Nursing Elites

1. A client with asthma is prescribed a corticosteroid inhaler. Which of the following instructions should the nurse include?

• A. Use the inhaler as needed for acute symptoms.
• B. Rinse the mouth after each use.
• C. Take the medication only during asthma attacks.
• D. Administer a bronchodilator after using the corticosteroid.

Correct answer: B

Rationale: The correct instruction is to rinse the mouth after each use of a corticosteroid inhaler to prevent oral candidiasis (thrush). Choice A is incorrect because corticosteroid inhalers are usually used on a regular schedule to control asthma symptoms, not just for acute symptoms. Choice C is incorrect as corticosteroid inhalers are typically used for long-term management, not just during asthma attacks. Choice D is incorrect as administering a bronchodilator after using a corticosteroid is not a standard practice and is not necessary for the effectiveness of the corticosteroid inhaler.

2. A client who has a prescription for insulin glargine is talking to a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I will mix this insulin with my regular insulin before injecting it.
• B. I will store this insulin in the refrigerator after opening it.
• C. I will take this insulin twice a day.
• D. I will inject this insulin when my blood glucose is above 200 mg/dL.

Correct answer: B

Rationale: The correct answer is B because insulin glargine should be stored in the refrigerator after opening to maintain its potency. Choice A is incorrect as insulin glargine should not be mixed with other insulins. Choice C is incorrect because insulin glargine is typically taken once a day. Choice D is incorrect because insulin glargine is usually taken regardless of blood glucose levels.

3. How should a healthcare professional monitor a patient receiving IV potassium?

• A. Monitor urine output
• B. Check blood pressure
• C. Monitor IV site
• D. Check respiratory rate

Correct answer: C

Rationale: When a patient is receiving IV potassium, it is crucial to monitor the IV site. Potassium can be irritating to the veins and may cause phlebitis or infiltration. Monitoring the IV site allows early detection of any potential complications. Checking urine output (Choice A) is important to assess kidney function but is not directly related to monitoring IV potassium. Blood pressure (Choice B) and respiratory rate (Choice D) are essential vital signs to monitor in general patient care but are not specific to monitoring IV potassium administration.

4. A nurse is providing teaching to family members of a client who has dementia. Which of the following instructions should the nurse include?

• A. Establish a toileting schedule for the client.
• B. Use clothing with buttons and zippers.
• C. Discourage physical activity during the day.
• D. Engage the client in activities that increase sensory stimulation.

Correct answer: A

Rationale: The correct answer is A: Establish a toileting schedule for the client. A toileting schedule helps manage incontinence and prevent accidents, promoting client dignity. Choice B is incorrect because clothing with buttons and zippers may be difficult for a client with dementia to manage independently. Choice C is incorrect as physical activity during the day is beneficial for clients with dementia. Choice D is incorrect as activities that increase sensory stimulation may be overwhelming for a client with dementia.

5. A healthcare provider is reviewing laboratory results for a client who is receiving heparin therapy. Which of the following results indicates that the medication is effective?

• A. Platelets 250,000/mm³
• B. aPTT 60 seconds
• C. Hemoglobin 15 g/dL
• D. INR 1.5

Correct answer: B

Rationale: An aPTT of 60 seconds indicates that the client is receiving an effective dose of heparin. The activated partial thromboplastin time (aPTT) measures the time it takes for blood to clot and is used to monitor heparin therapy. A therapeutic range for aPTT during heparin therapy is usually 1.5 to 2 times the control value, which is around 25-35 seconds. Platelets, hemoglobin, and INR values are not direct indicators of the effectiveness of heparin therapy.

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