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The nurse is teaching a client with a new diagnosis of asthma about inhaler use. Which of the following instructions should be included for a metered-dose inhaler?
- A. Shake the inhaler before use.
- B. Hold breath for 10 seconds after inhalation.
- C. Rinse the mouth after each use.
- D. Use a spacer if prescribed.
Correct Answer: A, B, D
Rationale: Shaking the inhaler, holding breath, and using a spacer ensure effective medication delivery.
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The nurse is preparing to care for a client who has undergone esophagogastroduodenoscopy (EGD). After checking the vital signs, what should be the nurse's next priority?
- A. Monitor for sharp epigastric pain.
- B. Give warm gargles for sore throat.
- C. Check for a return of the gag reflex.
- D. Monitor for complaints of heartburn.
Correct Answer: C
Rationale: The nurse places highest priority on assessing for the return of the gag reflex, which is part of maintaining the client's airway. The nurse should also monitor the client for sharp pain (may indicate a potential complication) and heartburn. The client would receive warm gargles, but this cannot be done until the gag reflex has returned.
Your client has an allergy to both penicillin and latex. Which of these pathophysiological facts should you apply when you are providing to this client?
- A. The sensitizing dose of penicillin can lead to anaphylaxis.
- B. The second dose of penicillin can lead to distributive shock.
- C. You should be aware of the fact that about 10% of the population has an allergy to both penicillin and latex.
- D. You should be aware of the fact that about 20% of the population has an allergy to both penicillin and latex.
Correct Answer: A
Rationale: A sensitizing dose of penicillin can lead to anaphylaxis , a life-threatening allergic reaction, which is critical to consider when caring for a client with a penicillin allergy. The prevalence of dual allergies (C, D) is not accurate, and distributive shock is not specific to a second dose.
Which of the following measures should be implemented promptly after a client's nasogastric (NG) tube has been removed?
- A. Provide the client with oral hygiene.
- B. Offer the client liquids to drink.
- C. Encourage the client to cough and deep breathe.
- D. Auscultate the client's bowel sounds.
Correct Answer: A
Rationale: Oral hygiene removes residual tube-related irritation and promotes comfort after NG tube removal.
The nurse is caring for a client with a history of Crohn's disease who is prescribed mesalamine (Asacol). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild diarrhea.
- B. Abdominal pain.
- C. Fever.
- D. Headache.
Correct Answer: C
Rationale: Fever may indicate an exacerbation of Crohn's disease or a side effect of mesalamine, requiring immediate reporting.
The nursing assessment of a client with osteomyelitis of the left great toe reveals pain with partial weight-bearing, unsteady gait, and fever. The priority nursing diagnosis for the client is:
- A. Impaired physical mobility.
- B. Impaired skin integrity.
- C. Ineffective coping.
- D. Risk for injury.
Correct Answer: D
Rationale: Risk for injury is the priority due to unsteady gait and pain, which increase the likelihood of falls in a client with osteomyelitis.