Nursing Elites

1. The client is being instructed on the correct technique for using... what to provide the client?

• A. Angle the tip of the inhaler upwards while spraying
• B. Hold one nostril closed while spraying the other nostril
• C. Avoid shaking the inhaler immediately before using
• D. Use the inhaler when first awakening in the morning

Correct answer: B

Rationale: The correct technique for using an inhaler for allergic rhinitis involves holding one nostril closed while spraying the other nostril to ensure proper delivery of the medication. This technique helps direct the medication into the nasal passages for optimal effectiveness. Choice A is incorrect as it refers to an incorrect technique for inhaler use. Choice C is incorrect as shaking the inhaler is often necessary to ensure proper mixing of the medication. Choice D is incorrect as the timing of inhaler use is typically based on individual preferences or healthcare provider recommendations, not specifically tied to the morning.

2. A client with a diagnosis of bipolar disorder is prescribed carbamazepine. The nurse should monitor for which potential adverse effect?

• A. Agranulocytosis
• B. Hair loss
• C. Liver toxicity
• D. Weight gain

Correct answer: A

Rationale: Carbamazepine is associated with the potential adverse effect of agranulocytosis, a serious condition characterized by a low white blood cell count. Monitoring white blood cell counts regularly is crucial to detect this adverse effect early and prevent complications.

3. A client with a diagnosis of generalized anxiety disorder is prescribed buspirone. The nurse should include which instruction in the client's teaching plan?

• A. This medication may cause drowsiness; avoid driving.
• B. This medication may take several weeks to take effect.
• C. This medication can be taken on an as-needed basis.
• D. This medication should be taken with food.

Correct answer: B

Rationale: Buspirone may take several weeks to take effect, so clients should continue taking it as prescribed and not expect immediate relief.

4. A client has been prescribed losartan. Which change in data indicates to the practical nurse (PN) that the desired effect of this medication has been achieved?

• A. Dependent edema reduced from +3 to +1.
• B. Serum HDL increased from 35 to 55 mg/dL.
• C. Pulse rate reduced from 150 to 90 beats/min.
• D. Blood pressure reduced from 160/90 to 130/80 mm Hg.

Correct answer: D

Rationale: The correct answer is D. Losartan is prescribed for the treatment of hypertension. The desired effect of losartan is to reduce blood pressure. Therefore, a reduction in blood pressure from 160/90 to 130/80 mm Hg indicates that the desired effect of the medication has been achieved. Choices A, B, and C are not specific effects of losartan and do not directly relate to the expected outcomes of this medication. Dependent edema, serum HDL levels, and pulse rate are not typically influenced by losartan, making choices A, B, and C incorrect.

5. A client with anxiety is prescribed alprazolam. What instruction should the nurse include in the client's teaching plan?

• A. Take this medication with food.
• B. Avoid activities that require alertness.
• C. Do not stop taking this medication abruptly.
• D. This medication may cause drowsiness.

Correct answer: C

Rationale: The correct answer is C: 'Do not stop taking this medication abruptly.' Alprazolam should not be stopped suddenly as it can lead to withdrawal symptoms. It is important for clients to taper off the medication gradually under medical supervision to prevent adverse effects. Choices A, B, and D are incorrect. Choice A is irrelevant to alprazolam administration instructions. Choice B, 'Avoid activities that require alertness,' is not the priority teaching point for alprazolam. Choice D, 'This medication may cause drowsiness,' is a common side effect of alprazolam but not the most critical instruction to include in the teaching plan.

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