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A client with a diagnosis of osteoporosis is prescribed alendronate (Fosamax). What is the most important instruction the nurse should provide?
- A. Take the medication in the morning on an empty stomach.
- B. Take the medication at bedtime.
- C. Remain upright for at least 30 minutes after taking the medication.
- D. Take the medication with a full glass of water.
Correct Answer: D
Rationale: The most important instruction the nurse should provide to a client prescribed alendronate (Fosamax) for osteoporosis is to take the medication with a full glass of water. This is crucial to help prevent esophageal irritation. Option A is correct as alendronate should be taken in the morning on an empty stomach. Option C is incorrect because the client should remain upright for at least 30 minutes after taking the medication, not lie down. Option B is incorrect and a duplicate of Option A.
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A client with asthma is prescribed a corticosteroid inhaler. What instruction should the nurse give about the inhaler?
- A. Use it only during asthma attacks
- B. Rinse the mouth after each use to prevent oral thrush
- C. It will provide immediate relief during an asthma attack
- D. Increase the dose if breathing does not improve
Correct Answer: B
Rationale: The correct instruction for a client using a corticosteroid inhaler is to rinse the mouth after each use to prevent the development of oral thrush, a common side effect of these inhalers. Choice A is incorrect as corticosteroid inhalers are often used regularly as a maintenance treatment, not just during asthma attacks. Choice C is incorrect because corticosteroid inhalers provide long-term control of asthma symptoms, not immediate relief during an attack. Choice D is incorrect and potentially dangerous advice as increasing the dose without medical guidance can lead to adverse effects.
In a community health setting, which individual is at highest risk for contracting an HIV infection?
- A. 17-year-old who is sexually active with numerous partners
- B. 34-year-old homosexual in a monogamous relationship
- C. 30-year-old cocaine user who inhales and smokes drugs
- D. 45-year-old who has received two blood transfusions in the past 6 months
Correct Answer: C
Rationale: The correct answer is C. Substance abuse, particularly using shared inhalation equipment like needles and pipes for drug inhalation, significantly increases the risk of contracting HIV. Choice A, the 17-year-old with multiple sexual partners, poses a risk of HIV transmission through sexual contact, but it is lower compared to the direct risk associated with sharing drug paraphernalia. Choice B, the 34-year-old homosexual in a monogamous relationship, is at lower risk since being in a monogamous relationship reduces exposure to HIV. Choice D, the 45-year-old who received blood transfusions, is also at lower risk as blood transfusions are now screened for HIV, decreasing the likelihood of transmission through this route.
The nurse is providing care for a client with a draining postoperative wound infected with methicillin-resistant Staphylococcus aureus (MRSA). Which is the most important action for the nurse to take?
- A. Encourage increased oral fluids.
- B. Provide high-protein snacks.
- C. Change the wound dressing.
- D. Administer prescribed antibiotics.
Correct Answer: D
Rationale: Administering prescribed antibiotics is crucial in treating MRSA infections. MRSA is a type of bacteria that is resistant to many antibiotics, including methicillin. Therefore, prompt administration of the appropriate antibiotics is essential to target the MRSA infection effectively. Encouraging increased oral fluids (Choice A) and providing high-protein snacks (Choice B) may be beneficial for overall recovery but are not the most important actions in treating an MRSA infection. Changing the wound dressing (Choice C) is important for wound care but does not directly address the infection caused by MRSA.
The nurse is caring for a client who has just returned from surgery with a urinary catheter in place. What is the most important action to prevent catheter-associated urinary tract infections (CAUTIs)?
- A. Irrigate the catheter daily
- B. Ensure the catheter bag is always below bladder level
- C. Change the catheter every 48 hours
- D. Administer prophylactic antibiotics
Correct Answer: B
Rationale: The correct answer is to ensure the catheter bag is always below bladder level. This positioning helps prevent backflow of urine, reducing the risk of CAUTIs. Choice A, irrigating the catheter daily, is not recommended as it can introduce pathogens into the bladder. Changing the catheter too frequently (Choice C) can increase the risk of introducing pathogens. Administering prophylactic antibiotics (Choice D) is not the primary intervention for preventing CAUTIs and can lead to antibiotic resistance.
A client with asthma is prescribed an albuterol inhaler. Which instruction should the nurse provide?
- A. Use the inhaler only during an asthma attack
- B. Rinse your mouth after using the inhaler
- C. Shake the inhaler before each use
- D. Exhale fully before inhaling the medication
Correct Answer: C
Rationale: The correct instruction for the nurse to provide is to shake the inhaler before each use. Shaking the inhaler ensures proper mixing of the medication before administration, which is crucial for its effectiveness. Choice A is incorrect because albuterol inhalers are often used as a preventive measure, not just during asthma attacks. Choice B is a good practice to prevent oral fungal infections associated with inhaled corticosteroids, not typically with albuterol. Choice D is important for proper inhaler technique, but the primary step before inhaling is shaking the inhaler to ensure the medication is well mixed.