Nokea
The nurse administers theophylline (TheoDur) to a client. To evaluate the effectiveness of this medication, which of the following drug actions should the nurse anticipate?
- A. Suppression of the client's respiratory infection.
- B. Decrease in bronchial secretions.
- C. Relaxation of bronchial smooth muscle.
- D. Thinning of tenacious, purulent sputum.
Correct Answer: C
Rationale: Theophylline relaxes bronchial smooth muscle, relieving bronchospasm in COPD. It does not suppress infection, reduce secretions, or thin sputum.
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A 45-year-old single mother of three teenaged boys has metastatic breast cancer. Her parents live 750 miles away and have only been able to visit twice since her initial diagnosis 14 months ago. The progression of her disease has forced the client to consider high-dose chemotherapy. She is concerned about the children's welfare during the treatment. When assessing the client's present support systems, the nurse will be most concerned about the potential problems with:
- A. Denial as a primary coping mechanism.
- B. Support systems and coping strategies.
- C. Decision-making abilities.
- D. Transportation and money for the boys.
Correct Answer: B
Rationale: Limited support systems and coping strategies are a major concern, as the client's isolation and responsibility for her children may hinder her ability to manage treatment and emotional stress.
A client has had multiple sclerosis (MS) for 15 years and has received various drug therapies. What is the primary reason why the nurse has found it difficult to evaluate the effectiveness of the drugs that the client has used?
- A. The client exhibits intolerance to many drugs.
- B. The client experiences spontaneous remissions from time to time.
- C. The client requires multiple drugs simultaneously.
- D. The client endures long periods of exacerbation before the illness responds to a particular drug.
Correct Answer: B
Rationale: Spontaneous remissions in MS make it challenging to attribute symptom improvement to drugs versus natural disease course. Intolerance, multiple drugs, or delayed responses are less primary factors.
The nurse is instructing a client with COPD how to do pursed-lip breathing. In which order should the nurse explain the steps to the client?
- A. Breathe in normally through your nose for 2 counts (while counting to yourself, one, two).
- B. Relax your neck and shoulder muscles.
- C. Pucker your lips as if you were going to whistle.
- D. Breathe out slowly through pursed lips for 4 counts (while counting to yourself, one, two, three, four).
Correct Answer: B,A,C,D
Rationale: The correct order for pursed-lip breathing is: relax muscles (B), inhale through nose for 2 counts (A), pucker lips (C), exhale through pursed lips for 4 counts (D). This prolongs exhalation, reducing air trapping.
Which intervention is contraindicated for a client with a seizure disorder?
- A. Provide a safe environment.
- B. Use a padded tongue depressor.
- C. Administer prescribed anticonvulsants.
- D. Monitor post-seizure status.
Correct Answer: B
Rationale: Using a padded tongue depressor is contraindicated as it can cause injury during a seizure.
The nurse should teach the client who is receiving warfarin sodium that:
- A. Partial thromboplastin time values determine the dosage of warfarin sodium.
- B. Protamine sulfate is used to reverse the effects of warfarin sodium.
- C. International Normalized Ratio (INR) is used to assess effectiveness.
- D. Warfarin sodium will facilitate clotting of the blood.
Correct Answer: C
Rationale: INR monitors warfarin's anticoagulant effectiveness, guiding dosage adjustments to prevent clotting or bleeding.