Nursing Elites

1. A healthcare provider is educating a client about the use of montelukast. Which of the following should be included?

• A. It is used for acute asthma attacks
• B. It is taken once daily in the evening
• C. It should be taken with food
• D. It has no side effects

Correct answer: B

Rationale: The correct answer is B. Montelukast is a leukotriene receptor antagonist that is typically taken once daily in the evening for asthma management. Choice A is incorrect as montelukast is not used for acute asthma attacks but rather for the prevention of asthma symptoms. Choice C is also incorrect because montelukast can be taken with or without food. Choice D is misleading as all medications, including montelukast, have potential side effects.

2. A client with hepatic encephalopathy is being educated about their diet by a nurse. Which of the following food selections indicates that the client understands the teaching?

• A. A sandwich and a milkshake
• B. Rice with black beans
• C. Cottage cheese and tuna on lettuce
• D. A three-egg omelet with low-sodium ham

Correct answer: B

Rationale: The correct answer is B: Rice with black beans. Clients with hepatic encephalopathy should limit protein intake to prevent the buildup of ammonia. Plant-based proteins are preferred over animal-based proteins in this condition. Rice with black beans provides a good balance of nutrients and is a suitable choice for a client with hepatic encephalopathy. Choices A, C, and D are incorrect because they contain animal-based proteins, which should be limited in clients with hepatic encephalopathy.

3. A nurse is providing teaching for a client who has GERD. Which of the following assessment findings should the nurse expect to find?

• A. Shortness of breath
• B. Rebound tenderness
• C. Atypical chest pain
• D. Vomiting blood

Correct answer: C

Rationale: The correct answer is C: Atypical chest pain. GERD often presents with atypical chest pain due to acid reflux, which can mimic the symptoms of cardiac conditions but is related to the esophagus. Shortness of breath (choice A) is not a typical assessment finding in GERD. Rebound tenderness (choice B) is associated with peritoneal inflammation, not GERD. Vomiting blood (choice D) is a severe symptom that may indicate esophageal damage but is not a common assessment finding in GERD.

4. A nurse is caring for a client who is receiving IV diltiazem for atrial fibrillation. Which of the following findings is a contraindication to the administration of diltiazem?

• A. Hypotension
• B. Tachycardia
• C. Decreased level of consciousness
• D. History of diuretic use

Correct answer: A

Rationale: The correct answer is A: Hypotension. Diltiazem can cause further lowering of blood pressure, so it should not be administered if the client is already hypotensive. Monitoring blood pressure is crucial before giving diltiazem. Choice B, tachycardia, is not a contraindication for diltiazem use; in fact, diltiazem is used to slow down the heart rate. Choice C, decreased level of consciousness, may indicate other issues but is not a direct contraindication for diltiazem. Choice D, history of diuretic use, is not a contraindication by itself; however, caution should be exercised when diltiazem is given with diuretics due to potential interactions.

5. A client is receiving ferrous sulfate. Which of the following should be monitored?

• A. Serum potassium levels
• B. Hemoglobin levels
• C. Liver function tests
• D. Blood glucose levels

Correct answer: B

Rationale: The correct answer is B: Hemoglobin levels. Ferrous sulfate is used to treat iron deficiency anemia by increasing the body's iron stores. Monitoring hemoglobin levels is crucial as it reflects the effectiveness of the treatment in improving the client's anemia. Serum potassium levels (Choice A) are typically not directly affected by ferrous sulfate. Liver function tests (Choice C) and blood glucose levels (Choice D) are not routinely monitored when a client is receiving ferrous sulfate unless there are specific indications or pre-existing conditions that warrant such monitoring.

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