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A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?
- A. Use this medication for acute asthma attacks.
- B. Use this medication before using your albuterol inhaler.
- C. Use this medication twice daily for long-term control.
- D. Use this medication as needed for wheezing.
Correct Answer: C
Rationale: The correct instruction is C: Use this medication twice daily for long-term control. Salmeterol is a long-acting beta-agonist used for maintenance therapy in asthma to provide long-term control of symptoms and prevent exacerbations. It should not be used for acute asthma attacks as it does not provide quick relief like rescue inhalers such as albuterol (choice A). It is not meant to replace albuterol, so it should not be used before using albuterol (choice B). Using salmeterol as needed for wheezing (choice D) is not appropriate as it is a maintenance medication and not a rescue medication.
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A client with a history of chronic heart failure is experiencing severe shortness of breath and has pink, frothy sputum. Which action should the nurse take first?
- A. Administer morphine sulfate.
- B. Place the client in a high Fowler's position.
- C. Initiate continuous ECG monitoring.
- D. Prepare the client for intubation.
Correct Answer: B
Rationale: The correct action for the nurse to take first is to place the client in a high Fowler's position (Choice B). This position helps improve lung expansion and oxygenation by reducing pressure on the diaphragm and improving ventilation. With severe shortness of breath and pink, frothy sputum, the priority is to optimize respiratory function. Administering morphine sulfate (Choice A) may be indicated later for pain and anxiety but is not the immediate priority. Initiating continuous ECG monitoring (Choice C) is important but not as urgent as addressing the respiratory distress. Preparing the client for intubation (Choice D) should be considered if respiratory distress worsens, but initial interventions should focus on improving oxygenation through positioning.
The client has been prescribed metformin (Glucophage) for type 2 diabetes. Which instruction should the nurse include in discharge teaching?
- A. Take the medication at bedtime.
- B. Take the medication with meals.
- C. Take the medication on an empty stomach.
- D. Take the medication as needed for high blood sugar.
Correct Answer: B
Rationale: The correct answer is B: Take the medication with meals. Metformin is typically taken with meals to minimize gastrointestinal side effects. Food helps in the absorption and tolerance of the medication. Taking it on an empty stomach can lead to stomach upset. Taking it at bedtime may also cause nighttime disruptions. Taking it as needed for high blood sugar is not appropriate as metformin is usually taken regularly to control blood sugar levels.
A client with hypothyroidism is prescribed levothyroxine (Synthroid). Which instruction should the nurse provide?
- A. Take the medication with a meal.
- B. Take the medication at bedtime.
- C. Take the medication on an empty stomach.
- D. Take the medication with an antacid.
Correct Answer: C
Rationale: The correct answer is C: Take the medication on an empty stomach. Levothyroxine should be taken on an empty stomach in the morning, at least 30 minutes before eating, to ensure optimal absorption. Food can interfere with the absorption of levothyroxine, reducing its effectiveness. Taking it with a meal (option A) or at bedtime (option B) may lead to decreased absorption. Taking it with an antacid (option D) can also interfere with absorption. Therefore, the best instruction is to take the medication on an empty stomach to maximize its therapeutic effects.
The nurse is caring for a client with a spinal cord injury. Which intervention should the nurse implement to prevent autonomic dysreflexia?
- A. Restrict the client's fluid intake.
- B. Keep the client's room warm.
- C. Ensure the client's bladder is emptied regularly.
- D. Limit the client's intake of high-fiber foods.
Correct Answer: C
Rationale: The correct answer is C: Ensure the client's bladder is emptied regularly. Autonomic dysreflexia is a potentially life-threatening condition that occurs in clients with spinal cord injuries. It is triggered by a distended bladder or bowel. By regularly emptying the client's bladder, the nurse can prevent the stimulus that leads to autonomic dysreflexia. Option A is incorrect because restricting fluid intake can lead to dehydration, exacerbating the condition. Option B is incorrect as temperature regulation is not directly related to preventing autonomic dysreflexia. Option D is incorrect as high-fiber foods do not play a role in triggering this condition.
A client with chronic kidney disease (CKD) is experiencing hyperkalemia. Which intervention should the nurse implement to address this condition?
- A. Administer calcium gluconate.
- B. Encourage a diet high in potassium.
- C. Provide potassium supplements.
- D. Restrict sodium intake.
Correct Answer: A
Rationale: The correct answer is A: Administer calcium gluconate. Calcium gluconate is used to stabilize the cardiac membrane in hyperkalemia, preventing dangerous cardiac arrhythmias. It does not lower potassium levels but helps protect the heart.
B: Encouraging a diet high in potassium would worsen hyperkalemia.
C: Providing potassium supplements would further elevate potassium levels.
D: Restricting sodium intake does not directly address hyperkalemia.