Nursing Elites

1. When caring for a client with asthma experiencing an acute exacerbation, which medication should the nurse administer first?

• A. Montelukast
• B. Salmeterol
• C. Albuterol
• D. Fluticasone

Correct answer: C

Rationale: During an acute asthma exacerbation, the priority is to quickly relieve bronchoconstriction and improve airflow. Albuterol is a short-acting bronchodilator that acts rapidly to dilate the airways, making it the first-line medication for acute symptom relief. Montelukast is a leukotriene receptor antagonist used for long-term asthma control, not for immediate relief. Salmeterol is a long-acting bronchodilator used for maintenance therapy, not for acute exacerbations. Fluticasone is an inhaled corticosteroid that reduces airway inflammation and is also used for long-term control, not for immediate relief during an exacerbation.

2. A client has a new prescription for metformin. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid drinking alcohol while taking this medication.
• C. Eat 3 large meals each day.
• D. Report any muscle pain to your provider.

Correct answer: B

Rationale: The correct instruction the nurse should include for a client prescribed metformin is to avoid drinking alcohol. Alcohol consumption while on metformin increases the risk of lactic acidosis, a serious condition. Taking metformin at bedtime (choice A) is not a standard instruction. Eating 3 large meals each day (choice C) is not specific to metformin use and may not be suitable for all individuals. Reporting muscle pain (choice D) is important but not directly related to metformin use.

3. A nurse is caring for a client who has pneumonia and is receiving oxygen therapy. Which of the following findings indicates the need for suctioning?

• A. Increased respiratory rate.
• B. Oxygen saturation 96%.
• C. Clear lung sounds.
• D. Productive cough.

Correct answer: A

Rationale: The correct answer is A: Increased respiratory rate. An increased respiratory rate suggests the client is having difficulty clearing secretions and may require suctioning. Oxygen saturation of 96% is within the normal range and indicates adequate oxygenation. Clear lung sounds suggest good air entry without the need for suctioning. A productive cough, although a symptom of pneumonia, does not directly indicate the need for suctioning.

4. A nurse is caring for a client who has severe preeclampsia and is receiving magnesium sulfate intravenously. The nurse discontinues the magnesium sulfate after the client displays toxicity. Which of the following actions should the nurse take?

• A. Position the client supine.
• B. Prepare an IV bolus of dextrose 5% in water.
• C. Administer methylergonovine IM.
• D. Administer calcium gluconate IV.

Correct answer: D

Rationale: Administering calcium gluconate IV is the correct action when a client displays toxicity from magnesium sulfate. Calcium gluconate is used as the antidote for magnesium sulfate toxicity as it counteracts the effects. Positioning the client supine (Choice A) is not the immediate action needed. Administering dextrose 5% in water (Choice B) is not indicated for magnesium sulfate toxicity. Administering methylergonovine IM (Choice C) is used in postpartum hemorrhage, not for magnesium sulfate toxicity.

5. A client is starting therapy with a statin medication. Which of the following instructions should the nurse include?

• A. Take the medication on an empty stomach.
• B. Avoid consuming grapefruit juice.
• C. Increase intake of dietary fiber.
• D. Take the medication in the morning.

Correct answer: B

Rationale: The correct instruction the nurse should include is to advise the client to avoid consuming grapefruit juice when taking statin medication. Grapefruit juice can interfere with the metabolism of statins, leading to an increased risk of adverse effects. Taking the medication on an empty stomach (Choice A) or in the morning (Choice D) is not specifically necessary for statins. While increasing dietary fiber intake (Choice C) is generally beneficial for health, it is not a specific instruction related to taking statin medication.

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