Nursing Elites

1. A client with a new prescription for an albuterol metered-dose inhaler is being taught by a nurse. Which of the following instructions should the nurse include in the teaching?

• A. Inhale quickly when using the inhaler.
• B. Hold your breath for 10 seconds after inhaling the medication.
• C. Take a second puff of the inhaler immediately after the first.
• D. Exhale fully after using the inhaler.

Correct answer: B

Rationale: The correct instruction is to hold your breath for 10 seconds after inhaling the medication. This allows the medication to settle in the lungs and maximize its effectiveness. Choice A is incorrect as inhaling quickly may lead to improper medication delivery. Choice C is wrong because taking a second puff immediately after the first without waiting for the prescribed interval may cause an overdose. Choice D is also incorrect as exhaling fully after using the inhaler may result in the medication being exhaled rather than absorbed by the lungs.

2. A nurse is caring for a client who is postpartum, has a deep-vein thrombosis, and is receiving heparin therapy via subcutaneous injections. Which of the following actions should the nurse take?

• A. Request a prescription for PRN aspirin from the provider.
• B. Massage the injection site thoroughly following administration.
• C. Instruct the client that they cannot breastfeed while receiving heparin.
• D. Administer the injection in the client's abdomen.

Correct answer: D

Rationale: The nurse should administer the injection in the abdomen, as this is a common site for subcutaneous heparin administration. Massaging the injection site can lead to bruising or discomfort and should be avoided. Instructing the client not to breastfeed while on heparin is inaccurate, as heparin does not pass into breast milk in significant amounts. Aspirin is contraindicated for clients on heparin due to the increased risk of bleeding, so requesting a prescription for PRN aspirin would not be appropriate in this situation.

3. A healthcare professional is assessing the pain level of a client who has dementia and difficulty communicating. Which pain assessment technique should the healthcare professional use?

• A. Numeric rating scale
• B. Behavioral indicators
• C. Visual analog scale
• D. Faces pain scale

Correct answer: B

Rationale: For clients with dementia who have difficulty communicating, assessing pain using behavioral indicators like increased agitation and restlessness is more effective than relying on self-reported scales such as numeric rating scale, visual analog scale, or faces pain scale. Behavioral indicators provide valuable insights into pain perception in individuals who may have challenges expressing themselves verbally.

4. A client is experiencing suicidal thoughts and states, 'Why not end my misery?' What is the best response by the nurse?

• A. Why do you think your life isn’t worth living anymore?
• B. Do you have a plan to end your life?
• C. I need to understand what you mean by misery.
• D. You can trust me to share your thoughts.

Correct answer: B

Rationale: The correct answer is B: 'Do you have a plan to end your life?' When a client expresses suicidal thoughts, it is crucial to assess the immediate risk. Inquiring about a specific plan can help determine the seriousness of the situation. Choice A is less direct and may not provide a clear indication of the immediate risk. Choice C focuses on the interpretation of 'misery' rather than assessing the risk of suicide. Choice D offers support but does not address the critical assessment of the client's immediate safety.

5. A nurse is caring for a client with a new prescription for metoprolol. Which of the following should the nurse monitor?

• A. Blood pressure
• B. Liver function
• C. Serum potassium levels
• D. Blood glucose

Correct answer: A

Rationale: Corrected Rationale: Metoprolol is a beta-blocker commonly used to treat conditions like hypertension and angina. As a beta-blocker, it primarily affects the cardiovascular system by reducing heart rate and blood pressure. Therefore, the nurse should monitor the client's blood pressure regularly to assess the drug's effectiveness and ensure that it is within the therapeutic range. Monitoring liver function, serum potassium levels, or blood glucose is not typically required for clients taking metoprolol, as its primary impact is on the heart and blood vessels, making choice A the most appropriate monitoring parameter.

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