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1. A client with asthma is being taught how to use a peak flow meter by a nurse. Which of the following instructions should the nurse include?
- A. Perform the test in the morning after taking medications
- B. Blow into the meter as slowly as possible
- C. Perform the test when feeling short of breath
- D. Use the peak flow meter after using your rescue inhaler
Correct answer: D
Rationale: The correct instruction is to use the peak flow meter after using the rescue inhaler. This ensures accurate monitoring of asthma control during symptoms. Choice A is incorrect because peak flow measurements should be done before taking medications. Choice B is incorrect as the client should blow into the meter quickly and forcefully to get an accurate reading. Choice C is also incorrect as peak flow should be measured regularly, not just when feeling short of breath.
2. A client is receiving furosemide. Which of the following laboratory values should the nurse monitor?
- A. Sodium
- B. Potassium
- C. Calcium
- D. Magnesium
Correct answer: B
Rationale: The correct answer is B: Potassium. Furosemide is a loop diuretic that can cause potassium depletion through increased urinary excretion. Monitoring potassium levels is crucial to prevent hypokalemia, which can lead to cardiac dysrhythmias, muscle weakness, and other serious complications. Monitoring sodium, calcium, and magnesium levels is not typically associated with furosemide therapy, making choices A, C, and D incorrect.
3. A client is expressing concern about extreme fatigue following an acute myocardial infarction. What is the best strategy to promote independence?
- A. Instruct the client to rest until fully recovered
- B. Encourage the client to gradually resume self-care tasks with frequent rest periods
- C. Assign assistive personnel to complete self-care tasks
- D. Ask the client's family to assist with self-care
Correct answer: B
Rationale: Encouraging the client to gradually resume self-care tasks with frequent rest periods is the best strategy to promote independence. This approach helps the client regain confidence and autonomy in performing self-care activities. Instructing the client to rest until fully recovered (Choice A) may lead to decreased muscle strength and independence. Assigning assistive personnel (Choice C) does not empower the client to actively participate in their care. Involving the client's family (Choice D) may provide support but does not directly encourage the client's independence.
4. A client is scheduled for a 12-lead ECG. Which of the following actions should the nurse include in the plan of care?
- A. Ensure the client is fasting before the test
- B. Provide a warm blanket for the client
- C. Apply cold compresses to the client's chest
- D. Instruct the client to remain still
Correct answer: D
Rationale: During a 12-lead ECG, the client needs to remain still to obtain accurate readings. Therefore, instructing the client to remain still is essential. Choices A, B, and C are incorrect because fasting is not necessary for an ECG, providing a warm blanket is not a standard procedure, and applying cold compresses may interfere with the ECG results.
5. A nurse is reviewing the plan of care for a client who is taking digoxin. Which of the following findings should the nurse monitor as an adverse effect of this medication?
- A. Hypokalemia
- B. Hypernatremia
- C. Hypertension
- D. Tachycardia
Correct answer: A
Rationale: The correct answer is A: Hypokalemia. Hypokalemia is an adverse effect of digoxin. Digoxin can cause hypokalemia, which increases the risk of toxicity. Monitoring potassium levels is crucial when a client is taking digoxin. Choices B, C, and D are incorrect as hypernatremia, hypertension, and tachycardia are not directly associated with digoxin use.
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