Nursing Elites

1. A client has a new prescription for a metered-dose inhaler (MDI). Which of the following statements indicates an understanding of the teaching?

• A. I will shake the inhaler before use.
• B. I will breathe out forcefully after inhaling the medication.
• C. I will take the medication with food.
• D. I will use a spacer with the inhaler.

Correct answer: A

Rationale: The correct answer is A: 'I will shake the inhaler before use.' Shaking the inhaler before use is crucial to ensure proper mixing of the medication inside the inhaler. This action helps to disperse the medication evenly, allowing for consistent dosing during inhalation. Choices B, C, and D are incorrect. Breathing out forcefully after inhaling the medication, taking the medication with food, and using a spacer with the inhaler are not related to the correct use of a metered-dose inhaler. These actions may not lead to optimal medication delivery and do not demonstrate an understanding of the proper technique for using an MDI.

2. Following a total hip arthroplasty, what intervention should the healthcare provider implement for the client?

• A. Place a pillow between the client's legs.
• B. Elevate the head of the bed to 45 degrees.
• C. Position the client on the operative side.
• D. Keep the client’s legs adducted.

Correct answer: A

Rationale: Placing a pillow between the client's legs is crucial post hip arthroplasty surgery to prevent hip dislocation. This intervention helps maintain proper alignment and prevents legs from crossing midline, reducing the risk of hip prosthesis dislocation. Elevating the head of the bed to 45 degrees, positioning the client on the operative side, or keeping the client's legs adducted are not recommended postoperative interventions for a total hip arthroplasty, as they can increase the risk of complications and compromise the surgical site.

3. A client has a new diagnosis of gout, and the nurse is providing dietary management education. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of purine-rich foods.
• B. You should decrease your intake of purine-rich foods.
• C. You should avoid foods that contain lactose.
• D. You should increase your intake of dairy products.

Correct answer: B

Rationale: The correct answer is to decrease intake of purine-rich foods to manage uric acid levels and symptoms of gout. Purine-rich foods can exacerbate gout symptoms by increasing uric acid production, leading to flare-ups. Therefore, reducing purine intake is essential in the dietary management of gout. Option A is incorrect because increasing purine-rich foods can worsen gout symptoms. Option C is irrelevant as lactose is not directly related to gout. Option D is incorrect as increasing dairy products is not a recommended dietary modification for managing gout.

4. When teaching a client with a new diagnosis of hypertension about medication adherence, which statement should the nurse include?

• A. You can stop taking your medication once your blood pressure is normal.
• B. You should take your medication at the same time every day.
• C. You can double your dose if you miss a dose.
• D. You should take your medication with a high-fat meal.

Correct answer: B

Rationale: The correct answer is B: 'You should take your medication at the same time every day.' Taking medication consistently at the same time daily is crucial for maintaining steady blood levels and effectively managing hypertension. It helps ensure that the medication works optimally and provides the best control of blood pressure throughout the day. Choice A is incorrect because stopping medication once blood pressure is normal can lead to a relapse or worsening of hypertension. Choice C is incorrect as doubling the dose without healthcare provider guidance can be dangerous. Choice D is incorrect as taking medication with a high-fat meal can affect its absorption and efficacy.

5. A client is being discharged with a prescription for furosemide. Which of the following instructions should be included?

• A. Avoid foods high in potassium.
• B. Monitor your weight daily.
• C. Take the medication with food.
• D. Change positions slowly.

Correct answer: D

Rationale: The correct instruction to include for a client being discharged with a prescription for furosemide is to 'Change positions slowly.' Furosemide, a diuretic, can cause dizziness and orthostatic hypotension, increasing the risk of falls. By advising the client to change positions slowly, the body can adjust to postural changes gradually, reducing the likelihood of falls and related injuries.

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