Nursing Elites

1. A client with asthma has new prescriptions for cromolyn and albuterol by nebulizer. Which statement by the client indicates an understanding of the teaching?

• A. If my breathing begins to feel tight, I will use the cromolyn immediately.
• B. I will be sure to take the albuterol before taking the cromolyn.
• C. I will use both medications immediately after exercising.
• D. I will administer the medications 10 minutes apart.

Correct answer: B

Rationale: The correct answer is B. Taking albuterol before cromolyn ensures that the airways are open, allowing the cromolyn to reach the lungs effectively. Choice A is incorrect because cromolyn is a preventive medication and should be used regularly, not just when symptoms worsen. Choice C is incorrect because medications should be used as prescribed, not based on a specific event like exercising. Choice D is incorrect because there is no need to wait 10 minutes between administering these two medications when using a nebulizer.

2. During a unit of whole blood transfusion, a client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The healthcare professional should anticipate a prescription for which of the following medications?

• A. Epinephrine
• B. Lorazepam
• C. Furosemide
• D. Diphenhydramine

Correct answer: C

Rationale: In the scenario described, the client is exhibiting signs of fluid overload, which can occur during blood transfusion. Furosemide, a loop diuretic, is commonly prescribed in such situations to help relieve manifestations of circulatory overload by promoting diuresis and reducing fluid volume. Therefore, the correct choice is C - Furosemide. Epinephrine (Choice A) is not indicated for fluid overload but for severe allergic reactions. Lorazepam (Choice B) is a benzodiazepine used for anxiety or sedation, not for fluid overload. Diphenhydramine (Choice D) is an antihistamine often used for allergic reactions, not for fluid overload.

3. A client has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

• A. Diarrhea
• B. Dry mouth
• C. Insomnia
• D. Hypertension

Correct answer: B

Rationale: Dry mouth is a common adverse effect associated with clonidine use. Clonidine is known to cause xerostomia (dry mouth) due to its effect on reducing salivary flow. Monitoring for dry mouth is important as it can lead to oral health issues and discomfort for the client. Diarrhea, insomnia, and hypertension are not typically associated with clonidine use, making them less likely adverse effects to monitor for in this scenario.

4. A client in labor is receiving IV Opioid analgesics. Which of the following actions should the nurse take?

• A. Instruct the client to self-ambulate every 2 hours.
• B. Offer oral hygiene every 2 hours.
• C. Anticipate medication administration 2 hours prior to delivery.
• D. Monitor fetal heart rate every 2 hours.

Correct answer: B

Rationale: When a client is receiving IV Opioid analgesics during labor, the nurse should offer oral hygiene every 2 hours. Opioid analgesics can cause adverse effects like dry mouth, nausea, and vomiting. Providing oral hygiene care helps alleviate these symptoms and maintains the client's comfort and well-being during labor. Instructing the client to self-ambulate every 2 hours is not appropriate during labor as mobility may be limited. Anticipating medication administration 2 hours prior to delivery is not necessary as the timing of medication administration should be based on the client's needs and the progress of labor. Monitoring fetal heart rate every 2 hours is important during labor, but it is not specifically related to the client receiving IV Opioid analgesics.

5. A client has a new prescription for metronidazole. The client should avoid which of the following?

• A. Dairy products
• B. Alcohol
• C. Leafy green vegetables
• D. Grapefruit juice

Correct answer: B

Rationale: The correct answer is B: Alcohol. Clients should avoid alcohol while taking metronidazole to prevent a disulfiram-like reaction, which can cause symptoms such as nausea, vomiting, headache, and flushing. Alcohol can interact with metronidazole and lead to adverse effects. Choices A, C, and D are not typically contraindicated with metronidazole. Dairy products, leafy green vegetables, and grapefruit juice do not have significant interactions with metronidazole, unlike alcohol.

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