Nursing Elites

1. A client prescribed hydromorphone for severe pain has a decreased respiratory rate from 16 breaths per minute to 6. Which of the following medications should the nurse prepare to administer?

• A. Flumazenil
• B. Naloxone
• C. Activated charcoal
• D. Aluminum hydroxide

Correct answer: B

Rationale: Naloxone is the correct answer as it is used to reverse opioid-induced respiratory depression. Hydromorphone is an opioid medication that can cause respiratory depression at high doses. Naloxone is an opioid antagonist that competes with opioids at receptor sites, reversing the effects of opioids like hydromorphone. Flumazenil (Choice A) is a benzodiazepine antagonist used for benzodiazepine overdose, not opioid overdose. Activated charcoal (Choice C) is used for toxin ingestion to prevent absorption in the gastrointestinal tract, but it is not indicated for opioid overdose. Aluminum hydroxide (Choice D) is an antacid and would not be the appropriate intervention for respiratory depression caused by opioid overdose.

2. A nurse is reviewing a client's new prescription for albuterol. What client education should the nurse provide?

• A. You may experience a dry cough after taking this medication
• B. Use this medication only as a rescue inhaler
• C. Take this medication with food to avoid nausea
• D. Use this medication daily to prevent asthma attacks

Correct answer: B

Rationale: The correct answer is B. Albuterol is a rescue inhaler that should be used during asthma attacks to provide quick relief by opening the airways. Using it daily as a preventive measure is not recommended. Choice A is incorrect because a dry cough is not a common side effect of albuterol. Choice C is incorrect as albuterol does not need to be taken with food. Choice D is incorrect because albuterol is not meant to be used daily for asthma prevention.

3. A nurse is caring for a client receiving theophylline for chronic obstructive pulmonary disease (COPD). Which of the following client findings indicates the need for immediate intervention?

• A. Productive cough
• B. Drowsiness
• C. Vomiting
• D. Polyuria

Correct answer: D

Rationale: Polyuria is a sign of theophylline toxicity and requires immediate intervention. Theophylline toxicity can lead to serious complications, and polyuria is a concerning symptom that indicates the need for urgent medical attention. Productive cough, drowsiness, and vomiting are common side effects of theophylline but are not typically indicative of immediate life-threatening issues like polyuria in the context of theophylline toxicity.

4. A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?

• A. Advise the client to take the medication once daily at bedtime
• B. This medication is for the acute management of asthma
• C. Avoid dairy products while taking this medication
• D. If the client forgets to take the medication for a few days, he should not double up on doses to catch up

Correct answer: A

Rationale: The correct answer is to advise the client to take montelukast once daily at bedtime to maintain therapeutic effects. Choice B is incorrect because montelukast is not typically used for acute asthma management but for chronic treatment. Choice C is incorrect as there are no known interactions between montelukast and dairy products. Choice D is incorrect as it is not safe to double up on doses if the client forgets to take the medication; the missed dose should be skipped and the regular dosing schedule maintained.

5. A client is receiving chemotherapy and develops stomatitis. Which of the following interventions should the nurse include in the client's plan of care?

• A. Apply warm compresses to the mouth
• B. Rinse mouth with alcohol-free mouthwash
• C. Increase fluid intake
• D. Clean the mouth gently with a soft toothbrush after meals

Correct answer: A

Rationale: The correct answer is to apply warm compresses to the mouth. Stomatitis is an inflammation of the mucous lining in the mouth and can be a side effect of chemotherapy. Warm compresses can help soothe the affected area and promote healing. Choice B is incorrect because alcohol-based mouthwash can further irritate the mouth. Choice C is also a good intervention as increasing fluid intake can help keep the mouth moist and promote healing. However, the most direct intervention for soothing and healing the affected area is applying warm compresses. Choice D is incorrect because using a firm toothbrush can be too harsh and cause further irritation.

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