Respiratory
A client is using albuterol inhaler for asthma management. What is the correct sequence for using the inhaler?
A. Breathe out fully, shake the inhaler, press the inhaler, breathe in slowly, hold breath for 10 seconds
B. Shake the inhaler, press the inhaler, breathe out fully, breathe in slowly, hold breath for 10 seconds
C. Shake the inhaler, breathe out fully, press the inhaler, breathe in slowly, hold breath for 10 seconds
D. Press the inhaler, shake the inhaler, breathe in slowly, breathe out fully, hold breath for 10 seconds
C. The correct sequence is to shake the inhaler, breathe out fully, press the inhaler, breathe in slowly, and hold the breath for 10 seconds.
What should a nurse monitor for in a client receiving lidocaine for a cardiac arrhythmia?
A.Metallic taste
B.Hypertension
C.Hyperglycemia
D.Tachycardia
A is correct: Metallic taste is an early sign of lidocaine toxicity.
A client with postoperative constipation is prescribed docusate sodium. What is the primary action of this medication?
A.Stimulates bowel movements
B.Softens the stool
C.Draws water into the intestines
D.Increases bowel motility
B. is correct. Docusate sodium is a surfactant laxative that softens the stool by allowing water and fats to penetrate the stool, making it easier to pass.
A nurse is caring for a client who has just been diagnosed with Parkinson's disease and started on levodopa/carbidopa. Which statement by the client indicates a need for further education?
A."I should take this medication with a high-protein meal to improve absorption."
B."I might experience some nausea when I first start this medication."
C."This medication helps increase the dopamine levels in my brain."
D."I should get up slowly to avoid dizziness."
A is correct: Taking levodopa/carbidopa with a high-protein meal can decrease its absorption, leading to reduced effectiveness. Clients should be advised to take it with low-protein foods or on an empty stomach.
A client with type 1 diabetes is prescribed insulin glargine. What is an important teaching point for this client?
A."Take insulin glargine with meals to prevent hypoglycemia."
B."Insulin glargine peaks 2 hours after administration."
C."Insulin glargine should be administered once daily at the same time each day."
D."You can mix insulin glargine with other insulins in the same syringe."
C is correct: Insulin glargine is a long-acting insulin that should be administered once daily at the same time to maintain consistent blood glucose levels.
A client with COPD is prescribed tiotropium. What should the nurse educate the client about this medication?
B. Tiotropium should be taken with food to avoid gastrointestinal upset
C. Tiotropium is a long-acting bronchodilator that should be used daily
D. Tiotropium can be mixed with albuterol in the same inhaler
C. Tiotropium is a long-acting bronchodilator that should be used daily
Remember:
✓ Tiotropium is used for maintenance therapy in COPD and is not intended for acute relief.
✓ Memory trick: "T for Tiotropium = T for Take daily."
Which of the following medications is a non-selective beta-blocker?
A.Metoprolol
B.Carvedilol
C.Atenolol
D.Bisoprolol
A is incorrect: Metoprolol
Remember:
✓ Non-selective beta-blockers like carvedilol affect cardiac and pulmonary systems, requiring caution in respiratory patients.
A client with irritable bowel syndrome (IBS) is prescribed loperamide. Which instruction should the nurse include?
A."Take this medication before meals."
B."Increase your fiber intake while taking this medication."
C."Take this medication as needed for diarrhea."
D."Avoid drinking fluids while taking this medication."
C is correct. Loperamide is typically taken as needed to control diarrhea, with the dosage adjusted based on the frequency and severity of symptoms.
Remember:
Loperamide is an antidiarrheal medication used to control symptoms of diarrhea by slowing intestinal motility and reducing fluid secretion in the intestines.
A nurse is caring for a client with Alzheimer’s disease who is taking donepezil. What is the most important instruction the nurse should give the client or caregiver?
A.Take the medication in the morning with food
B.Report any unusual gastrointestinal symptoms immediately
C.Donepezil may cause weight gain, so monitor diet closely
D.Avoid taking the medication with other acetylcholinesterase inhibitors
B is correct: Donepezil can cause gastrointestinal side effects, including nausea, vomiting, and diarrhea, which can lead to serious complications, especially in older adults. Prompt reporting of these symptoms is crucial.
Which client is at the greatest risk for developing osteoporosis?
A.A 25-year-old woman on oral contraceptives
B.A 45-year-old man taking calcium supplements
C.A 60-year-old woman on long-term corticosteroid therapy
D.A 30-year-old man with a high-protein diet
C is correct: A 60-year-old woman on long-term corticosteroid therapy is at high risk for developing osteoporosis due to the bone-resorbing effects of corticosteroids.
A client using inhaled corticosteroids for asthma management reports white patches in the mouth. What is the likely cause?
B. Leukoplakia
C. Allergic reaction to the inhaler
D. Oral herpes
A. Oral thrush (candidiasis)
Remember:
✓ Clients should rinse their mouth after using inhaled corticosteroids to prevent oral thrush.
✓ Memory trick: "C for Corticosteroids = Clean your mouth."
Which of the following diuretics is associated with an increased risk of gout?
A.Furosemide
B.Hydrochlorothiazide
C.Amiloride
D.Verapamil
B is correct: Hydrochlorothiazide
a thiazide diuretic, can increase uric acid levels, leading to gout.
Remember:
✓ Clients on thiazide diuretics should be monitored for signs of hyperuricemia and gout, particularly if they have a history of gout.
✓ Encourage adequate hydration to help reduce the risk of gout flare-ups in clients taking thiazide diuretics.
A client undergoing chemotherapy is prescribed ondansetron. Which side effect should the nurse monitor for?
A.Diarrhea
B.Constipation
C.Hypotension
D.Tachycardia
B is correct. Constipation is a common side effect of ondansetron, an antiemetic used to prevent nausea and vomiting associated with chemotherapy.
A client with Parkinson's disease is prescribed benztropine. What should the nurse include in the teaching plan about potential side effects?
A.Increased salivation
B.Bradycardia
C.Urinary retention
D.Diarrhea
C is correct: Benztropine is an anticholinergic medication that can cause urinary retention, a common side effect due to its inhibitory effect on the parasympathetic nervous system.
A client on insulin therapy presents with sweating, shakiness, and confusion. What is the priority nursing action?
A.Administer glucagon IM
B.Check the client's blood glucose level
C.Give the client a snack with protein
D.Encourage the client to lie down and rest
B is correct: The priority is to check the client’s blood glucose level to confirm hypoglycemia before taking further action.
A client with a persistent dry cough is prescribed codeine as an antitussive. What is a critical nursing consideration for this client?
B. Assess for respiratory depression
C. Encourage fluid intake to thin secretions
D. Advise the client to take the medication with meals
B. Assess for respiratory depression
(Codeine, being an opioid, can cause respiratory depression, especially in high doses or when combined with other CNS depressants. )
Which medication is preferred for clients with hypertension and heart failure with reduced ejection fraction?
A.Diltiazem
B.Nifedipine
C.Verapamil
D.Spironolactone
D is correct: Spironolactone is a potassium-sparing diuretic and aldosterone antagonist that is commonly used in clients with heart failure with reduced ejection fraction to help manage symptoms and improve outcomes.
Which of the following are potential complications of TPN? Select all that apply.
A. Hyperglycemia
B. Infection
C. Electrolyte imbalances
D. Hypercalcemia
E. Fluid overload
A, B, C, and E are correct. Potential complications of TPN include hyperglycemia, infection, electrolyte imbalances, and fluid overload.
A client is being treated for postoperative pain with a PCA (patient-controlled analgesia) pump. Which of the following statements indicates that the client understands the use of the PCA?
A."I will have to wait until the nurse checks on me before I can get pain medication."
B."I can press the button whenever I feel pain, but it will only give me medication if it's safe."
C."My family can press the button for me if I am sleeping and they think I am in pain."
D."I should press the button as often as possible to avoid feeling any pain."
B is correct: The PCA pump is designed to allow the client to self-administer pain medication safely, with preset limits to prevent overdose.
A client with hyperthyroidism is scheduled for a thyroidectomy. Which preoperative instruction is most important?
A."You will need to stop taking your antithyroid medication the day before surgery."
B."Avoid all iodine-containing foods and supplements before surgery."
C."Report any signs of a sore throat or fever before surgery."
D."You will not need any special preparations before the surgery."
C is correct: Reporting signs of a sore throat or fever is critical because an infection can complicate surgery and delay the procedure.
What is the primary action of corticosteroids in asthma management?
A. Increase bronchodilation
B. Suppress the inflammatory response
C. Reduce mucus production
D. Block muscarinic receptors
B. Suppress the inflammatory response
Which of the following drugs should be used with caution in clients with a shellfish allergy?
A.Ezetimibe
B.Fish Oil
C.Gemfibrozil
D.Niacin
B is correct: Fish Oil supplements may cause allergic reactions in clients with shellfish allergies.
A client with a duodenal ulcer is prescribed cimetidine. Which potential drug interaction should the nurse be aware of?
A.Increased effects of warfarin
B.Decreased effects of insulin
C.Increased effects of calcium channel blockers
D.Decreased effects of NSAIDs
A is correct. Cimetidine can increase the effects of warfarin by inhibiting its metabolism, leading to an increased risk of bleeding.
A client who has undergone surgery with general anesthesia is in the postoperative unit. The nurse observes that the client is difficult to arouse and has a respiratory rate of 8 breaths per minute. What should be the nurse's first action?
A.Administer naloxone
B.Increase the oxygen flow rate
C.Administer the ordered pain medication
D.Call the anesthesia provider immediately
A is correct: Naloxone should be administered if opioid-induced respiratory depression is suspected. It is a priority to reverse the effects of opioids, which are often used in conjunction with general anesthesia.
Which client statement indicates the need for further teaching about the use of radioactive iodine therapy for hyperthyroidism?
A."I will avoid close contact with others for a few days after the treatment."
B."I can share food and utensils with my family immediately after the treatment."
C."I will flush the toilet twice after each use for the first few days."
D."I will need to have my thyroid function monitored regularly after treatment."
B is correct: Sharing food and utensils immediately after radioactive iodine treatment increases the risk of exposing others to radiation and is not recommended.