A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications?
- A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone.
- B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol.
- C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone.
- D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.
Correct Answer: A
Rationale: Salmeterol, a long-acting bronchodilator, should be inhaled first to open the airways, followed by Fluticasone, a corticosteroid, after a 5-minute wait to ensure optimal delivery and reduce inflammation.
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A patient taking Isoniazid (INH) should be monitored for what deficiency?
- A. Vitamin C
- B. Calcium
- C. Vitamin B6
- D. Potassium
Correct Answer: C
Rationale: This medication can lead to low Vitamin B6 levels. Most patients will take a supplement of B6 while taking this medication.
Your patient with a diagnosis of latent tuberculosis infection needs a bronchoscopy. During transport to endoscopy, the patient will need to wear?
- A. N95 mask
- B. Surgical mask
- C. No special PPE is needed
- D. Face mask with shield
Correct Answer: B
Rationale: Patients with latent tuberculosis are not contagious and have no symptoms, but during procedures like bronchoscopy that may generate aerosols, a surgical mask is worn to prevent potential spread if the infection is active.
Which outcome is appropriate for the client problem 'ineffective gas exchange' for the client recently diagnosed with COPD?
- A. The client demonstrates the correct way to pursed-lip breathe.
- B. The client lists three (3) signs/symptoms to report to the HCP.
- C. The client will drink at least 2,500 mL of water daily.
- D. The client will be able to ambulate 100 feet with dyspnea.
Correct Answer: A
Rationale: Pursed-lip breathing (A) improves gas exchange by prolonging exhalation. Symptom reporting (B), hydration (C), and ambulation with dyspnea (D) are unrelated to gas exchange.
A patient with emphysema may present with all of the following symptoms EXCEPT?
- A. Barrel chest
- B. Hyperinflation of the lungs
- C. Hypoventilation
- D. Hypercapnia
Correct Answer: C
Rationale: Emphysema causes barrel chest , lung hyperinflation , and often hypercapnia due to air trapping. Hypoventilation is not typical, as patients hyperventilate to compensate for poor gas exchange.
The nurse is caring for a client diagnosed with a pneumothorax who had chest tubes inserted four (4) hours ago. There is no fluctuating (tidaling) in the water-seal compartment of the closed chest drainage system. Which action should the nurse implement first?
- A. Milk the chest tube.
- B. Check the tubing for kinks.
- C. Instruct the client to cough.
- D. Assess the insertion site.
Correct Answer: B
Rationale: No tidaling in the water-seal compartment suggests a blockage or kink. Checking for kinks (B) is the first, non-invasive action to restore function. Milking (A) is avoided due to pressure risks. Coughing (C) is ineffective if tubing is blocked. Assessing the site (D) is secondary.