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. When educating a patient on the use of levodopa-carbidopa, which information should the nurse include?

• A. It is a cure for Parkinson's disease
• B. Monitor for dyskinesia
• C. It can be taken at any time
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B: 'Monitor for dyskinesia.' Levodopa-carbidopa can cause dyskinesia as a side effect, which is characterized by involuntary muscle movements. Patients need to be monitored for this adverse effect and instructed to report it to their healthcare provider. Choices A, C, and D are incorrect because levodopa-carbidopa is not a cure for Parkinson's disease, it should be taken at specific times for optimal effect, and it does have side effects, such as dyskinesia.

3. A nurse is assessing a client with chronic kidney disease. Which of the following should the nurse monitor for?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Clients with chronic kidney disease are at risk for hyperkalemia due to impaired potassium excretion. In chronic kidney disease, the kidneys are unable to effectively excrete potassium, leading to its accumulation in the blood. Hypercalcemia (Choice B) is not typically associated with chronic kidney disease. Hypoglycemia (Choice C) refers to low blood sugar levels and is not directly related to chronic kidney disease. Hyponatremia (Choice D) is a condition characterized by low sodium levels and is not a typical concern in chronic kidney disease.

4. While in the cafeteria, a nurse overhears two APs discussing a hospitalized patient. What action should the nurse take?

• A. Report the incident to the supervisor.
• B. Join the conversation to intervene.
• C. Quietly tell the APs that this is not appropriate.
• D. Ignore the conversation.

Correct answer: C

Rationale: The correct action for the nurse to take in this situation is to choose option C: 'Quietly tell the APs that this is not appropriate.' The nurse should immediately and discreetly address the situation, reminding the APs that discussing patient information in public areas violates confidentiality. Reporting the incident to the supervisor (option A) may be necessary if the behavior continues. Joining the conversation to intervene (option B) may escalate the situation and compromise patient confidentiality. Ignoring the conversation (option D) does not address the violation or prevent it from recurring.

5. When caring for a client prescribed azithromycin, what should the nurse monitor?

• A. Liver function
• B. Signs of diarrhea
• C. Blood glucose levels
• D. Serum electrolytes

Correct answer: B

Rationale: The correct answer is to monitor signs of diarrhea when a client is prescribed azithromycin. Azithromycin is known to cause gastrointestinal side effects, particularly diarrhea. Monitoring for diarrhea is crucial to assess the client's response to the medication and to prevent complications such as dehydration. Monitoring liver function (choice A), blood glucose levels (choice C), and serum electrolytes (choice D) are not typically indicated specifically for clients prescribed azithromycin unless there are other specific reasons or conditions that warrant such monitoring.

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