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. A client has a prescription for long-term use of oral prednisone for the treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

• A. Weight gain
• B. Nervousness
• C. Bradycardia
• D. Constipation

Correct answer: A

Rationale: The correct answer is weight gain. Oral prednisone can lead to weight gain and fluid retention due to its sodium and water retention effects. Monitoring weight changes is crucial to identify and manage this adverse effect. Choices B, C, and D are incorrect because oral prednisone is not typically associated with nervousness, bradycardia, or constipation as common adverse effects. Therefore, the nurse should primarily focus on monitoring weight gain in clients prescribed long-term oral prednisone therapy.

3. A client is starting a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take the medication at bedtime.
• B. Take the medication with food.
• C. Take the medication first thing in the morning on an empty stomach.
• D. Take the medication with a full glass of milk.

Correct answer: C

Rationale: The correct instruction for taking levothyroxine is to take the medication first thing in the morning on an empty stomach. This timing is important for optimal absorption of the medication. Taking levothyroxine with food or at bedtime can interfere with its absorption. Milk and other foods, as well as certain medications, can reduce the effectiveness of levothyroxine by interfering with its absorption, so it should be taken separately from these items. Therefore, the correct choice is to take the medication first thing in the morning on an empty stomach.

4. To which pharmacologic classification does the drug propranolol belong?

• A. Beta Blockers
• B. Cholinergics
• C. Immune globulins
• D. Barbiturates

Correct answer: A

Rationale: Propranolol belongs to the pharmacologic classification of Beta Blockers. Beta blockers work by blocking the action of adrenaline and other stress hormones on beta-adrenergic receptors. They are commonly used to manage conditions like high blood pressure, angina, and arrhythmias. Choice B, Cholinergics, is incorrect because cholinergics work by stimulating the parasympathetic nervous system, unlike beta blockers that block adrenergic receptors. Choice C, Immune globulins, is incorrect as it refers to antibodies used to boost the immune system, not the mechanism of action of propranolol. Choice D, Barbiturates, is incorrect as barbiturates are a different class of drugs that act as central nervous system depressants, primarily used as sedatives and anesthetics.

5. Why should the nitrate patch be off for 8 hours per day?

• A. “There is no reason to take the patch off each day.”
• B. “The patch can be addictive; leaving it off reduces the addiction.”
• C. “You should only leave the patch off for 15 minutes.”
• D. “Leaving the patch off for 8 hours per day helps to delay the development of tolerance.”

Correct answer: D

Rationale: Removing the nitrate patch for 8 hours each day is essential to prevent the body from developing tolerance to the medication. By allowing the body to have a drug-free period, the effectiveness of the medication is maintained over time. This practice helps in ensuring that the nitrate patch continues to provide its intended therapeutic effects without diminishing its efficacy. Therefore, it is important for the client to adhere to the prescribed schedule of removing the patch for 8 hours daily to optimize the treatment outcomes.

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