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The nurse is teaching a client with a new diagnosis of asthma about fluticasone (Flovent). Which of the following instructions should the nurse include?
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after use.
- C. Stop the medication if symptoms improve.
- D. Avoid regular asthma follow-ups.
Correct Answer: B
Rationale: Rinsing the mouth prevents oral thrush, a fluticasone side effect. Options A, C, and D are incorrect.
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A mother brings her two-year-old boy to the pediatrician’s office.
- A. Which symptom would suggest to the nurse that a two-year-old boy has strabismus?
- B. When the child draws, he places his head close to the table.
- C. The child rubs his eyes frequently.
- D. The child closes one eye to see a poster on the wall.
- E. The child is unable to see objects in the periphery of his visual field.
Correct Answer: C
Rationale: Strabismus is characterized by misaligned visual axes, causing the brain to receive two images. Closing one eye to focus on an object, such as a poster, is a compensatory behavior indicative of strabismus. The other symptoms suggest refractive errors or other visual impairments, not strabismus.
A client had a radical mastectomy for cancer in her right breast.
After the client returns to the unit, which of the following actions, if performed by the nurse, would be MOST appropriate?
- A. Position the client on her left side with her right arm protected in a sling.
- B. Position the client on her right side with her right arm elevated.
- C. Position the client in semi-Fowler's position with her right arm elevated.
- D. Position the client in the prone position with her right arm elevated.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) sling is not necessary, arm needs to be elevated (2) right arm cannot be elevated from this position (3) correct-this position will facilitate removal of fluid from venous pathways and lymphatic system through gravity; arm is elevated to enhance circulation and prevent edema (4) prone position is not appropriate
The nurse is teaching a client with a new diagnosis of type 2 diabetes about glimepiride (Amaryl). Which of the following statements by the client indicates a need for further teaching?
- A. I should take this medication before breakfast.
- B. I should report sweating to my doctor.
- C. I should avoid drinking alcohol.
- D. I should stop this medication if my blood sugar is normal.
Correct Answer: D
Rationale: Stopping glimepiride when blood sugar is normal is incorrect, as type 2 diabetes requires ongoing treatment to maintain control. Options A, B, and C are correct: pre-breakfast dosing maximizes efficacy, sweating indicates hypoglycemia, and alcohol increases hypoglycemia risk.
A male client's behavior begins to escalate into aggressive behavior.
The nurse is caring for clients on the psychiatric unit. Suddenly, a male client's behavior begins to escalate into aggressive behavior. It would be MOST important for the nurse to take which of the following actions?
- A. Utilize an organized team to place the client in seclusion.
- B. Leave the client alone in his room to identify feelings of anger.
- C. Redirect the client to a quiet activity to divert his attention and not disturb the other clients.
- D. Assist the client to identify and express his feelings of increasing anxiety, frustration, and anger.
Correct Answer: D
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) nurse can be helpful in using psychological/communication strategies before utilizing seclusion (2) leaving the client alone can become potentially dangerous to the client and the property (3) encouraging the client to become involved in a quiet activity might further escalate his frustration and anger because the ability to focus and concentrate is diminished due to an elevated anxiety level (4) correct-as client's anger begins to escalate, nurse can be helpful in using psychological/communication strategies before utilizing seclusion
The nurse checks for placement of a nasogastric (NG) tube before beginning a tube feeding for a client.
Which of the following results would indicate to the nurse that the tube feeding can begin?
- A. A small amount of white mucus is aspirated from the NG tube.
- B. The pH of the contents removed from the NG tube is 3.
- C. No bubbles are seen when the nurse inverts the NG tube in water.
- D. The client says he can feel the NG tube in the back of his throat.
Correct Answer: B
Rationale: Strategy: Determine how the answers relate to a tube feeding. (1) mucus may be from lungs (2) correct-stomach contents are acidic (3) not a safe way to check placement (4) not a reliable indication