Nursing Elites

1. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?

• A. Reduce mucus production
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.

2. A healthcare professional is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the healthcare professional administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 1
• B. 2
• C. 3
• D. 4

Correct answer: B

Rationale: To achieve the prescribed dose of 0.25 mg, the healthcare professional should administer 2 tablets of 0.125 mg each, totaling 0.25 mg.

3. Which assessment finding indicates a client's readiness to leave the nursing unit for a bronchoscopy?

• A. Client denies allergies to contrast media.
• B. Skin prep to insertion site completed.
• C. On-call sedation administered.
• D. Oxygen at 2 L/minute via nasal cannula.

Correct answer: C

Rationale: Administering on-call sedation is crucial before a bronchoscopy to ensure the client is comfortable and adequately prepared for the procedure. Sedation helps reduce anxiety, discomfort, and ensures the client remains still during the bronchoscopy, enabling the healthcare provider to perform the procedure effectively.

4. A client with rheumatoid arthritis is prescribed methotrexate. Which instruction should the nurse include in the client's teaching?

• A. Avoid alcohol while taking this medication.
• B. Take the medication with a full meal.
• C. Increase your intake of high-fiber foods.
• D. Avoid exposure to sunlight.

Correct answer: A

Rationale: The correct instruction for the client prescribed with methotrexate is to avoid alcohol while taking this medication. Methotrexate can cause liver toxicity, and alcohol consumption can further exacerbate this risk. It is crucial for patients to abstain from alcohol to prevent adverse effects on the liver. Therefore, instructing the client to avoid alcohol is a key component of safe medication use and management of rheumatoid arthritis.

5. A 60-year-old man presents with fatigue, weight gain, and constipation. Laboratory tests reveal low TSH and high free T4 levels. What is the most likely diagnosis?

• A. Hypothyroidism
• B. Hyperthyroidism
• C. Thyroiditis
• D. Thyroid cancer

Correct answer: B

Rationale: The combination of low TSH and high free T4 levels is characteristic of hyperthyroidism, not hypothyroidism. Hyperthyroidism is associated with symptoms such as fatigue, weight loss, and diarrhea, contrasting with the typical presentation of hypothyroidism. Therefore, in this case, the most likely diagnosis is hyperthyroidism.

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