Nursing Elites

1. A client with a new prescription for a dry-powder inhaler (DPI) is receiving teaching from a healthcare provider. Which of the following statements indicates an understanding of the teaching?

• A. I will shake the inhaler before use.
• B. I will take the medication with food.
• C. I will inhale the medication quickly.
• D. I will use a spacer with the inhaler.

Correct answer: C

Rationale: Choosing option C, 'I will inhale the medication quickly,' demonstrates an understanding of DPI use. Inhaling the medication quickly ensures effective delivery of the dry powder to the lungs, maximizing its therapeutic effects. Options A, B, and D are incorrect as shaking the DPI, taking it with food, and using a spacer are not recommended practices for DPI administration. Shaking a DPI can cause clumping or uneven dispersion of the medication, taking it with food may not affect its efficacy but can increase the risk of side effects, and using a spacer is not necessary for DPIs which are breath-actuated and do not require coordination with inhalation through a spacer.

2. A healthcare professional is educating a client with osteoporosis about dietary management. Which of the following foods should the professional recommend?

• A. Green beans
• B. Fortified cereal
• C. Red meat
• D. White bread

Correct answer: B

Rationale: Fortified cereal is the correct answer as it is an excellent choice for individuals with osteoporosis due to its high calcium and vitamin D content, both essential nutrients for bone health. These nutrients help in maintaining bone density and strength, which is crucial for individuals with osteoporosis. Green beans (choice A) do not provide as much calcium and vitamin D as fortified cereal. Red meat (choice C) is a good source of protein but is not as rich in calcium and vitamin D compared to fortified cereal. White bread (choice D) lacks the essential nutrients needed for bone health, making it a less suitable choice for individuals with osteoporosis.

3. A client has a new prescription for furosemide. Which of the following instructions should the nurse include during discharge teaching?

• A. Avoid foods high in potassium.
• B. Monitor weight daily.
• C. Take the medication with food.
• D. Increase salt intake.

Correct answer: B

Rationale: Monitoring weight daily is crucial when taking furosemide to detect fluid retention or loss. Furosemide is a diuretic that helps the body get rid of excess water and salt through urine. Changes in weight can indicate fluid shifts, which could be a sign of inadequate response to the medication or worsening condition. Therefore, monitoring weight daily is essential to assess the effectiveness of furosemide therapy and detect any potential issues early on. Choices A, C, and D are incorrect. Avoiding foods high in potassium is more relevant for clients taking potassium-sparing diuretics, not furosemide. Taking furosemide with food is not necessary, as it can be taken with or without food. Increasing salt intake is contradictory to the purpose of furosemide, which aims to eliminate excess salt from the body.

4. A client has a new diagnosis of renal calculi, and the nurse is teaching about dietary management. Which of the following statements should the nurse include in the teaching?

• A. You should increase your intake of calcium-rich foods.
• B. You should decrease your intake of calcium-rich foods.
• C. You should increase your intake of sodium-rich foods.
• D. You should decrease your intake of potassium-rich foods.

Correct answer: B

Rationale: The correct answer is to decrease the intake of calcium-rich foods when managing renal calculi. Calcium can contribute to the formation of stones in the kidneys, so reducing its intake can help prevent the development of new calculi and manage existing ones.

5. A client has a stage 1 pressure ulcer on the right heel. Which of the following interventions should the nurse include in the plan?

• A. Apply a heat lamp to the area for 20 minutes each day.
• B. Change the dressing on the heel every 12 hours.
• C. Apply a transparent dressing over the heel.
• D. Use a water pressure mattress.

Correct answer: C

Rationale: Applying a transparent dressing over the heel is beneficial as it can protect the ulcer from friction and shear, and allow for continuous observation of the wound. This intervention promotes healing and prevents further damage to the skin. Choice A is incorrect because applying heat can increase the risk of tissue damage and should be avoided. Choice B is incorrect as changing the dressing every 12 hours may disrupt the wound healing process and is not necessary for a stage 1 pressure ulcer. Choice D is incorrect because using a water pressure mattress is not a specific intervention for a stage 1 pressure ulcer on the heel.

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