Nokea
The nurse is instructing a client with moderate persistent asthma on the proper method for using MDIs (multi-dose inhalers). Which medication should be administered first?
- A. Steroid
- B. Anticholinergic
- C. Mast cell stabilizer
- D. Beta agonist
Correct Answer: D
Rationale: Beta agonist. The beta-agonist drugs help to relieve bronchospasm by relaxing the smooth muscle of the airway. These drugs should be taken first so that other medications can reach the lungs.
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A nurse is caring for a client who is receiving methyldopa hydrochloride (Aldomet) intravenously. Which of the following assessment findings would indicate to the nurse that the client may be having an adverse reaction to the medication?
- A. Headache
- B. Mood changes
- C. Hyperkalemia
- D. Palpitations
Correct Answer: B
Rationale: Mood changes. The nurse should assess the client for alterations in mental status such as mood changes. These symptoms should be reported promptly.
An adult is receiving Gantrisin 1 g PO qid for a urinary tract infection. Which statement that she makes indicates a need for more teaching?
- A. If I get a rash, I will apply calamine lotion.
- B. I will take my pills with a full glass of water.
- C. I will take all the pills even if I feel better.
- D. I will stay out of the sun while I am taking the pills.
Correct Answer: A
Rationale: A rash may indicate an adverse reaction to Gantrisin, requiring physician consultation, not self-treatment with calamine lotion.
An adult client has been diagnosed as having rheumatoid arthritis and is started on piroxicam (Feldene) 20 mg daily. Two days later, the client calls the nurse and says that her joints still hurt. What is the best response for the nurse to make?
- A. It may take up to two weeks before results are seen with Feldene.
- B. Take aspirin with the Feldene. It has an additive effect.
- C. Come in to see the physician. You should have pain relief by now.
- D. You may need more medication. Take one additional pill each day.
Correct Answer: A
Rationale: Piroxicam, an NSAID, may take up to two weeks for full anti-inflammatory effects.
The client in the intensive care department is receiving 2 mcg/kg/min of dopamine, an inotropic vasopressor. Which intervention should the nurse include in the plan of care?
- A. Monitor the client's blood pressure every two (2) hours.
- B. Assess the client's peripheral pulses every shift.
- C. Use a urometer to assess hourly output.
- D. Ensure the IV tubing is not exposed to the light.
Correct Answer: C
Rationale: Dopamine affects renal perfusion; hourly urine output via urometer monitors efficacy and prevents toxicity. BP, pulses, or light exposure are less critical.
The client is complaining of low-back pain and is prescribed the muscle relaxant carisoprodol (Soma). Which teaching intervention has priority?
- A. Explain this medication causes GI distress.
- B. Discuss the need to taper off this medication.
- C. Warn this medication will cause drowsiness.
- D. Instruct the client to limit alcohol intake.
Correct Answer: C
Rationale: Carisoprodol causes drowsiness, a safety risk (e.g., falls, driving); warning is the priority. GI distress, tapering, or alcohol are secondary.