Nursing Elites

1. A provider is discharging a client with a prescription for home oxygen therapy. Client and family teaching by the nurse should include all of the following instructions except?

• A. Cleanse the mask or collar with soapy water every other day.
• B. Ensure that the straps on the mask are secure but not too tight.
• C. Apply petroleum jelly around and inside the nares.
• D. Post 'no smoking' warning signs at home in a prominent location.

Correct answer: C

Rationale: When providing instructions for home oxygen therapy, it is important to ensure safety and proper care. Choices A, B, and D are all essential instructions for the client and family. Choice C, 'Apply petroleum jelly around and inside the nares,' is incorrect. Petroleum jelly should not be used near oxygen sources as it is flammable and can increase the risk of fire hazard. Therefore, this instruction should not be included in the teaching.

2. A client is telling the nurse in the clinic that he gets a headache after taking sublingual nitroglycerin (Nitrostat) for his angina pain. Which of the following should the nurse instruct the client to do?

• A. Reduce the nitroglycerin dose
• B. Ask the provider to prescribe a strong analgesic
• C. Lie down in a cool environment and rest
• D. Ask the provider to prescribe a different medication

Correct answer: C

Rationale: The correct answer is to instruct the client to lie down in a cool environment and rest after taking sublingual nitroglycerin for angina pain. Headaches are a common side effect of nitroglycerin due to its vasodilatory effects, and resting in a cool environment can help alleviate the headache. Reducing the nitroglycerin dose is not recommended without consulting the healthcare provider as it may compromise the effectiveness of the medication in managing angina. Asking for a strong analgesic is not appropriate since the headache is likely related to the nitroglycerin and not a separate issue requiring a pain reliever. Requesting a different medication should also involve consulting the healthcare provider to ensure an appropriate alternative is prescribed for angina management.

3. A client is receiving oxygen therapy via a nasal cannula. The nurse should explain that this method of oxygen delivery does which of the following?

• A. Delivers a specific concentration of oxygen constantly
• B. Delivers a high concentration of oxygen
• C. Delivers a low concentration of oxygen
• D. Restricts the client's ability to eat, speak, or drink

Correct answer: A

Rationale: A nasal cannula is a device used for delivering supplemental oxygen to patients. It delivers a specific concentration of oxygen constantly, typically ranging from 1-6 liters per minute. This method is effective for patients who require low to moderate levels of oxygen. Choices B and C are incorrect because a nasal cannula does not deliver a high concentration of oxygen and is not considered a low concentration delivery method. Choice D is incorrect because a nasal cannula does not restrict the client's ability to eat, speak, or drink; it allows them to perform these activities while receiving oxygen therapy.

4. A client with angina pectoris is being taught about starting therapy with nitroglycerin (Nitrostat) tablets. The nurse should instruct the client to take the medication

• A. after each meal and at bedtime.
• B. every 15 minutes during an acute attack.
• C. at the first indication of chest pain.
• D. with 8 oz of water.

Correct answer: C

Rationale: Nitroglycerin (Nitrostat) tablets are used to relieve chest pain associated with angina. The client should take the medication at the first indication of chest pain to help dilate blood vessels and improve blood flow to the heart muscle. Choice A is incorrect because nitroglycerin should not be scheduled after each meal or at bedtime. Choice B is incorrect as taking the medication every 15 minutes during an acute attack is excessive and not recommended. Choice D is incorrect because while it is important to take nitroglycerin with water, the timing of water intake is not as critical as taking the medication at the first sign of chest pain.

5. A client with peripheral arterial disease (PAD) is experiencing muscle pain or cramping during physical activity that resolves with rest. Which of the following symptoms is typically the initial reason clients with PAD seek medical attention?

• A. Intermittent claudication
• B. Dependent rubor
• C. Rest pain
• D. Foot ulcers

Correct answer: A

Rationale: The correct answer is Intermittent claudication. Intermittent claudication, which manifests as muscle pain or cramping during physical activity that improves with rest, is typically the initial reason clients with PAD seek medical attention. Dependent rubor, rest pain, and foot ulcers are more advanced symptoms of PAD and are not usually the initial reasons for seeking medical care.

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