Nokea
The nurse is caring for a client who is suffering from severe anxiety. What must the client do first when learning to deal with his anxiety?
- A. Recognize that he is feeling anxious
- B. Identify the situations that precipitated his anxiety
- C. Understand the reason for his anxiety
- D. Select a strategy to use to help him cope with his anxiety
Correct Answer: A
Rationale: Recognizing anxiety is the first step in managing it, enabling the client to address triggers, reasons, and coping strategies sequentially.
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The nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) who is receiving salmeterol (Serevent) via inhaler. Which of the following client statements would be of GREATest concern to the nurse?
- A. I use my inhaler twice a day.
- B. I have a dry mouth.
- C. I feel shaky sometimes.
- D. I rinse my mouth after using the inhaler.
Correct Answer: C
Rationale: Shakiness suggests systemic beta-agonist effects, a concerning side effect of salmeterol in COPD, requiring evaluation to prevent tachycardia or arrhythmias. Options A, B, and D are less concerning: twice-daily use is standard, dry mouth is common, and rinsing is appropriate.
The nurse is teaching a client with a new diagnosis of heart failure about furosemide (Lasix). Which of the following statements by the client indicates a need for further teaching?
- A. I should report muscle cramps to my doctor.
- B. I should take this medication in the morning.
- C. I should eat foods high in potassium.
- D. I should stop this medication if I feel better.
Correct Answer: D
Rationale: Stopping furosemide when feeling better is incorrect, as heart failure requires lifelong treatment to manage fluid overload. Options A, B, and C are correct: muscle cramps may indicate hypokalemia, morning dosing minimizes nocturia, and potassium-rich foods are recommended.
A client is placed on sulfamethoxazole-trimethoprim (Bactrim) for a recurrent urinary tract infection. Which of the following is appropriate reinforcement of information by the nurse?
- A. Drink at least 8 glasses of water a day.
- B. Be sure to take the medication with food.
- C. It is safe to take with oral contraceptives.
- D. Stop the medication after 5 days.
Correct Answer: A
Rationale: Bactrim is a highly insoluble drug and requires a large volume of fluid intake. It is not necessary to take it with food. Options C and D are incorrect instructions for those taking Bactrim.
The primary teaching for a client following an extracorporeal shock-wave lithotripsy (ESWL) procedure is
- A. Drink 3000 to 4000 cc of fluid each day for one month.'
- B. Limit fluid intake to 1000 cc each day for one month.'
- C. Increase fluid intake for the next three days.'
- D. Restrict milk and dairy products for one month.'
Correct Answer: A
Rationale: Drink 3000 to 4000 cc of fluid each day for one month.' Drinking three to four quarts (3000 to 4000 cc) of fluid each day will aid passage of fragments and help prevent formation of new calculi.
The nurse is teaching a client with a new diagnosis of multiple sclerosis about interferon beta-1a (Avonex). Which of the following instructions should the nurse include?
- A. Take the medication with grapefruit juice
- B. Report any fever or flu-like symptoms
- C. Stop the medication if symptoms improve
- D. Avoid regular neurological exams
Correct Answer: B
Rationale: Fever or flu-like symptoms are common interferon beta-1a side effects but may also indicate infection, requiring reporting. Options A, C, and D are incorrect: grapefruit juice is irrelevant, stopping the medication risks relapse, and exams are essential.