Nursing Elites

1. For a patient with asthma, what is the primary purpose of prescribing salmeterol?

• A. Relieve acute bronchospasm
• B. Prevent asthma attacks
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Salmeterol is classified as a long-acting beta2-agonist, which is used to prevent asthma attacks by providing extended bronchodilation. It is not typically used for immediate relief of acute bronchospasm or for suppressing cough. Additionally, salmeterol does not have the primary purpose of thinning respiratory secretions.

2. The healthcare professional is caring for a client with heart failure who is receiving digoxin (Lanoxin). Which assessment finding requires immediate intervention?

• A. Heart rate of 58 beats per minute.
• B. Nausea and vomiting.
• C. Blood pressure of 130/80 mm Hg.
• D. Shortness of breath.

Correct answer: B

Rationale: The correct answer is B. Nausea and vomiting are common signs of digoxin toxicity, which can lead to serious complications like dysrhythmias. Prompt intervention is crucial to prevent further harm to the client. Choice A, a heart rate of 58 beats per minute, although slightly lower than normal, may be appropriate for a client on digoxin. Choice C, a blood pressure of 130/80 mm Hg, is within normal limits and does not indicate an immediate need for intervention. Choice D, shortness of breath, is a common symptom in heart failure and requires monitoring but is not as indicative of digoxin toxicity as nausea and vomiting.

3. A patient with chronic obstructive pulmonary disease (COPD) is experiencing severe dyspnea. What position should the nurse encourage the patient to assume?

• A. Supine
• B. Prone
• C. High Fowler's
• D. Trendelenburg

Correct answer: C

Rationale: The High Fowler's position is the most appropriate position for a patient with COPD experiencing severe dyspnea. This position helps improve lung expansion and reduce dyspnea by allowing the diaphragm to move more freely and increasing the efficiency of breathing. It also helps reduce the work of breathing and enhances oxygenation in patients with COPD. Supine position (Choice A) may worsen dyspnea by limiting lung expansion. Prone position (Choice B) is not ideal for COPD patients experiencing severe dyspnea as it may restrict breathing. Trendelenburg position (Choice D) is not recommended for COPD patients with dyspnea as it can further compromise breathing.

4. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which intervention should the nurse implement to ensure the client's safety?

• A. Increase the oxygen flow rate to 6 liters/minute if the client is short of breath.
• B. Instruct the client to breathe deeply and cough frequently.
• C. Use a nasal cannula to deliver oxygen at a low flow rate.
• D. Encourage the client to remove the oxygen when eating or drinking.

Correct answer: C

Rationale: Using a nasal cannula to deliver oxygen at a low flow rate is the appropriate intervention for clients with COPD receiving oxygen therapy. High flow rates can lead to respiratory depression in COPD patients. This intervention helps maintain a safe and controlled oxygen delivery to prevent potential complications associated with high oxygen flow rates.

5. A patient with rheumatoid arthritis is prescribed methotrexate. What is an important teaching point for the nurse to provide?

• A. Take folic acid supplements as prescribed.
• B. Avoid alcohol completely.
• C. Expect to see immediate results.
• D. Limit fluid intake to 1 liter per day.

Correct answer: A

Rationale: The correct teaching point for a patient prescribed methotrexate is to take folic acid supplements as prescribed. Methotrexate can lead to a folate deficiency, which is why supplementing with folic acid is essential to reduce the risk of side effects such as mouth sores, nausea, and liver problems.

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