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A healthcare professional is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The healthcare professional should not concentrate on which of the following adverse effects of this medication?
- A. Hypokalemia
- B. Tachycardia
- C. Fluid retention
- D. Black, tarry stools
Correct Answer: B
Rationale: When administering prednisone, a corticosteroid medication, to a client with COPD, the healthcare professional should be aware of potential adverse effects. Tachycardia is not a common adverse effect of prednisone use. The correct adverse effects to monitor for include hypokalemia, fluid retention, and gastrointestinal issues like black, tarry stools due to potential gastrointestinal bleeding. Therefore, the healthcare professional should not concentrate on tachycardia but should focus on the other listed adverse effects when administering prednisone to a client with COPD.
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A client experiencing acute dyspnea and diaphoresis reports anxiety and difficulty breathing. Vital signs include HR 117/min, respirations 38/min, temperature 38.4 C (101.2 F), and blood pressure 100/54 mm Hg. What should the nurse prioritize?
- A. Notify the provider.
- B. Administer heparin via IV infusion.
- C. Administer oxygen therapy.
- D. Obtain a spiral CT scan.
Correct Answer: C
Rationale: In a client with acute dyspnea, diaphoresis, tachycardia, tachypnea, fever, and hypotension, the priority is to ensure adequate oxygenation. Administering oxygen therapy helps improve oxygenation levels and stabilize the client's condition. This intervention takes precedence over notifying the provider, administering heparin, or obtaining a CT scan, as oxygen therapy addresses the client's immediate need for respiratory support.
When educating a client who experienced a pneumothorax, which of the following statements should the nurse use?
- A. Notify the provider if you experience weakness.
- B. You should be able to return to work in 1 week.
- C. You need to wear a mask when in crowded areas.
- D. Notify your provider if you experience a productive cough.
Correct Answer: D
Rationale: After experiencing a pneumothorax, it is crucial for the client to be educated on potential complications. A productive cough can indicate infection or another issue, requiring prompt medical attention. Weakness, returning to work, and wearing a mask in crowded areas are important considerations but not as critical as monitoring for respiratory symptoms post-pneumothorax.
A healthcare professional is assessing a client who has a pulmonary embolism. Which of the following information should the healthcare professional not expect to find?
- A. Bradypnea
- B. Pleural friction rub
- C. Petechiae
- D. Tachycardia
Correct Answer: A
Rationale: In a client with a pulmonary embolism, bradypnea, which is abnormally slow breathing, is not an expected finding. Pulmonary embolism typically presents with tachypnea (rapid breathing) due to the body's compensatory mechanism to increase oxygen levels. Pleural friction rub, petechiae, and tachycardia are commonly associated with a pulmonary embolism due to the impaired oxygenation and increased workload on the heart. Therefore, the healthcare professional should not expect to find bradypnea during the assessment of a client with a pulmonary embolism.
A client is receiving discharge instructions from a healthcare provider after being prescribed albuterol for COPD. Which statement by the client indicates understanding of the teaching?
- A. Albuterol can increase my blood sugar levels.
- B. Albuterol can decrease my immune response.
- C. I can experience an increase in my heart rate while taking albuterol.
- D. I may develop mouth sores while taking albuterol.
Correct Answer: C
Rationale: Albuterol is a bronchodilator commonly used to treat conditions like COPD. One of its common side effects is an increase in heart rate (tachycardia) due to its action on beta-2 receptors in the body. This statement by the client demonstrates an understanding of a potential side effect of albuterol, indicating comprehension of the discharge teaching provided by the healthcare provider.
A client is to receive thrombolytic therapy. Which of the following factors should be recognized as a contraindication to the therapy?
- A. Hip arthroplasty 2 weeks ago
- B. Elevated sedimentation rate
- C. Incident of exercise-induced asthma 1 week ago
- D. Elevated platelet count
Correct Answer: A
Rationale: Thrombolytic therapy involves the use of medications to dissolve blood clots. Hip arthroplasty (joint replacement surgery) performed recently is a contraindication to thrombolytic therapy due to the risk of bleeding. Elevated sedimentation rate, exercise-induced asthma, and elevated platelet count are not contraindications to thrombolytic therapy.