Nursing Elites

1. When teaching a client with a new prescription for Ipratropium, which of the following instructions should the nurse include?

• A. This medication can be used as a rescue inhaler.
• B. This medication should be taken before albuterol.
• C. Wait 5 minutes between medications if two inhaled medications are prescribed.
• D. Ipratropium can be used before exercise.

Correct answer: C

Rationale: When two inhaled medications are prescribed, waiting 5 minutes between medications allows for optimal absorption and effectiveness of each medication. This ensures that each medication can work properly without interference from the other, improving the client's respiratory condition.

2. A healthcare provider is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. How many mL/hr should the IV pump be set to deliver?

• A. 125 mL/hr
• B. 100 mL/hr
• C. 150 mL/hr
• D. 200 mL/hr

Correct answer: A

Rationale: To calculate the flow rate, divide the total volume by the total time: (750 mL / 6 hr) = 125 mL/hr. Therefore, the IV pump should be set to deliver 125 mL/hr to infuse dextrose 5% in water (D5W) over 6 hours. Choice B, 100 mL/hr, is incorrect as it does not match the correct calculation. Choice C, 150 mL/hr, is incorrect as it is higher than the calculated flow rate. Choice D, 200 mL/hr, is incorrect as it is also higher than the calculated flow rate.

3. A client has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

• A. Take the albuterol at the same time each day.
• B. Administer the albuterol inhaler prior to using the beclomethasone inhaler.
• C. Use beclomethasone if experiencing an acute episode.
• D. Avoid shaking the beclomethasone before use.

Correct answer: B

Rationale: When a client is prescribed an inhaled beta2-agonist, such as albuterol, and an inhaled glucocorticoid, such as beclomethasone, for asthma control, the beta2-agonist should be administered first. This sequence is important because the beta2-agonist promotes bronchodilation, which enhances the absorption and effectiveness of the glucocorticoid. Instructing the client to administer the albuterol inhaler before using the beclomethasone inhaler ensures optimal therapeutic benefit. Therefore, option B is the correct choice. Option A is incorrect because the timing of albuterol administration may vary based on the prescribed regimen. Option C is incorrect because beclomethasone is a controller medication, not a rescue medication, and should not be used during acute episodes. Option D is incorrect because beclomethasone should be shaken before use to ensure proper dispersion of the medication.

4. A client has a new prescription for spironolactone. The client should be monitored for which of the following adverse effects?

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

Correct answer: A

Rationale: Corrected Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone. Choices B, C, and D are incorrect because spironolactone is not known to cause hyponatremia, hypokalemia, or hypercalcemia as adverse effects.

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

• A. Take the medication with meals and snacks.
• B. Expect your urine to turn orange.
• C. Increase your intake of high-calcium foods.
• D. Avoid consuming dairy products.

Correct answer: A

Rationale: The correct answer is A: 'Take the medication with meals and snacks.' Pancrelipase should be taken with meals and snacks to aid in the digestion of fats, proteins, and carbohydrates. This timing ensures that the medication functions optimally by assisting in the digestion process when food is present in the gastrointestinal system. Choice B is incorrect because urine discoloration is not a common side effect of Pancrelipase. Choice C is incorrect as there is no specific need to increase high-calcium foods with Pancrelipase. Choice D is also incorrect as avoiding dairy products is not necessary when taking Pancrelipase.

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