Nursing Elites

1. When teaching a client with chronic obstructive pulmonary disease who will start using fluticasone via MDI twice daily, which instruction should the nurse include?

• A. Monitor your heart rate before each dose.
• B. Inspect your mouth for lesions daily.
• C. Do not use this medication to relieve an acute attack.
• D. Do not skip the morning dose even if symptom-free.

Correct answer: B

Rationale: It is crucial for clients using inhaled corticosteroids like fluticasone to inspect their mouths daily for signs of oral thrush, a common side effect. Checking the mouth can help identify lesions early, allowing for timely intervention to prevent worsening of the condition. Monitoring heart rate is not specifically required for this medication. Fluticasone is a maintenance medication used to manage COPD, not to relieve acute attacks. Skipping doses, especially in the morning, can lead to inadequate control of COPD symptoms.

2. A client in the emergency department is being cared for by a nurse and has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, blood pressure 110/79 mm Hg, and apical heart rate 112/min. What is the nurse's priority intervention?

• A. Provide the client with supplemental oxygen at 5 L/min via facemask.
• B. Place the client in high-Fowler's position with their legs in a dependent position
• C. Give the client sublingual nitroglycerin
• D. Administer morphine sulfate IV

Correct answer: A

Rationale: In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation and reduce the workload on the heart. Providing supplemental oxygen at 5 L/min via facemask helps increase oxygen levels and alleviate respiratory distress. This intervention can help improve oxygen saturation, alleviate dyspnea, and support the client's respiratory function. Placing the client in a high-Fowler's position with legs dependent can also help with respiratory effort, but ensuring adequate oxygenation takes precedence. Sublingual nitroglycerin and IV morphine sulfate are commonly used interventions for cardiac-related conditions, but in this case, addressing oxygenation is the priority to prevent further deterioration.

3. A client is receiving oxygen therapy via nasal cannula. Which finding indicates that the therapy is effective?

• A. The client is able to ambulate in the hall without dyspnea.
• B. The client has a respiratory rate of 24 breaths per minute.
• C. The client's oxygen saturation is 92%.
• D. The client has a productive cough.

Correct answer: A

Rationale: The correct answer is A. Effective oxygen therapy should improve the client's ability to perform activities without dyspnea. This indicates that the oxygen therapy is adequately supporting the client's respiratory needs. An oxygen saturation of 92% may suggest the need for a higher flow rate to improve oxygenation. A respiratory rate of 24 breaths per minute is elevated, indicating potential respiratory distress. A productive cough does not necessarily indicate effective oxygen therapy, as it is a symptom of respiratory irritation or infection, not oxygenation status.

4. A client with newly diagnosed osteoporosis is being taught about lifestyle modifications. Which instruction should be included?

• A. Increase intake of caffeinated beverages.
• B. Engage in weight-bearing exercises regularly.
• C. Avoid exposure to sunlight.
• D. Take calcium supplements with iron.

Correct answer: B

Rationale: Engaging in weight-bearing exercises is crucial for individuals with osteoporosis as it helps strengthen bones and reduce the risk of fractures. Weight-bearing exercises include activities like walking, jogging, dancing, and strength training. These exercises help improve bone density and overall bone health, making them an essential component of lifestyle modifications for individuals with osteoporosis.

5. A nurse is interested in providing community education and screening on hypertension. In order to reach a priority population, to what target audience should the nurse provide this service?

• A. African American churches
• B. Asian American groceries
• C. High school sports camps
• D. Women's health clinics

Correct answer: A

Rationale: The correct answer is African American churches. African Americans in the United States have one of the highest rates of hypertension globally. By providing services at African American churches, the nurse can effectively reach this priority population. While hypertension education and screening are essential for all groups, African Americans are the priority population for this intervention due to their disproportionately high rates of hypertension.

Similar Questions