Nokea
The nurse is caring for a client with a history of chronic obstructive pulmonary disease who is prescribed salmeterol (Serevent). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after using the inhaler.
- C. Shake the inhaler before use.
- D. Use the inhaler twice daily.
Correct Answer: D
Rationale: Salmeterol is a long-acting bronchodilator used twice daily for maintenance therapy in COPD.
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A client who had a total knee replacement with a metal prosthesis is being prepared for discharge to home. Which statement by the client indicates to the nurse a need for further teaching?
- A. I can expect that changes in the shape of the knee will occur.
- B. I need to tell any future caregivers about the metal prosthesis.
- C. I need to report bleeding gums or tarry stools to the primary health care provider.
- D. I need to report fever, redness, or increased pain to the primary health care provider.
Correct Answer: A
Rationale: After a total knee replacement, the client should be taught to report any changes in the shape of the knee. This is not an expected event during recuperation from surgery. The client must notify caregivers of the metal implant because the client will need antibiotic prophylaxis for invasive procedures, and will be ineligible for magnetic resonance imaging as a diagnostic procedure. With a metal prosthesis, the client must be on anticoagulant therapy and should report adverse effects of this therapy, such as evidence of bleeding from a variety of sources. Fever, redness, or increased pain may indicate infection.
The nurse is caring for a client with a tracheostomy. Which of the following actions is the highest priority to maintain airway patency?
- A. Suctioning the tracheostomy as needed.
- B. Cleaning the tracheostomy site daily.
- C. Humidifying the inspired air.
- D. Securing the tracheostomy tube.
Correct Answer: A
Rationale: Suctioning as needed is the highest priority to maintain airway patency by removing mucus or obstructions from the tracheostomy.
Which of the following should the nurse teach a client with generalized anxiety disorder to help the client cope with anxiety?
- A. Cognitive and behavioral strategies.
- B. Issue avoidance and denial of problems.
- C. Rest and sleep.
- D. Withdrawal from role expectations and role relationships.
Correct Answer: A
Rationale: Cognitive and behavioral strategies, such as relaxation techniques, help clients manage anxiety effectively.
The nurse is caring for a client with a chest tube. Which finding indicates a potential complication?
- A. Continuous bubbling in the water seal chamber.
- B. Fluctuation in the water seal with breathing.
- C. Serosanguineous drainage.
- D. Pain at the insertion site.
Correct Answer: A
Rationale: Continuous bubbling in the water seal chamber suggests an air leak, a potential complication requiring immediate attention.
The nurse is teaching a client with a new diagnosis of atrial fibrillation about dabigatran (Pradaxa). Which of the following instructions is most important?
- A. Take the medication with food to reduce stomach upset.
- B. Report any signs of bleeding immediately.
- C. Avoid taking the medication with aspirin.
- D. Store the medication in the refrigerator.
Correct Answer: B
Rationale: Dabigatran, an anticoagulant, increases bleeding risk, so reporting signs of bleeding is critical for safety.