Nursing Elites

1. A client with asthma is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?

• A. Hypoglycemia
• B. Hypertension
• C. Polyuria
• D. Oral candidiasis

Correct answer: D

Rationale: Fluticasone is a corticosteroid often used to manage asthma. One of the common adverse effects associated with inhaled corticosteroids like fluticasone is oral candidiasis, also known as thrush. This fungal infection can develop in the mouth and throat due to the steroid's local immunosuppressive effects. Patients should be advised to rinse their mouths after using inhaled corticosteroids to reduce the risk of oral candidiasis. Monitoring for symptoms such as white patches, sore throat, or difficulty swallowing is essential to detect and manage this adverse effect promptly.

2. A client is postoperative with shallow respirations at 9/min. Which acid-base imbalance should the nurse identify the client as being at risk for developing initially?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: A

Rationale: The client's shallow respirations at 9/min indicate hypoventilation, leading to an accumulation of carbon dioxide in the blood, causing respiratory acidosis. In this scenario, the client is at risk for developing respiratory acidosis due to inadequate ventilation and subsequent CO2 retention.

3. When working as a professional nurse, what is the priority for a new nurse working on an inpatient medical-surgical unit with a preceptor?

• A. Attending to holistic client needs
• B. Ensuring client safety
• C. Avoiding medication errors
• D. Providing client-focused care

Correct answer: B

Rationale: The priority for a nurse working on an inpatient medical-surgical unit is to ensure client safety. This is crucial as errors in hospital care can lead to preventable deaths. While attending to holistic client needs and providing client-focused care are important aspects of nursing, ensuring client safety takes precedence to prevent harm and promote positive patient outcomes.

4. The healthcare provider is caring for a postoperative client who has a chest tube connected to suction and a water seal drainage system. Which of the following indicates to the healthcare provider that the chest tube is functioning properly?

• A. Fluctuation of the fluid level within the water seal chamber
• B. Absence of fluid in the drainage tubing
• C. Continuous bubbling within the water seal chamber
• D. Equal amounts of fluid drainage in each collection chamber

Correct answer: A

Rationale: Fluctuation of the fluid level within the water seal chamber indicates proper functioning of the chest tube. This fluctuation reflects the normal ebb and flow of air and fluid in the pleural space, demonstrating that the system is maintaining the appropriate pressure. Continuous bubbling in the water seal chamber may indicate an air leak, absence of fluid in the drainage tubing suggests a blockage, and equal amounts of fluid drainage in each collection chamber are not expected in this system.

5. A client with tuberculosis (TB) is taking isoniazid (INH). Which instruction is most important for the nurse to include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid exposure to sunlight while taking this medication.
• C. Report any numbness or tingling in extremities.
• D. Have liver function tests done regularly.

Correct answer: D

Rationale: Regular monitoring of liver function tests is crucial for clients taking isoniazid (INH) due to the potential risk of hepatotoxicity. Isoniazid can cause liver damage, and early detection through routine liver function tests can help prevent severe complications.

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