Nursing Elites

1. The client is being instructed on the correct technique for using... what to provide the client?

• A. Angle the tip of the inhaler upwards while spraying
• B. Hold one nostril closed while spraying the other nostril
• C. Avoid shaking the inhaler immediately before using
• D. Use the inhaler when first awakening in the morning

Correct answer: B

Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.

2. A client who is obtunded arrives in the emergency center with a suspected drug overdose. Intravenous naloxone is given, but within a short period, the client's level of consciousness deteriorates. What action should the nurse take first?

• A. Initiate a second intravenous access site
• B. Prepare to initiate cardiopulmonary resuscitation
• C. Determine the results of the drug toxicity screen
• D. Administer an additional dose of naloxone

Correct answer: D

Rationale: Administering an additional dose of naloxone should be the first action taken by the nurse in this scenario. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. If the client's level of consciousness deteriorates after the initial dose, administering another dose can help further reverse the overdose effects and improve the client's condition. Once the additional naloxone dose is given, the nurse can then proceed to assess the client's response and consider other interventions as needed.

3. A client with a diagnosis of schizophrenia is prescribed quetiapine. The nurse should monitor the client for which potential side effect?

• A. Weight gain
• B. Dry mouth
• C. Nausea
• D. Headache

Correct answer: A

Rationale: Quetiapine is known to cause weight gain as a common side effect. Monitoring the client's weight is crucial to identify any significant changes that may occur due to the medication.

4. A client with chronic heart failure is prescribed spironolactone. The nurse should monitor for which potential side effect?

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

Correct answer: A

Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic that can lead to an excess of potassium in the body, resulting in hyperkalemia. This side effect is important to monitor in clients taking spironolactone, especially those with chronic heart failure, as hyperkalemia can lead to serious cardiac complications.

5. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

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