Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the client's teaching?

• A. Use this medication only during acute exacerbations.
• B. Rinse your mouth after using the inhaler.
• C. Take this medication with food.
• D. Increase your fluid intake to at least 3 liters per day.

Correct answer: B

Rationale: The correct instruction for the nurse to include in the teaching for a client prescribed tiotropium (Spiriva) is to rinse the mouth after using the inhaler. Rinsing the mouth helps prevent oral thrush, a common side effect of inhaled medications. This action reduces the risk of developing oral fungal infections, promoting better oral health for the client.

2. A client's telemetry monitor indicates the sudden onset of ventricular fibrillation. Which assessment finding should the nurse anticipate?

• A. Bounding erratic pulse.
• B. Regularly irregular pulse.
• C. Thready irregular pulse.
• D. No palpable pulse.

Correct answer: D

Rationale: Ventricular fibrillation is a life-threatening arrhythmia characterized by chaotic, asynchronous contractions of the ventricles, resulting in ineffective cardiac output. This leads to the absence of a palpable pulse. Nurses should be prepared to initiate immediate interventions such as defibrillation to restore normal cardiac rhythm in a client experiencing ventricular fibrillation.

3. A client who has just started taking levodopa-carbidopa (Sinemet) for Parkinson's disease reports experiencing nausea. What should the nurse recommend to the client?

• A. Take the medication on an empty stomach.
• B. Consume a low-protein snack with the medication.
• C. Increase your intake of dairy products.
• D. Stop taking the medication and notify your healthcare provider.

Correct answer: B

Rationale: Nausea is a common side effect of levodopa-carbidopa (Sinemet). Consuming a low-protein snack with the medication can help reduce nausea. The protein in food can compete with levodopa for absorption, so taking it with a low-protein snack may improve its effectiveness and reduce gastrointestinal side effects. Option A is incorrect as taking the medication on an empty stomach may exacerbate nausea. Option C is incorrect because increasing intake of dairy products is not recommended to alleviate nausea. Option D is incorrect because abruptly stopping the medication without healthcare provider guidance can lead to adverse effects.

4. What dietary advice should the nurse provide to help reduce the occurrence of hot flashes in a post-menopausal client?

• A. Increase intake of spicy foods.
• B. Limit caffeine and alcohol consumption.
• C. Consume a high-protein diet.
• D. Eat more dairy products.

Correct answer: B

Rationale: Limiting caffeine and alcohol consumption is recommended to help reduce the frequency of hot flashes in post-menopausal individuals. Caffeine and alcohol can trigger hot flashes and worsen their occurrence. Encouraging the client to reduce these stimulants in their diet may help alleviate hot flashes and improve their quality of life.

5. A healthcare professional is participating in the emergency care of a client who has just developed variceal bleeding. What intervention should the healthcare professional anticipate?

• A. Infusion of intravenous heparin
• B. IV administration of albumin
• C. STAT administration of vitamin K by the intramuscular route
• D. IV administration of octreotide

Correct answer: D

Rationale: The correct intervention for variceal bleeding is IV administration of octreotide. Octreotide helps control bleeding from varices by reducing portal blood flow and pressure, which is crucial in managing this emergency situation.

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