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A nurse is providing teaching to a client who has mild persistent asthma and has been prescribed montelukast. Which of the following statements should the nurse include in the teaching?
- A. This medication can be used to help you during an acute asthma attack.
- B. This medication helps decrease swelling and mucus production.
- C. This medication should be taken before exercise.
- D. This medication should be taken daily in the evening.
Correct Answer: D
Rationale: The correct answer is D. Montelukast should be taken daily in the evening for long-term control of asthma, rather than for immediate relief. Choice A is incorrect because montelukast is not used for acute asthma attacks. Choice B is incorrect as montelukast works by blocking leukotrienes, not by decreasing swelling and mucus production. Choice C is incorrect as montelukast is not specifically taken before exercise.
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How should a healthcare provider respond to a patient refusing treatment for religious reasons?
- A. Respect the patient's beliefs
- B. Attempt to persuade the patient
- C. Provide education on treatment benefits
- D. Document the refusal and notify the provider
Correct Answer: A
Rationale: Respecting the patient's beliefs is crucial in providing patient-centered care. Attempting to persuade the patient may violate their autonomy and decision-making capacity, leading to a breakdown in trust. Providing education on treatment benefits may be appropriate in other situations but is not the best approach when a patient refuses treatment based on religious reasons. Documenting the refusal and notifying the provider are important steps to ensure proper continuity of care, but the primary response should be to respect the patient's beliefs to maintain a trusting relationship and uphold ethical standards.
How should signs of infection in a post-surgical patient be assessed?
- A. Check the surgical site
- B. Check the patient's vital signs
- C. Monitor for fever
- D. Check for abnormal breath sounds
Correct Answer: A
Rationale: Assessing the surgical site is crucial in identifying early signs of infection post-surgery. Changes such as redness, swelling, warmth, or drainage may indicate an infection developing. While monitoring vital signs and fever are important in infection assessment, they are general indicators and may not show localized signs at the surgical site. Checking for abnormal breath sounds is more relevant when assessing respiratory issues rather than infection at the surgical site.
How should a healthcare provider monitor a patient with fluid overload?
- A. Monitor daily weight
- B. Check for edema
- C. Monitor input and output
- D. Monitor blood pressure
Correct Answer: A
Rationale: Monitoring daily weight is crucial in assessing fluid retention accurately in a patient with fluid overload. Changes in weight can indicate fluid accumulation or loss, providing valuable information for healthcare providers. Checking for edema (choice B) is important but may not always accurately reflect total body fluid status. Monitoring input and output (choice C) and blood pressure (choice D) are also essential aspects of patient assessment, but they may not directly reflect the extent of fluid overload as effectively as monitoring daily weight.
A nurse is caring for a client who has chronic kidney disease. The nurse should identify which of the following laboratory values as an indication for hemodialysis?
- A. Glomerular filtration rate of 14 mL/min
- B. BUN 16 mg/dL
- C. Serum magnesium 1.8 mg/dL
- D. Serum phosphorus 4.0 mg/dL
Correct Answer: A
Rationale: A glomerular filtration rate (GFR) of 14 mL/min is significantly low, indicating poor kidney function and the need for hemodialysis to remove waste products effectively. BUN, serum magnesium, and serum phosphorus levels are important in assessing kidney function and electrolyte balance but are not direct indicators for the initiation of hemodialysis. BUN (blood urea nitrogen) reflects the kidney's ability to filter waste products, serum magnesium levels are important for muscle and nerve function, and serum phosphorus levels are vital for bone health.
A client is receiving discharge teaching regarding a new prescription for warfarin. Which of the following statements by the client indicates a need for further teaching?
- A. I will eat more leafy green vegetables while taking warfarin.
- B. I will have my INR checked regularly while taking warfarin.
- C. I will avoid drinking grapefruit juice while taking warfarin.
- D. I will use a soft toothbrush while taking warfarin.
Correct Answer: A
Rationale: The correct answer is A. Clients taking warfarin should avoid leafy green vegetables as they are high in vitamin K, which can reduce the effectiveness of the medication. Therefore, the statement 'I will eat more leafy green vegetables while taking warfarin' indicates a need for further teaching. Choice B is correct as regular monitoring of INR levels is necessary for clients on warfarin. Choice C is correct as grapefruit juice can interact with warfarin and should be avoided. Choice D is correct as using a soft toothbrush is recommended to prevent gum bleeding while on warfarin.