Nokea
An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. The nurse would suggest a spacer to
- A. enhance the administration of the medication
- B. increase client compliance
- C. improve aerosol delivery in clients who are not able to coordinate the MDI
- D. prevent exacerbation of COPD
Correct Answer: C
Rationale: Spacers improve the medication delivery in clients who are unable to coordinate the movements of administering a dose with an MDI.
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For which client should the nurse question administering the muscarinic cholinergic agonist oxybutynin (Ditropan)?
- A. The client diagnosed with overactive bladder.
- B. The client diagnosed with type 2 diabetes.
- C. The client diagnosed with glaucoma.
- D. The client diagnosed with peripheral vascular disease.
Correct Answer: C
Rationale: Oxybutynin’s anticholinergic effects can increase intraocular pressure, contraindicating it in glaucoma. It’s appropriate for overactive bladder; diabetes or PVD are not contraindications.
The nurse is caring for an elderly client who is eight (8) hours postoperative hip replacement and is reporting incisional pain. Which intervention is priority for this client?
- A. Assist the client to sit in the bedside chair.
- B. Initiate pain medication at the lowest dose.
- C. Assess the client's pupil size and accommodation.
- D. Monitor the client's urinary output hourly.
Correct Answer: B
Rationale: Pain management is the priority post-op to promote recovery and comfort; lowest dose minimizes side effects in the elderly. Sitting, pupil assessment, or urine output are secondary.
The nurse is preparing to administer Synthroid, a thyroid hormone replacement, to the client diagnosed with hypothyroidism. Which assessment data would indicate the client is receiving too much medication?
- A. Bradypnea and weight gain.
- B. Lethargy and hypotension.
- C. Irritability and tachycardia.
- D. Normothermia and constipation.
Correct Answer: C
Rationale: Excess Synthroid causes hyperthyroidism symptoms like irritability and tachycardia. Bradypnea, lethargy, or constipation suggest hypothyroidism.
A 10-month-old child has been diagnosed as having acute otitis media. The pediatrician prescribed amoxicillin suspension. What instructions should the nurse give the child's mother?
- A. When your child's temperature has been normal for two days, discontinue the medicine.
- B. Discard any unused medication.
- C. If your child has symptoms of an ear infection again, start giving her the leftover medication.
- D. Give your child all of the medication in the bottle.
Correct Answer: B
Rationale: The nurse should instruct to discard unused medication to prevent misuse. The full course should be completed, but the bottle is only good for two weeks.
The nurse is assessing a client who is on long term glucocorticoid therapy. Which of the following findings would the nurse expect?
- A. Buffalo hump
- B. Increased muscle mass
- C. Peripheral edema
- D. Jaundice
Correct Answer: A
Rationale: Buffalo hump. With high doses of glucocorticoid, iatrogenic Cushing's syndrome develops. The exaggerated physiological action causes abnormal fat distribution which results in a moon-shaped face, an intrascapular pad on the neck (buffalo hump) and truncal obesity with slender limbs.