Nursing Elites

1. A healthcare provider is providing discharge instructions to a client who has a new prescription for metformin. Which of the following instructions should the healthcare provider include?

• A. Take this medication with meals.
• B. Avoid consuming alcohol while taking this medication.
• C. Take this medication at bedtime.
• D. Report any muscle pain to your healthcare provider.

Correct answer: B

Rationale: The correct answer is B: 'Avoid consuming alcohol while taking this medication.' Clients taking metformin should avoid alcohol as it increases the risk of lactic acidosis. Choice A is incorrect because metformin is usually taken with meals to reduce gastrointestinal side effects. Choice C is incorrect as metformin is typically taken with meals, not at bedtime. Choice D is incorrect because muscle pain is not a common side effect of metformin.

2. A nurse is planning care for a client who has pneumonia. Which of the following interventions should the nurse include to promote airway clearance?

• A. Encourage the client to increase fluid intake.
• B. Suction the client every 2 hours.
• C. Perform chest physiotherapy every 8 hours.
• D. Administer oxygen via nasal cannula.

Correct answer: A

Rationale: Encouraging the client to increase fluid intake is essential to promote airway clearance in pneumonia. Adequate hydration helps to thin respiratory secretions, making them easier to expectorate. Suctioning every 2 hours may be too frequent and can lead to airway trauma and irritation. Chest physiotherapy is not typically indicated for pneumonia unless there are specific complications. Administering oxygen via nasal cannula may be necessary to maintain oxygen saturation but does not directly promote airway clearance.

3. A nurse is caring for a client who is 1 hour postoperative following a thoracentesis. Which of the following findings should the nurse report to the provider?

• A. Oxygen saturation of 96%
• B. Tracheal deviation
• C. Pain level of 4 on a scale of 0 to 10
• D. Temperature of 37.4°C (99.3°F)

Correct answer: B

Rationale: Tracheal deviation is the correct finding to report to the provider. It can indicate a pneumothorax, which is a serious complication following a thoracentesis that requires immediate attention. Oxygen saturation of 96% is within the normal range and does not indicate an immediate issue. A pain level of 4 on a scale of 0 to 10 is subjective and may not be related to a serious complication. A temperature of 37.4°C (99.3°F) is slightly elevated but not a priority over tracheal deviation in this context.

4. A healthcare professional is reviewing the results of an ABG performed on a client with chronic emphysema. Which of the following results suggests the need for further treatment?

• A. PaO2 level of 89 mm Hg
• B. PaCO2 level of 55 mm Hg
• C. HCO3 level of 25 mEq/L
• D. pH level of 7.37

Correct answer: B

Rationale: The correct answer is B. A high PaCO2 level (55 mm Hg) in a client with chronic emphysema suggests respiratory acidosis, which requires further treatment. In chronic emphysema, impaired gas exchange leads to elevated carbon dioxide levels in the blood. Option A (PaO2 level of 89 mm Hg) is near the normal range and does not indicate immediate treatment. Option C (HCO3 level of 25 mEq/L) and option D (pH level of 7.37) are within normal limits and do not suggest the need for further treatment in this context.

5. Which electrolyte imbalance is a common concern for patients on loop diuretics?

• A. Hypokalemia
• B. Hyperkalemia
• C. Hyponatremia
• D. Hypercalcemia

Correct answer: A

Rationale: The correct answer is A, Hypokalemia. Loop diuretics can lead to potassium loss, resulting in hypokalemia. This imbalance is a common concern because potassium plays a vital role in various physiological functions, including maintaining proper heart function. Choices B, C, and D are incorrect because loop diuretics typically do not cause hyperkalemia, hyponatremia, or hypercalcemia.

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