Nokea
A client with a history of asthma is experiencing an acute exacerbation. Which medication should the nurse administer first?
- A. Albuterol
- B. Prednisone
- C. Montelukast
- D. Cromolyn sodium
Correct Answer: A
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma exacerbations to relieve bronchospasm and improve airflow.
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A client has had sucralfate (Carafate) ordered as treatment for peptic ulcer disease. Which of the following statements indicates that the client understands how to take the medication?
- A. I should take the Carafate every evening at bedtime.'
- B. It is important that I take this drug on an empty stomach.'
- C. I should avoid milk products while taking this drug.'
- D. I should have my hemoglobin checked monthly while taking Carafate.'
Correct Answer: B
Rationale: Sucralfate should be taken on an empty stomach to coat the stomach lining effectively. Bedtime dosing, avoiding milk, or monthly hemoglobin checks are not required.
A 57-year-old Hispanic woman with breast cancer who does not speak English is admitted for a lumpectomy. Her daughter, who speaks English, accompanies her. In order to obtain admission information from the client, what should the nurse do?
- A. Add the client's daughter to serve as an interpreter.
- B. Ask one of the Hispanic nursing assistants to serve as an interpreter.
- C. Use the limited Spanish learned in high school along with nonverbal communication.
- D. Obtain a trained medical interpreter.
Correct Answer: D
Rationale: A trained medical interpreter is required to ensure safety, accuracy of history data, and client confidentiality. The medical interpreter knows the client's rights and is familiar with the client's culture. Using the family member as interpreter violates the client's confidentiality. Using the nursing assistant or limited Spanish and nonverbal communication reduces the accuracy of interpretation and back-translation into English.
Which adverse effect of heparin sodium therapy, delivered continuously by intravenous infusion, should the nurse monitor the client for?
- A. Tinnitus
- B. Ecchymoses
- C. Increased pulse rate
- D. Decreased blood pressure
Correct Answer: B
Rationale: Heparin sodium is an anticoagulant. The client who receives heparin sodium is at risk for bleeding. The nurse monitors for signs of bleeding, which includes bleeding from the gums, ecchymoses on the skin, cloudy or pink-tinged urine, tarry stools, and body fluids that test positive for occult blood. The remaining options are not related side or adverse effects of this medication.
A client with a history of schizophrenia is prescribed quetiapine (Seroquel). The nurse should monitor the client for which of the following adverse effects?
- A. Weight gain.
- B. Hypoglycemia.
- C. Bradycardia.
- D. Hypotension.
Correct Answer: A, D
Rationale: Quetiapine can cause weight gain and hypotension.
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.