Nursing Elites

1. A nurse is caring for a client with congestive heart failure. Which of the following prescriptions should the nurse anticipate?

• A. Call the provider if the respiratory rate is less than 18/min
• B. Administer a 500 mL IV bolus of 0.9% sodium chloride over 1 hour
• C. Administer enalapril 2.5 mg PO twice daily
• D. Call the provider if the client’s pulse rate is less than 80/min

Correct answer: C

Rationale: Enalapril, an ACE inhibitor, is commonly prescribed to manage hypertension and heart failure. It helps reduce the workload on the heart and prevent fluid retention. Options A, B, and D are incorrect. Option A focuses on a respiratory rate, which is not specific to heart failure management. Option B suggests administering a large IV bolus of fluid, which can worsen heart failure by increasing fluid volume. Option D addresses the pulse rate, which is not a typical parameter to monitor for heart failure specifically.

2. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which of the following assessment findings requires immediate intervention by the nurse?

• A. Prealbumin level of 20 mg/dL
• B. Weight increase of 2 kg/day
• C. Temperature of 37.6°C
• D. Blood glucose level of 120 mg/dL

Correct answer: B

Rationale: A rapid weight gain of 2 kg/day suggests fluid overload, a possible complication of TPN. This requires immediate intervention to prevent further complications such as pulmonary edema. The other options are not indicative of immediate complications related to TPN. A low prealbumin level may indicate malnutrition but does not require immediate intervention. A slightly elevated temperature and blood glucose level are within normal ranges and do not warrant immediate action.

3. A client with ulcerative colitis has a new prescription for sulfasalazine. What adverse effect should the client monitor for according to the nurse?

• A. Jaundice
• B. Constipation
• C. Oral candidiasis
• D. Sedation

Correct answer: A

Rationale: The correct answer is A: Jaundice. Sulfasalazine can lead to liver toxicity, making it essential to monitor for jaundice, a sign of liver dysfunction. Choices B, C, and D are incorrect because constipation, oral candidiasis, and sedation are not commonly associated with sulfasalazine use.

4. A nurse is teaching a client with mild persistent asthma who has been prescribed montelukast. Which statement by the nurse is appropriate?

• A. This medication can be used during an acute asthma attack.
• B. This medication should be taken before exercise.
• C. You can take this medication for 10 days, then discontinue.
• D. This medication helps decrease swelling and mucus production.

Correct answer: D

Rationale: The correct answer is D: 'This medication helps decrease swelling and mucus production.' Montelukast is used for long-term asthma management as it helps reduce inflammation and mucus production in the airways. It is not appropriate for acute asthma attacks. Choice A is incorrect because montelukast is not a rescue medication for acute attacks. Choice B is incorrect because montelukast is not specifically taken before exercise. Choice C is incorrect because montelukast is usually taken regularly, not just for a short duration.

5. 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 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 can double up on doses to catch up.

Correct answer: A

Rationale: The correct answer is to advise the client to take the medication once daily at bedtime. Montelukast, a leukotriene modifier, is used for long-term therapy of asthma in adults and children, as well as to prevent exercise-induced bronchospasm. It should be taken once daily in the evening for optimal effectiveness. Choice B is incorrect because montelukast is not for acute management but for long-term therapy. Choice C is incorrect as there is no need to avoid dairy products while taking montelukast. Choice D is incorrect and potentially harmful advice; clients should never double up on doses if they forget to take a medication.

Similar Questions