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. A nurse is reviewing the medical records of a client who has thrombocytopenia. Which of the following actions should the nurse include in the care plan?

• A. Encourage the client to floss daily.
• B. Remove fresh flowers from the client's room.
• C. Provide the client with a stool softener.
• D. Avoid serving raw vegetables.

Correct answer: C

Rationale: The correct answer is to provide the client with a stool softener. Thrombocytopenia is a condition characterized by a low platelet count, leading to decreased blood clotting ability. Providing a stool softener is essential to prevent constipation and straining during bowel movements, which can lead to bleeding in thrombocytopenic clients. Encouraging the client to floss daily (Choice A) is a good oral hygiene practice but is not directly related to managing thrombocytopenia. Removing fresh flowers from the client's room (Choice B) is important for immunocompromised clients to prevent exposure to pathogens but is not specifically related to thrombocytopenia. Avoiding serving raw vegetables (Choice D) is a precaution to reduce the risk of infection in immunocompromised clients but does not directly address the complications of thrombocytopenia.

3. A healthcare professional is receiving a telephone prescription from a provider for a client who requires additional medication for pain control. Which of the following entries should the professional make in the medical record?

• A. Morphine 3 mg SC every 4 hr. PRN for pain
• B. Morphine 3 mg Subcutaneous
• C. Morphine 3.0 mg subq every 4 hr. PRN for pain
• D. Morphine 3 mg SC q 4 hr. PRN for pain

Correct answer: A

Rationale: The correct entry for the medication in the medical record should include the abbreviation 'SC' (subcutaneous) for the route of administration. Choice A is the correct answer as it accurately represents the prescription received. Choice B is incorrect because it lacks the frequency and PRN indication. Choice C is incorrect due to the incorrect abbreviation 'subq' and the missing 'q' before the frequency. Choice D is incorrect because it uses 'SC' but the frequency abbreviation 'q' should be followed by the time interval.

4. Which electrolyte imbalance is commonly seen in patients receiving furosemide?

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

Correct answer: A

Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss, resulting in hypokalemia. This electrolyte imbalance necessitates close monitoring to prevent complications such as cardiac arrhythmias. Choices B, C, and D are incorrect. Hypercalcemia is not a common side effect of furosemide. Hyponatremia is more commonly associated with other medications like thiazide diuretics. Hyperkalemia is the opposite electrolyte imbalance and is not typically seen with furosemide use.

5. A nurse is assessing a client who has heart failure and is receiving furosemide. Which of the following findings should the nurse identify as an indication that the client is developing hypokalemia?

• A. Positive Trousseau's sign.
• B. Hyperactive reflexes.
• C. Hypoactive bowel sounds.
• D. Decreased deep-tendon reflexes.

Correct answer: A

Rationale: The correct answer is A: Positive Trousseau's sign. When a patient receiving furosemide is developing hypokalemia, they may exhibit a positive Trousseau's sign, an indication of low potassium levels. This sign is elicited by inflating a blood pressure cuff above systolic pressure for a few minutes, resulting in carpal spasm. Choices B, C, and D are incorrect. Hyperactive reflexes are associated with hyperkalemia, not hypokalemia. Hypoactive bowel sounds are not specifically related to hypokalemia. Decreased deep-tendon reflexes are not typically seen in hypokalemia.

Similar Questions