Nursing Elites

1. What is an important teaching point for a patient prescribed dabigatran for atrial fibrillation?

• A. Take the medication with food to enhance absorption.
• B. Do not crush or chew the capsules.
• C. Increase intake of green leafy vegetables.
• D. Avoid all dairy products.

Correct answer: B

Rationale: The correct teaching point for a patient prescribed dabigatran is not to crush or chew the capsules. Doing so can alter the absorption of the medication, increasing the risk of bleeding. It is important for patients to swallow the capsules whole to ensure proper delivery of the medication.

2. A client with chronic obstructive pulmonary disease (COPD) is experiencing respiratory distress. Which intervention should the nurse implement first?

• A. Administer bronchodilators as prescribed.
• B. Encourage pursed-lip breathing.
• C. Position the client in a high Fowler's position.
• D. Obtain a stat arterial blood gas (ABG) sample.

Correct answer: C

Rationale: In a client with COPD experiencing respiratory distress, the priority intervention should be to position the client in a high Fowler's position. This position helps optimize lung expansion, improve oxygenation, and reduce the work of breathing. Administering bronchodilators and encouraging pursed-lip breathing are important interventions but positioning the client to enhance respiratory function takes precedence in this situation. Obtaining an ABG sample may provide valuable information but is not the initial priority when addressing respiratory distress.

3. A 70-year-old woman presents with fatigue, anorexia, and weight loss. She has noticed darkening of her skin, particularly in sun-exposed areas. Laboratory tests reveal hyponatremia, hyperkalemia, and low cortisol levels. What is the most likely diagnosis?

• A. Cushing's syndrome
• B. Addison's disease
• C. Hypothyroidism
• D. Pheochromocytoma

Correct answer: B

Rationale: The combination of symptoms such as fatigue, anorexia, weight loss, hyperpigmentation of the skin, along with hyponatremia, hyperkalemia, and low cortisol levels, points towards Addison's disease. This condition is characterized by adrenal insufficiency, leading to a deficiency in cortisol and aldosterone production.

4. When providing dietary instructions to a client with cirrhosis, which dietary restriction is important for the nurse to emphasize?

• A. Low-protein diet
• B. Low-sodium diet
• C. High-fiber diet
• D. High-calcium diet

Correct answer: B

Rationale: A low-sodium diet is crucial for clients with cirrhosis to manage fluid retention and ascites. Excessive sodium intake can worsen fluid accumulation in the body, leading to complications. By restricting sodium intake, the client can help reduce fluid retention and maintain better overall health. Therefore, emphasizing a low-sodium diet is essential in the dietary management of cirrhosis. Choices A, C, and D are not the primary focus for cirrhosis management. While protein restriction may be necessary in advanced stages of liver disease, it is not the main dietary concern in cirrhosis. High-fiber and high-calcium diets are generally beneficial for overall health but are not specifically emphasized in cirrhosis management.

5. A client with a history of asthma is prescribed salmeterol (Serevent). Which instruction should the nurse provide?

• A. Use this medication for acute asthma attacks.
• B. Use this medication before using your albuterol inhaler.
• C. Use this medication twice daily for long-term control.
• D. Use this medication as needed for wheezing.

Correct answer: C

Rationale: The correct instruction for a client prescribed salmeterol (Serevent) is to use it twice daily for long-term control. Salmeterol is a long-acting bronchodilator that is not intended for acute asthma attacks or as-needed use for wheezing. Choice A is incorrect because salmeterol is not used for acute asthma attacks. Choice B is incorrect as salmeterol is not meant to replace the albuterol inhaler but rather used for long-term control. Choice D is incorrect because salmeterol should not be used as needed; it is a maintenance medication for asthma.

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