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A nurse is evaluating teaching on a client who has a new prescription for montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?
- A. I'll take this medication once a day in the evening.
- B. I'll take this medication only when I have an asthma attack.
- C. I'll take this medication in the morning before exercise.
- D. I'll stop the medication if I feel better.
Correct Answer: A
Rationale: Correct Answer: A. "I'll take this medication once a day in the evening."
Rationale:
1. Montelukast is usually taken once daily in the evening to provide optimal control of asthma symptoms.
2. Taking it consistently at the same time every day helps maintain a steady level of the medication in the body.
3. This statement shows the client understands the prescribed dosing schedule and is likely to adhere to it.
Summary of other choices:
B. Incorrect: Waiting to take the medication only during an asthma attack is not the correct way to manage asthma as montelukast is meant for daily maintenance.
C. Incorrect: Taking the medication before exercise is not the recommended timing for montelukast administration.
D. Incorrect: Stopping the medication when feeling better can lead to a worsening of asthma symptoms as montelukast helps prevent asthma attacks.
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A nurse is caring for a client who reports a new onset of severe chest pain. Which of the following actions should the nurse take to determine if the client is experiencing a myocardial infarction?
- A. Perform a 12-lead ECG
- B. Administer nitroglycerin
- C. Place the client in a prone position
- D. Assess the client's blood pressure
Correct Answer: A
Rationale: The correct answer is A: Perform a 12-lead ECG. This is because an ECG is the most reliable and direct way to assess for myocardial infarction by identifying characteristic changes in the heart's electrical activity. Nitroglycerin (B) is used to relieve chest pain but should not be administered before confirming the diagnosis. Placing the client in a prone position (C) is not appropriate for assessing chest pain. Assessing blood pressure (D) is important but not the initial priority when suspecting myocardial infarction.
A nurse is teaching a client with a history of calcium oxalate kidney stones. What advice should be given?
- A. Limit fluid intake to 1 L per day.
- B. Drink 3 L of fluid every day.
- C. Increase calcium intake.
- D. Avoid all citrus juices.
Correct Answer: B
Rationale: The correct answer is B: Drink 3 L of fluid every day. Increasing fluid intake helps prevent the formation of kidney stones by diluting the urine and reducing the concentration of minerals like calcium oxalate. Adequate hydration promotes frequent urination, which helps flush out these minerals. Limiting fluid intake (choice A) can lead to concentrated urine and increase the risk of stone formation. Increasing calcium intake (choice C) can actually help prevent calcium oxalate stones, as calcium binds with oxalate in the intestines, reducing its absorption. Avoiding all citrus juices (choice D) is unnecessary, as they do not directly contribute to the formation of calcium oxalate stones.
A nurse is teaching a client who has been taking prednisone to treat asthma and has a new prescription to discontinue the medication. The nurse should explain to the client to reduce the dose gradually to prevent which of the following adverse effects?
- A. Osteoporosis
- B. Hypoglycemia
- C. Hyperkalemia
- D. Adrenocortical insufficiency
Correct Answer: D
Rationale: The correct answer is D: Adrenocortical insufficiency. Gradually reducing prednisone dose is important as prednisone suppresses the body's natural production of cortisol. Abrupt discontinuation can lead to adrenal insufficiency due to the sudden decrease in cortisol levels. This can result in symptoms such as fatigue, weakness, weight loss, and hypotension. Osteoporosis (A) is a long-term side effect of prednisone but not a concern with dose reduction. Hypoglycemia (B) and Hyperkalemia (C) are not typically associated with prednisone withdrawal.
A nurse is assessing a client before a packed RBC transfusion. What data is most important to obtain?
- A. Blood pressure
- B. Temperature
- C. Respiratory rate
- D. Oxygen saturation
Correct Answer: B
Rationale: The correct answer is B: Temperature. Before a packed RBC transfusion, it is crucial to assess the client's temperature as hyperthermia can indicate a possible transfusion reaction. Monitoring temperature helps in early detection and intervention. Blood pressure (A) is important but not the most crucial in this context. Respiratory rate (C) and oxygen saturation (D) are relevant but may not indicate an immediate issue with the transfusion. Other choices are not provided.
A nurse is monitoring a client who was admitted with a severe burn injury and is receiving IV fluid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate fluid replacement?
- A. Blood pressure
- B. Heart rate
- C. Urine output
- D. Respiratory rate
Correct Answer: B
Rationale: The correct answer is B: Heart rate. A decrease in heart rate indicates adequate fluid replacement in a burn-injured patient due to improved cardiac output and perfusion. When fluid resuscitation is effective, the heart doesn't need to work as hard to maintain circulation. Blood pressure (choice A) may fluctuate initially but is not a reliable indicator of fluid replacement alone. Urine output (choice C) is important but may take time to stabilize. Respiratory rate (choice D) may be affected by pain or stress, not solely fluid status. Other choices are not relevant.