Nursing Elites

1. A nurse is providing teaching to a client with asthma. Which of the following client statements indicates a need for further teaching?

• A. I should use my albuterol inhaler before I exercise.
• B. I should avoid using my inhaler more than twice a week.
• C. I should take my inhaler only when I feel short of breath.
• D. I should rinse my mouth after using my corticosteroid inhaler.

Correct answer: C

Rationale: The correct answer is C because the client stating they should only take the inhaler when feeling short of breath indicates a need for further teaching. Clients with asthma should use their inhaler as prescribed, not just when short of breath. Choices A, B, and D demonstrate good asthma management practices. Choice A indicates understanding of using the albuterol inhaler before exercise to prevent exercise-induced symptoms. Choice B mentions the importance of not overusing the inhaler, which can indicate poor asthma control. Choice D shows awareness of rinsing the mouth after using a corticosteroid inhaler to prevent oral thrush.

2. A client has a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Avoid consuming dairy products.
• B. Increase your intake of potassium-rich foods.
• C. Limit fluid intake to prevent dehydration.
• D. Take the medication at bedtime.

Correct answer: B

Rationale: The correct answer is to instruct the client to increase their intake of potassium-rich foods when taking furosemide. Furosemide is a loop diuretic that can cause potassium loss, so consuming potassium-rich foods like bananas and oranges can help maintain adequate potassium levels. Choice A is incorrect because there is no need to avoid consuming dairy products. Choice C is incorrect because while fluid intake may need to be monitored, the general instruction is not to limit fluids to prevent dehydration. Choice D is incorrect because furosemide is usually best taken during the day to avoid disrupting sleep with frequent urination.

3. A nurse is caring for a client who is 1 day postoperative following a total knee replacement. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 88/min
• B. Serous drainage on the dressing
• C. Temperature 37.3°C (99.1°F)
• D. Calf pain on dorsiflexion

Correct answer: D

Rationale: The correct answer is D. Calf pain on dorsiflexion following knee surgery may indicate a complication such as deep vein thrombosis, which is a serious condition requiring medical attention. Reporting this finding promptly is crucial to prevent further complications. Choices A, B, and C are within normal range for a client post knee surgery and do not typically indicate immediate complications that require urgent reporting.

4. A client receiving morphine via patient-controlled analgesia (PCA) should have naloxone administered if their respiratory rate is below 10/min. What action should the nurse take?

• A. Monitor the client's blood pressure every 4 hours.
• B. Ask the client to rate their pain every 2 hours.
• C. Administer naloxone if the client's respiratory rate is below 10/min.
• D. Evaluate the client's use of the PCA every 4 hours.

Correct answer: C

Rationale: The correct action for the nurse to take is to administer naloxone if the client's respiratory rate falls below 10/min. Naloxone is used to reverse opioid-induced respiratory depression, which is a life-threatening situation. Monitoring the client's blood pressure every 4 hours (Choice A) is not the priority in this scenario as respiratory depression requires immediate attention. Asking the client to rate their pain every 2 hours (Choice B) is important for pain management but addressing respiratory depression takes precedence. Evaluating the client's use of the PCA every 4 hours (Choice D) is a routine nursing intervention but does not directly address the urgent need to reverse respiratory depression in this case.

5. A nurse is providing teaching to a client who has irritable bowel syndrome (IBS). Which of the following dietary recommendations should the nurse make?

• A. Increase your intake of high-fiber foods.
• B. Avoid foods that are high in fat.
• C. Increase your intake of dairy products.
• D. Drink carbonated beverages to help with bloating.

Correct answer: B

Rationale: The correct answer is B: "Avoid foods that are high in fat." Clients with IBS should avoid foods high in fat as they can exacerbate symptoms such as abdominal pain, bloating, and diarrhea. High-fiber foods, choice A, can sometimes worsen symptoms in individuals with IBS. Increasing intake of dairy products, choice C, may also worsen symptoms for some individuals with IBS, especially if they are lactose intolerant. Drinking carbonated beverages, choice D, can contribute to bloating and gas, making symptoms worse for individuals with IBS.

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