Nursing Elites

1. A nurse is providing teaching to a client who has a new prescription for an albuterol inhaler. Which of the following instructions should the nurse include?

• A. Take one puff every 5 minutes until symptoms improve.
• B. Hold your breath for 10 seconds after inhaling the medication.
• C. Shake the inhaler for 2 seconds before use.
• D. Exhale forcefully after each puff.

Correct answer: B

Rationale: The correct answer is B. Instructing the client to hold their breath for 10 seconds after inhaling the medication allows it to reach deeper into the lungs for maximum effectiveness. Choice A is incorrect because taking one puff every 5 minutes may lead to overuse of the medication. Choice C is incorrect as shaking the inhaler for only 2 seconds may not provide adequate mixing of the medication. Choice D is incorrect because exhaling forcefully after each puff may reduce the amount of medication that reaches the lungs.

2. Which electrolyte imbalance is commonly associated with furosemide?

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

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide, a loop diuretic, commonly causes the loss of potassium in the urine, leading to hypokalemia. This electrolyte imbalance can result in various complications such as cardiac arrhythmias and muscle weakness. Choice B, Hyponatremia, is not typically associated with furosemide use. Choice C, Hyperkalemia, is the opposite of the expected electrolyte imbalance caused by furosemide. Choice D, Hypercalcemia, is not a common side effect of furosemide.

3. A nurse is assessing a client who has a history of seizure disorder and is receiving phenytoin. Which of the following findings should the nurse identify as an adverse effect of the medication?

• A. Bradycardia.
• B. Ataxia.
• C. Tachycardia.
• D. Insomnia.

Correct answer: B

Rationale: The correct answer is B: Ataxia. Ataxia, which refers to uncoordinated movements, is a common adverse effect of phenytoin, a medication used to manage seizure disorders. Bradycardia (Choice A) is not typically associated with phenytoin; instead, it may cause tachycardia (Choice C) as a side effect. Insomnia (Choice D) is not a common adverse effect of phenytoin.

4. A nurse is caring for a client who has Crohn's disease. Which of the following findings should the nurse expect?

• A. Weight gain.
• B. Bloody stools.
• C. Urinary retention.
• D. Abdominal distention.

Correct answer: B

Rationale: The correct answer is B: Bloody stools. Bloody stools are a common symptom of Crohn's disease, characterized by inflammation of the digestive tract. Weight gain (choice A) is less likely due to malabsorption issues associated with Crohn's disease. Urinary retention (choice C) is not directly related to Crohn's disease. Abdominal distention (choice D) may occur in Crohn's disease but is not as specific a finding as bloody stools.

5. A client has a chest tube. Which of the following interventions should the nurse include?

• A. Clamp the chest tube for 15 minutes every 2 hours.
• B. Maintain the drainage system below the client's chest.
• C. Strip the chest tube every 2 hours.
• D. Keep the collection device at the level of the client's chest.

Correct answer: B

Rationale: Maintaining the chest tube drainage system below the client's chest level is crucial to ensure proper drainage and prevent complications. Clamping the chest tube can lead to a tension pneumothorax, stripping the chest tube is an outdated practice that can cause damage to the tissues, and keeping the collection device at the level of the client's chest can impede proper drainage and lead to fluid accumulation.

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