Nokea
The client diagnosed with restrictive airway disease (asthma) has been prescribed a glucocorticoid inhaled medication. Which information should the nurse teach regarding this medication?
- A. Do not abruptly stop taking this medication; it must be tapered off.
- B. Immediately rinse the mouth following administration of the drug.
- C. Hold the medication in the mouth for 15 seconds before swallowing.
- D. Take the medication immediately when an attack starts.
Correct Answer: B
Rationale: Rinsing the mouth (B) prevents oral thrush from inhaled glucocorticoids. Tapering (A) applies to systemic steroids, holding/swallowing (C) is incorrect, and attack use (D) is for rescue inhalers.
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When the client asks the nurse about why the physician has prescribed two drugs, which response is most accurate?
- A. One medication diminishes the side effects of the other.
- B. One medication kills the live organism; the other, its spores.
- C. Using combined medications can reduce the dosages of both drugs.
- D. Using two or more drugs lowers the potential for bacterial resistance.
Correct Answer: D
Rationale: Combination therapy (rifampin and isoniazid) reduces the risk of bacterial resistance, ensuring effective tuberculosis treatment.
Which statement indicates to the nurse the client diagnosed with sleep apnea needs further teaching?
- A. If I lose weight I may not need treatment for sleep apnea.
- B. The CPAP machine holds my airway open with pressure.
- C. The CPAP will help me stay awake during the day while I am at work.
- D. It is all right to have a couple of beers because I have this CPAP machine.
Correct Answer: D
Rationale: Alcohol (D) worsens sleep apnea by relaxing airway muscles, contradicting effective CPAP use. Weight loss (A) can reduce sleep apnea severity. CPAP maintaining airway patency (B) and improving daytime alertness (C) are correct.
A patient was admitted to the intensive care unit 48 hours ago for treatment of a gunshot wound. The patient has recently developed a productive cough and a fever of 104.3 ' $F$. The patient is breathing on their own and doesn't require mechanical ventilation. On assessment, you note coarse crackles in the right lower lobe. A chest x-ray shows infiltrates with consolidation in the right lower lobe. Based on this specific patient scenario, this is known as what type of pneumonia?
- A. Aspiration pneumonia
- B. Ventilator acquired pneumonia
- C. Hospital-acquired pneumonia
- D. Community-acquired pneumonia
Correct Answer: C
Rationale: Hospital-acquired pneumonia (HAP) develops 48 hours or more after hospital admission, as seen in this patient. Aspiration pneumonia is linked to inhaling foreign material, ventilator-acquired pneumonia requires mechanical ventilation, and community-acquired pneumonia occurs outside healthcare settings.
A patient is ordered at 1400 to take Theophylline. You're assessing the patient's morning lab results and note that the Theophylline level drawn this morning reads: $15 \mathrm{mcg} / \mathrm{mL}$. You're next nursing action is to?
- A. Administer the dose at 1400 as ordered
- B. Notify the physician for further orders
- C. Hold the 1400 dose
- D. Collect another blood sample to confirm the level
Correct Answer: A
Rationale: A Theophylline level of 15 mcg/mL is within the therapeutic range (10-20 mcg/mL), so the dose should be administered as ordered . No further action is needed.
The client is three (3) days post-partial laryngectomy. Which type of nutrition should the nurse offer the client?
- A. Total parenteral nutrition.
- B. Soft, regular diet.
- C. Partial parenteral nutrition.
- D. Clear liquid diet.
Correct Answer: D
Rationale: Clear liquids (D) are safest 3 days post-laryngectomy to prevent aspiration. TPN (A), soft diet (B), and partial PN (C) are premature or unnecessary.