Nokea
A client with a diagnosis of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium (Atrovent). The nurse should teach the client that this medication works by:
- A. Reducing inflammation in the airways.
- B. Dilating the bronchioles.
- C. Thinning mucus secretions.
- D. Suppressing the cough reflex.
Correct Answer: B
Rationale: Ipratropium, an anticholinergic, dilates bronchioles, improving airflow in COPD.
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After a client undergoes a contraction stress test that is negative, which of the following should the nurse assess next?
- A. Evidence of ruptured membranes.
- B. Viability status of the fetus.
- C. Indications that contractions have ceased.
- D. Fetal heart rate variability.
Correct Answer: C
Rationale: A negative contraction stress test indicates no fetal distress, so the nurse should next ensure contractions have ceased to prevent preterm labor. The other assessments are less immediate.
The mother of a child with newly diagnosed Duchenne's muscular dystrophy asks how her child developed the disease. The nurse formulates a response incorporating which of the following statements about its transmission?
- A. It is an autosomal recessive genetic disorder
- B. It is a genetic disorder carried by males and transmitted to male children
- C. It is a disorder primarily transmitted by males in the family
- D. It is a disorder usually carried by females and transmitted to male children
Correct Answer: D
Rationale: Duchenne's muscular dystrophy is an X-linked recessive disorder, typically carried by females and transmitted to male children, who are more likely to express the disease.
A client who sustained a fractured leg has learned how to use crutches. The nurse should determine that the client has a need for further teaching if the client makes which statement about using crutches?
- A. I will keep spare crutch tips available.
- B. I will keep crutch tips dry so they don't slip.
- C. I will inspect the crutch tips for wear from time to time.
- D. I will keep the set of crutches my son used as a spare pair.
Correct Answer: D
Rationale: The client should use only crutches measured for the client. Crutches belonging to another person should not be used unless they have been adjusted to fit the client. Spare tips and crutches fitted to the client should be available if needed. Crutch tips should remain dry. Water could cause slipping by decreasing the surface friction of the rubber tip on the floor. If crutch tips get wet, the client should dry them with a cloth or paper towel. The tips should be regularly inspected for wear.
The nurse is caring for a client with a history of Crohn's disease who is prescribed mesalamine (Asacol). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild diarrhea.
- B. Abdominal pain.
- C. Fever.
- D. Headache.
Correct Answer: C
Rationale: Fever may indicate an exacerbation of Crohn's disease or a side effect of mesalamine, requiring immediate reporting.
A client with a history of heart failure is prescribed valsartan (Diovan). The nurse should monitor the client for which of the following side effects?
- A. Hyperkalemia.
- B. Hypoglycemia.
- C. Weight gain.
- D. Hypertension.
Correct Answer: A
Rationale: Valsartan, an ARB, can cause hyperkalemia, requiring monitoring of potassium levels.