase joint lubrication (Choice A) as its primary action is on the immune system. Choices C and D are incorrect since methotrexate does not enhance bone density or stimulate cartilage regeneration. It is crucial for healthcare providers to understand the mechanism of action of medications to provide safe and effective care to patients.

4. Which client is at the highest risk for developing pressure ulcers?

• A. A 50-year-old client with a fractured femur
• B. A 30-year-old client with diabetes mellitus
• C. A 65-year-old client with limited mobility
• D. A 70-year-old client with a history of stroke

Correct answer: C

Rationale: Clients with limited mobility are at the highest risk for developing pressure ulcers due to prolonged pressure on specific areas of the body. This constant pressure can lead to tissue damage and ultimately result in pressure ulcers. While age and medical conditions such as diabetes and a history of stroke can contribute to the risk of pressure ulcers, limited mobility is the most significant factor as it directly affects the ability to shift positions and relieve pressure on vulnerable areas of the body. Therefore, the 65-year-old client with limited mobility is at the highest risk compared to the other clients. The 50-year-old client with a fractured femur may have limited mobility due to the injury, but it is temporary and may not be as prolonged as chronic limited mobility. The 30-year-old client with diabetes mellitus and the 70-year-old client with a history of stroke are at risk for developing pressure ulcers, but their conditions do not directly impact their ability to shift positions and alleviate pressure like limited mobility does.

5. What intervention has the highest priority for a client with a fourth-degree midline laceration following the vaginal delivery of an 8-pound 10-ounce infant?

• A. Administer a prescribed stool softener
• B. Administer prescribed PRN sleep medications
• C. Encourage breastfeeding to promote uterine involution
• D. Encourage the use of prescribed analgesic perineal sprays

Correct answer: A

Rationale: Administering a prescribed stool softener is the highest priority intervention for a client with a fourth-degree midline laceration to prevent straining during bowel movements, which could potentially harm the healing laceration. Stool softeners help in maintaining soft stools, reducing the risk of injury to the suture line. Administering PRN sleep medications, encouraging breastfeeding, or promoting the use of analgesic perineal sprays are important aspects of care but are not the priority in this situation. Stool softeners play a crucial role in preventing complications and promoting healing in such cases, making it the most urgent intervention.

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