Nokea
A client is being discharged with albuterol (Proventil) and beclomethasone dipropionate (Vanceril) to be administered via inhalation three times a day and at bedtime. Client teaching regarding the sequential order in which the drugs should be administered includes:
- A. Glucocorticoid followed by the bronchodilator
- B. Bronchodilator followed by the glucocorticoid
- C. Alternate successive administrations
- D. According to the client's preference
Correct Answer: B
Rationale: The client would not receive therapeutic effects of the glucocorticoid when it is inhaled through constricted airways. Bronchodilating the airways first allows for the glucocorticoid to be inhaled through open airways and increases the penetration of the steroid for maximum effectiveness of the drug. Inaccurate use of the inhalers will lead to decreased effectiveness of the treatment. Client teaching regarding the use and effects of inhalers will promote client understanding and compliance.
You may also like to solve these questions
The nurse is formulating a plan of care for a client with a goiter. The priority nursing diagnosis for the client with a goiter is:
- A. Body image disturbance related to enlargement of the neck
- B. Activity intolerance related to fatigue
- C. Nutrition imbalance, less than body requirements, related to increased metabolism
- D. Risk for ineffective airway clearance related to pressure of goiter on the trachea
Correct Answer: D
Rationale: A large goiter can compress the trachea, posing a risk for ineffective airway clearance, which is a priority due to its potential to impair breathing.
A physician tells the nurse that he wants to orally intubate a client with a No. 8 endotracheal tube. The finding of normal breath sounds on the right side of the chest and diminished, distant breath sounds on the left side of the chest of a newly intubated client is probably due to:
- A. A left hemothorax
- B. A right hemothorax
- C. Intubation of the right mainstem bronchus
- D. An inadequate mechanical ventilator
Correct Answer: C
Rationale: The right mainstem bronchus is most frequently intubated in error because the angle of the right mainstem bronchus is very small as compared with that of the left mainstem bronchus. Because ventilation is only occurring on the right side, the nurse would auscultate diminished and distant breath sounds on the left.
Which of the following nursing diagnoses is of highest priority for the patient with hypothyroidism?
- A. Impaired physical mobility
- B. Hypothermia
- C. Disturbed thought processes
- D. Decreased cardiac output
Correct Answer: D
Rationale: Hypothyroidism reduces metabolic rate potentially decreasing cardiac output which can lead to life-threatening complications like heart failure. While hypothermia and other diagnoses are relevant decreased cardiac output is the most critical.
A client had abdominal surgery this morning. The nurse notices that there is a small amount of bloody drainage on his surgical dressing. The nurse would document this as what type of drainage?
- A. Serosanguinous
- B. Purulent
- C. Sanguinous
- D. Catarrhal
Correct Answer: C
Rationale: Drainage from a surgical incision is initially sanguinous, proceeding to serosanguinous, and then to serous.
A 3-year-old child is admitted with a diagnosis of possible noncommunicating hydrocephalus. What is the first symptom that indicates increased intracranial pressure?
- A. Bulging fontanelles
- B. Seizure
- C. Headache
- D. Ataxia
Correct Answer: C
Rationale: Headache is the earliest symptom of increased intracranial pressure in children, preceding other signs like seizures or ataxia.