Nursing Elites

1. A client with asthma is prescribed an inhaled corticosteroid. What teaching should the nurse provide?

• A. Rinse the mouth with water after using the inhaler.
• B. Take the medication only during asthma attacks.
• C. Avoid using the inhaler before exercise.
• D. Clean the inhaler with hot water after each use.

Correct answer: A

Rationale: The correct teaching the nurse should provide to a client prescribed an inhaled corticosteroid is to rinse the mouth with water after using the inhaler. This helps prevent oral fungal infections, a common side effect of inhaled corticosteroids. Choice B is incorrect because inhaled corticosteroids are usually used regularly, not just during asthma attacks. Choice C is incorrect as using the inhaler before exercise can actually help prevent exercise-induced bronchospasm. Choice D is incorrect because cleaning the inhaler with hot water after each use is not necessary and may damage the device.

2. A client with psoriasis is prescribed topical corticosteroids. What side effect should the nurse monitor for?

• A. Monitor for weight gain and skin thinning.
• B. Assess for increased sensitivity to sunlight.
• C. Monitor for hair loss and excessive bruising.
• D. Report any signs of increased redness or itching.

Correct answer: D

Rationale: The correct answer is D. When a client with psoriasis is prescribed topical corticosteroids, the nurse should monitor for signs of increased redness or itching. This is because topical corticosteroids can cause skin thinning and increased redness if overused. Choices A, B, and C are incorrect because weight gain, sensitivity to sunlight, hair loss, and excessive bruising are not typically associated with the use of topical corticosteroids.

3. The nurse administers an antibiotic for a respiratory tract infection. To evaluate the medication's effectiveness, which laboratory values should the nurse monitor?

• A. Platelet count and red blood cell count.
• B. White blood cell count and sputum culture.
• C. Hemoglobin A1c and glucose tolerance test.
• D. Arterial blood gases and serum electrolytes.

Correct answer: B

Rationale: The correct answer is B: White blood cell count and sputum culture. Monitoring white blood cell count and sputum cultures is essential to assess the effectiveness of the antibiotic in treating the respiratory tract infection. Changes in white blood cell count can indicate the body's response to infection, while sputum cultures help determine if the antibiotic is targeting the specific pathogens causing the infection. Choices A, C, and D are incorrect because platelet count, red blood cell count, hemoglobin A1c, glucose tolerance test, arterial blood gases, and serum electrolytes are not directly related to evaluating the effectiveness of an antibiotic in treating a respiratory tract infection.

4. A client recovering from a stroke is demonstrating slurred speech. What action should the nurse take?

• A. Consult the healthcare provider to order speech therapy.
• B. Administer a dose of aspirin to prevent further neurological damage.
• C. Encourage the client to use communication aids, such as writing.
• D. Encourage the client to eat soft foods to avoid choking.

Correct answer: C

Rationale: The correct action for a client recovering from a stroke demonstrating slurred speech is to encourage the client to use communication aids, such as writing. This intervention can help the client effectively communicate while working on regaining speech abilities. Consulting the healthcare provider to order speech therapy (choice A) is a valid option, but immediate encouragement of using communication aids is beneficial. Administering aspirin (choice B) without healthcare provider orders is not recommended. Encouraging the client to eat soft foods (choice D) is important for preventing aspiration but doesn't directly address the communication issue.

5. A client with hyperthyroidism is admitted to the postoperative unit after a subtotal thyroidectomy. Which of the client's serum laboratory values requires intervention by the nurse?

• A. Blood glucose 90 mg/dL
• B. Sodium 138 mEq/L
• C. Total calcium 5.0 mg/dL
• D. Potassium 4.2 mEq/L

Correct answer: C

Rationale: A total calcium level of 5.0 mg/dL is critically low and indicates possible hypocalcemia, a common complication after thyroid surgery. This condition can lead to tetany and requires immediate intervention. Blood glucose within normal range, sodium, and potassium levels are not indicative of an immediate postoperative complication like hypocalcemia in this case.

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