Nursing Elites

1. A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which instruction should the nurse include in the teaching?

• A. Inhale the medication deeply for 3-5 seconds
• B. Exhale forcefully before inhaling
• C. Shake the MDI vigorously before use
• D. Hold the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth

Correct answer: A

Rationale: Corrected Rationale: Inhaling the medication deeply for 3-5 seconds and holding the breath for 10 seconds after inhalation ensures effective medication delivery to the lungs. Choice A is the correct instruction for the use of a metered-dose inhaler (MDI). Choice B, exhaling forcefully before inhaling, is incorrect as it can lead to decreased medication delivery. Choice C, shaking the MDI vigorously before use, is also incorrect as excessive shaking can cause the medication to clump. Choice D, holding the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth, is not recommended as it may lead to improper inhalation technique.

2. A client is being taught about the use of nitroglycerin. Which of the following should be included?

• A. Take it with food
• B. Place the tablet under the tongue
• C. It can be stored in the refrigerator
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is to place the nitroglycerin tablet under the tongue. Nitroglycerin tablets are meant for sublingual absorption during angina episodes to provide quick relief. Option A is incorrect because nitroglycerin should not be taken with food. Option C is incorrect as nitroglycerin should be stored in a cool, dark place, not in the refrigerator. Option D is incorrect because nitroglycerin can have side effects, including headaches, dizziness, and low blood pressure.

3. A nurse is preparing to administer IV furosemide. Which of the following should the nurse monitor for during the infusion?

• A. Increased urinary output
• B. Ototoxicity
• C. Hypokalemia
• D. Hypoglycemia

Correct answer: C

Rationale: The correct answer is C: Hypokalemia. Furosemide is a loop diuretic that works by increasing the excretion of water and electrolytes, particularly potassium. Therefore, the nurse should monitor for hypokalemia, as low potassium levels can lead to various complications such as cardiac dysrhythmias. Choice A, increased urinary output, is an expected effect of furosemide due to its diuretic action but is not a side effect needing monitoring. Ototoxicity (Choice B) is a potential adverse effect of other medications like aminoglycoside antibiotics, not furosemide. Hypoglycemia (Choice D) is not a common side effect associated with furosemide administration.

4. A client with heart failure who presents with dyspnea, bibasilar crackles, and frothy sputum should receive which dietary recommendation?

• A. Decrease protein intake.
• B. Reduce sodium intake.
• C. Increase fluid intake.
• D. Decrease calcium intake.

Correct answer: B

Rationale: The correct answer is to reduce sodium intake. In heart failure, excess sodium can lead to fluid retention, exacerbating symptoms like dyspnea, bibasilar crackles, and frothy sputum. Therefore, reducing sodium intake is crucial in managing heart failure. Decreasing protein intake is not typically recommended in heart failure management. Increasing fluid intake would worsen the condition by further contributing to fluid overload. Decreasing calcium intake is not directly related to managing heart failure symptoms such as dyspnea, bibasilar crackles, and frothy sputum.

5. A client is reviewing information about advance directives with a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I understand that I can change my mind at any time.
• B. I have a living will that outlines my wishes when I am unable to make a decision.
• C. I need to inform my family about my wishes.
• D. I don’t need to worry about advance directives right now.

Correct answer: B

Rationale: The correct answer is B because having a living will indicates that the client understands and has documented their wishes regarding medical treatment when they are unable to make decisions. Choice A is incorrect because while it's true that clients can change their minds about advance directives, it doesn't specifically indicate an understanding of the teaching provided. Choice C is important but doesn't directly show if the client understands advance directives. Choice D is incorrect because it dismisses the importance of advance directives, indicating a lack of understanding.

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