Nokea
A client with asthma asks the nurse if she should use her salmeterol (Serevent) inhaler when she exercises and experiences wheezing and shortness of breath. The nurse's best response is which of the following?
- A. Yes, use the inhaler immediately for these symptoms.'
- B. No, this drug is a maintenance drug, not a rescue inhaler.'
- C. Use the inhaler 5 minutes before you exercise to prevent the wheezing.'
- D. This inhaler is for allergic rhinitis, not asthma.'
Correct Answer: B
Rationale: Salmeterol is a long-acting beta-agonist used for asthma maintenance, not for acute symptoms like wheezing during exercise. A rescue inhaler, such as albuterol, is appropriate for acute symptoms.
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A child with meningococcal meningitis is being admitted to the pediatric unit. In preparation for the child's arrival, the nurse should first?
- A. Institute droplet precautions.
- B. Obtain the child's vital signs.
- C. Ask the parent about medication allergies.
- D. Inquire about the health of siblings at home.
Correct Answer: A
Rationale: Meningococcal meningitis is transmitted via droplets, so instituting precautions is the priority to prevent spread.
A client with a urinary tract infection is prescribed ciprofloxacin. What should the nurse include in the teaching?
- A. Take the medication with dairy products.
- B. Report tendon pain or swelling.
- C. Increase fluid intake to 1 L/day.
- D. Avoid sunlight exposure completely.
Correct Answer: B
Rationale: Ciprofloxacin can cause tendonitis or tendon rupture, so reporting tendon pain or swelling is critical.
The nurse is assessing a client with irreversible shock. The nurse should document which of the following?
- A. Increased alertness.
- B. Circulatory collapse.
- C. Hypertension.
- D. Diuresis.
Correct Answer: B
Rationale: Irreversible shock is characterized by circulatory collapse, with failure of vital organs due to inadequate perfusion, a critical finding to document.
A client with a paranoid personality disorder sees some clients laughing during a group activity and asks the nurse, 'Why are they laughing at me? I bet they're making fun of me.' Which of the following responses by the nurse is most appropriate?
- A. You shouldn't let yourself get so upset
- B. Don't worry about them. They don't mean any harm
- C. Look. They seem to be having fun
- D. They're laughing at a joke John told. They aren't laughing at you
Correct Answer: D
Rationale: Providing a factual explanation that the laughter is due to a joke addresses the client's paranoia directly and reassuringly, reducing misinterpretation. Other responses dismiss or minimize the client's feelings.
Which lipid level would you report to the doctor because it is not normal and it is also a significant change in the client?
- A. Triglycerides: 75 mg/dL
- B. Total cholesterol: 6.5 mmol/L
- C. High-density lipoprotein (HDL): 60 mg/dL
- D. Low-density lipoprotein (LDL): 955 mg/dL
Correct Answer: D
Rationale: LDL of 955 mg/dL is extremely high (normal <130 mg/dL), indicating a significant risk for cardiovascular disease and requiring immediate reporting.