A 25 year-old female patient with pneumonia is prescribed Doxycycline. What question is important to ask the patient prior to administration of this medication?
- A. Do you take birth control pills?'
- B. Are you allergic to Penicillin?'
- C. Are you allergic to eggs?'
- D. Do you have a history of diabetes?'
Correct Answer: A
Rationale: Doxycycline can reduce the effectiveness of oral contraceptives, so asking about birth control use is critical. Penicillin allergy is unrelated, egg allergy is relevant for vaccines, and diabetes is not a primary concern.
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A 62-year-old man is admitted with emphysema and acute upper respiratory infection. Oxygen is ordered at 2 L/min. The reason for low-flow oxygen is to:
- A. prevent excessive drying of secretions.
- B. facilitate oxygen diffusion of the blood.
- C. prevent depression of the respiratory drive.
- D. compensate for increased airway resistance.
Correct Answer: C
Rationale: In COPD, low oxygen levels drive respiration. Low-flow oxygen prevents suppression of the respiratory drive, which could occur with high-flow oxygen.
The client diagnosed with restrictive airway disease (asthma) has been prescribed a glucocorticoid inhaled medication. Which information should the nurse teach regarding this medication?
- A. Do not abruptly stop taking this medication; it must be tapered off.
- B. Immediately rinse the mouth following administration of the drug.
- C. Hold the medication in the mouth for 15 seconds before swallowing.
- D. Take the medication immediately when an attack starts.
Correct Answer: B
Rationale: Rinsing the mouth (B) prevents oral thrush from inhaled glucocorticoids. Tapering (A) applies to systemic steroids, holding/swallowing (C) is incorrect, and attack use (D) is for rescue inhalers.
The nurse is planning the care of a client diagnosed with pneumonia and writes a problem of 'impaired gas exchange.' Which is an expected outcome for this problem?
- A. Performs chest physiotherapy three (3) times a day.
- B. Able to complete activities of daily living.
- C. Ambulates in the hall several times during each shift.
- D. Alert and oriented to person, place, time, and events.
Correct Answer: D
Rationale: Alert/oriented status (D) indicates improved oxygenation from resolved gas exchange impairment. Physiotherapy (A) is an intervention, ADLs (B) and ambulation (C) are secondary outcomes.
Which statement indicates the client with a total laryngectomy requires more teaching concerning the care of the tracheostomy?
- A. I must avoid hair spray and powders.
- B. I should take a shower instead of a tub bath.
- C. I will need to cleanse around the stoma daily.
- D. I can use an electric larynx to speak.
Correct Answer: D
Rationale: Using an electric larynx (D) is related to speech, not tracheostomy care, indicating a misunderstanding of tracheostomy management. Avoiding hair spray/powders (A), showering (B), and daily stoma cleaning (C) are correct tracheostomy care practices.
Which clinical manifestation should the nurse expect to assess in the client recently diagnosed with COPD?
- A. Clubbing of the client's fingers.
- B. Infrequent respiratory infections.
- C. Chronic sputum production.
- D. Nonproductive hacking cough.
Correct Answer: C
Rationale: Chronic sputum production (C) is a hallmark of COPD (chronic bronchitis). Clubbing (A) is late-stage, infections (B) are frequent, and nonproductive cough (D) is atypical.