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A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider?
- A. White coating in the mouth
- B. Increased heart rate
- C. Insomnia
- D. Shortness of breath
Correct Answer: A
Rationale: The correct answer is A: White coating in the mouth. This adverse effect can indicate oral thrush, a fungal infection common with inhaled corticosteroids like fluticasone. The nurse should instruct the client to report this to the provider promptly for appropriate treatment. Increased heart rate (B) and insomnia (C) are common side effects of the medication but not usually serious enough to report immediately. Shortness of breath (D) is a symptom of poorly controlled asthma and should be addressed promptly but not considered an adverse effect of the medication in this context.
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A nurse is collaborating on care for a client who has COPD. Which of the following tasks should the nurse recommend be referred to an occupational therapist for assistance?
- A. Instructing how to use kitchen tools to prepare a meal
- B. Administering oxygen therapy
- C. Monitoring oxygen saturation levels
- D. Assessing breathing patterns
Correct Answer: A
Rationale: The correct answer is A because an occupational therapist can help the client with COPD by providing strategies and adaptive tools for meal preparation to conserve energy and promote independence in daily activities. Administering oxygen therapy (B), monitoring oxygen saturation levels (C), and assessing breathing patterns (D) are within the scope of nursing practice for managing COPD. These tasks require clinical knowledge and skills that nurses are trained to perform.
A nurse is teaching a middle-aged client about hypertension. Which of the following information should the nurse include in the teaching?
- A. Calcium channel blockers are the first choice for hypertension.
- B. Beta-blockers are the first type of medication for hypertension.
- C. ACE inhibitors are the first choice for hypertension.
- D. Diuretics are the first type of medication to control hypertension.
Correct Answer: A
Rationale: Diuretics are the first-line treatment for hypertension as they reduce blood volume, lowering blood pressure.
A nurse is assessing a client who reports numbness and pain in his right palm, index finger, and middle finger. The client reports working with a keyboard most of the time while at work. The nurse suspects carpal tunnel syndrome. Which of the following tests should the nurse request that the client perform?
- A. Tinel's sign
- B. Phalen's test
- C. Rinne's test
- D. Romberg test
Correct Answer: B
Rationale: The correct answer is B: Phalen's test. Phalen's test is used to assess for carpal tunnel syndrome by having the client flex the wrists and press the backs of the hands together for 1 minute to compress the median nerve. This test reproduces symptoms in individuals with carpal tunnel syndrome due to increased pressure on the median nerve. Tinel's sign (A) is used to assess for nerve compression, but it is not specific to carpal tunnel syndrome. Rinne's test (C) is used to assess for hearing loss. Romberg test (D) is used to assess for balance and proprioception issues. Choices E, F, and G are not relevant to assessing carpal tunnel syndrome.
A nurse is reviewing the laboratory values of a client who had a myocardial infarction 3 hr ago. The nurse should expect which of the following laboratory values to be elevated?
- A. Serum sodium
- B. Serum glucose
- C. Troponin I
- D. White blood cell count
Correct Answer: C
Rationale: The correct answer is C: Troponin I. Troponin I is a specific marker for myocardial damage. After a myocardial infarction, the damaged heart muscle releases troponin I into the bloodstream, leading to elevated levels. This helps in diagnosing and monitoring the extent of myocardial damage.
A: Serum sodium levels are not typically affected by a myocardial infarction.
B: Serum glucose levels may be elevated due to stress response but are not specific to myocardial infarction.
D: White blood cell count may be elevated in response to inflammation caused by myocardial infarction, but it is not as specific as troponin I.
A nurse is providing teaching to a client about the manifestations of uterine prolapse. Which of the following statements by the client should indicate to the nurse a need for further teaching?
- A. I should avoid heavy lifting.
- B. Feces can be present in the vagina.
- C. I might experience urinary incontinence.
- D. Pelvic pressure may occur during intercourse.
Correct Answer: B
Rationale: The correct answer is B. Feces present in the vagina is not a manifestation of uterine prolapse; it is a symptom of rectocele. The other choices are correct for uterine prolapse: A - Heavy lifting can worsen prolapse, C - Urinary incontinence is common due to pelvic floor weakness, D - Pelvic pressure during intercourse is a symptom. Therefore, the client mentioning feces in the vagina indicates a need for further teaching on distinguishing between uterine prolapse and rectocele symptoms.