Nokea
The nurse is teaching a client with a new diagnosis of chronic obstructive pulmonary disease (COPD) about tiotropium (Spiriva). Which of the following statements by the client indicates a need for further teaching?
- A. I should rinse my mouth after using this inhaler.
- B. I should use this inhaler once a day.
- C. I should report eye pain to my doctor.
- D. I should use this inhaler when I have trouble breathing.
Correct Answer: D
Rationale: Using tiotropium as a rescue inhaler is incorrect, as it is a long-acting maintenance medication for COPD, not for acute symptoms. Options A, B, and C are correct: rinsing prevents oral thrush, daily use is standard, and eye pain may indicate glaucoma.
You may also like to solve these questions
The nurse is assessing a pregnant client in her third trimester. The parents are informed that the ultrasound suggests that the baby is small for gestational age (SGA). An earlier ultrasound indicated normal growth. The nurse understands that this change is most likely due to what factor?
- A. Sexually transmitted infection
- B. Exposure to teratogens
- C. Maternal hypertension
- D. Chromosomal abnormalities
Correct Answer: C
Rationale: Maternal hypertension. Pregnancy induced hypertension is a common cause of late pregnancy fetal growth retardation. Vasoconstriction reduces placental exchange of oxygen and nutrients.
An involuntary psychiatric patient asks the nurse to mail his letter to the President. He states that the letter will make the President regret his actions to prevent homosexuals from serving in the military. Which of the following responses by the nurse is BEST?
- A. Accept the letter and place it in the patient's medical record.
- B. Read the patient's letter and decide if it is appropriate to mail.
- C. Call the patient's psychiatrist and inform him of the letter.
- D. Discourage the patient from sending the letter, but mail it if patient insists.
Correct Answer: D
Rationale: Mailing the letter respects the patient’s communication rights while addressing potential concerns. Options A, B, and C violate autonomy or privacy.
The nurse is caring for a client who is receiving a continuous IV infusion of insulin for diabetic ketoacidosis. Which of the following laboratory results should the nurse report immediately?
- A. Blood glucose of 200 mg/dL.
- B. Potassium 3.0 mEq/L.
- C. pH of 7.30.
- D. Sodium 135 mEq/L.
Correct Answer: B
Rationale: Hypokalemia (3.0 mEq/L) risks arrhythmias during insulin therapy for DKA. Options A, C, and D are less urgent.
A nurse is to administer meperidine hydrochloride (Demerol) 100 mg, atropine sulfate (Atropesol) 0.4 mg, and promethazine hydrochloride (Phenergan) 50 mg IM to a pre-operative client. Which action should the nurse take first?
- A. Raise the side rails on the bed
- B. Place the call bell within reach
- C. Instruct the client to remain in bed
- D. Have the client empty bladder
Correct Answer: D
Rationale: Have the client empty bladder. The first step in the process is to have the client void prior to administering the pre-operative medication. The other actions follow this initial step in this sequence: D, C, B, A. Note: It is much easier to administer IM meds with the side rails down, and then raising them when the nurse is done. Other activities can then be carried out more safely.
The nurse is caring for a client with a history of atrial fibrillation who is receiving amiodarone (Cordarone) 200 mg PO daily. Which of the following symptoms should the nurse report immediately?
- A. Mild fatigue
- B. Dry cough and shortness of breath
- C. Occasional palpitations
- D. Mild nausea
Correct Answer: B
Rationale: Dry cough and shortness of breath suggest pulmonary toxicity, a serious amiodarone side effect. Options A, C, and D are less urgent: fatigue and nausea are common, and palpitations are expected in atrial fibrillation.