Nokea
The client is receiving discharge teaching for a new diagnosis of asthma. Which statement by the client indicates a need for further teaching?
- A. I should use my inhaler as soon as I begin to feel short of breath.
- B. I should avoid using my inhaler unless I am having an asthma attack.
- C. I should use my inhaler 30 minutes before exercise.
- D. I should rinse my mouth after using my inhaler.
Correct Answer: B
Rationale: The statement 'I should avoid using my inhaler unless I am having an asthma attack' (B) indicates a need for further teaching. It is important for clients to use their inhaler as prescribed, which may include regular use to prevent asthma attacks. Choice A is correct because using the inhaler when feeling short of breath can help manage asthma symptoms. Choice C is also correct as using the inhaler before exercise can prevent exercise-induced symptoms. Choice D is correct as rinsing the mouth after using the inhaler helps prevent oral thrush, a potential side effect of inhaled corticosteroids. Therefore, option B is the most concerning statement that needs clarification.
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In a client with moderate, persistent, chronic neuropathic pain due to diabetic neuropathy who takes gabapentin (Neurontin) and ibuprofen (Motrin, Advil) daily, if Step 2 of the World Health Organization (WHO) pain relief ladder is prescribed, which drug protocol should be implemented?
- A. Continue gabapentin.
- B. Discontinue ibuprofen.
- C. Add aspirin to the protocol.
- D. Add oral methadone to the protocol.
Correct Answer: A
Rationale: In the presence of moderate, persistent, chronic neuropathic pain, the WHO pain relief ladder recommends continuing gabapentin, as it is effective for managing both anxiety and pain. Ibuprofen, a nonsteroidal anti-inflammatory drug, is not the mainstay for neuropathic pain relief according to the ladder and can be discontinued if needed. Aspirin is not typically added to the protocol for neuropathic pain management at this step. Methadone is reserved for severe pain and is not the standard choice at Step 2 of the WHO pain relief ladder for neuropathic pain.
After insertion of the indwelling catheter, how should the nurse position the drainage container?
- A. With the drainage tubing taut to maintain maximum suction on the urinary bladder.
- B. Lower than the bladder to maintain a constant downward flow of urine from the bladder.
- C. At the head of the bed for easy and accurate measurement of urine.
- D. Beside the patient in their bed to avoid embarrassment.
Correct Answer: B
Rationale: The correct position for the drainage container after inserting an indwelling catheter is to have it placed lower than the bladder. This positioning helps maintain a constant downward flow of urine from the bladder, preventing backflow and ensuring proper drainage. Choice A is incorrect because having the drainage tubing taut does not promote proper urine flow and may cause kinking. Choice C is incorrect as placing the container at the head of the bed does not affect drainage and is not necessary for accurate measurement. Choice D is incorrect as the positioning of the drainage container should prioritize proper drainage and care over potential embarrassment.
The healthcare professional is obtaining a lie-sit-stand blood pressure reading on a client. Which action is most important for the healthcare professional to implement?
- A. Stay with the client while the client is standing.
- B. Record the findings on the graphic sheet in the chart.
- C. Keep the blood pressure cuff on the same arm.
- D. Record changes in the client's pulse rate.
Correct Answer: A
Rationale: In obtaining a lie-sit-stand blood pressure reading, it is crucial for the healthcare professional to stay with the client while the client is standing. This action is the most important as it ensures client safety during the procedure. Recording findings, keeping the blood pressure cuff on the same arm, and monitoring pulse rate are all important tasks, but staying with the client while standing takes priority to prevent any potential falls or adverse events. By staying with the client, the healthcare professional can promptly address any signs of dizziness or instability, ensuring a safe environment for the client throughout the procedure.
An older female client with rheumatoid arthritis is complaining of severe joint pain that is caused by the weight of the linen on her legs. What action should the nurse implement first?
- A. Apply flannel pajamas to provide warmth.
- B. Administer a PRN dose of ibuprofen.
- C. Perform range of motion exercises in a warm tub.
- D. Drape the sheets over the footboard of the bed.
Correct Answer: D
Rationale: The correct answer is D. The nurse should first address the immediate comfort concern of the client, which is the weight of the linen on her legs causing severe joint pain. By draping the sheets over the footboard of the bed rather than tucking them under the mattress, the nurse can alleviate the pressure that the client perceives as the source of her pain. This action is a simple and effective way to provide relief and should be the initial step taken by the nurse. Choices A, B, and C do not directly address the client's immediate discomfort caused by the weight of the linen on her legs, making them less appropriate initial actions.
While instructing a male client's wife in the performance of passive range-of-motion exercises to his contracted shoulder, the nurse observes that she is holding his arm above and below the elbow. What nursing action should the nurse implement?
- A. Acknowledge that she is supporting the arm correctly.
- B. Encourage her to keep the joint uncovered to maintain warmth.
- C. Reinforce the need to grip directly under the joint for better support.
- D. Instruct her to grip directly over the joint for better motion.
Correct Answer: A
Rationale: The wife is correctly performing the passive range-of-motion exercises by holding the arm above and below the elbow. The nurse should acknowledge this correct technique (A). It is essential to keep the joint uncovered (B) during exercises, while ensuring the rest of the body remains covered for warmth and privacy. Choices (C) and (D) do not provide optimal support to the joint for effective movement.