Nursing Elites

1. The client needs instruction on using a metered-dose inhaler (MDI). Which instruction should be given?

• A. Inhale the medication and then exhale immediately
• B. Exhale fully, then place the inhaler in your mouth and inhale deeply while pressing the canister
• C. Take two short breaths before inhaling the medication
• D. Hold your breath for 5 seconds after inhaling the medication

Correct answer: B

Rationale: The correct technique for using a metered-dose inhaler (MDI) involves exhaling fully before inhaling deeply while pressing the canister to ensure effective delivery of the medication. Choice A is incorrect as exhaling should precede inhaling. Choice C is incorrect as taking two short breaths is not part of the correct technique. Choice D is incorrect as there is no need to hold the breath for a specific time after inhaling the medication.

2. When educating a client with a new prescription for nitroglycerin, which of the following instructions should the nurse include?

• A. Store the medication in a cool, dark place.
• B. Take the medication before bedtime.
• C. Take the medication with food.
• D. Take the medication at the first sign of chest pain.

Correct answer: D

Rationale: The correct instruction for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator used to relieve chest pain associated with angina. Taking it at the onset of chest pain ensures prompt relief by dilating blood vessels and increasing blood flow to the heart muscle. Storing nitroglycerin in a cool, dark place helps maintain its potency, while taking it with food can alter its absorption. Timing the medication with bedtime is not necessary, but prompt administration at the first sign of chest pain is crucial for effective management of angina. Choices A, B, and C are incorrect because storing the medication in a cool, dark place, taking it before bedtime, and taking it with food are not essential instructions for nitroglycerin use. The priority is to administer it promptly when chest pain occurs to achieve optimal therapeutic effects.

3. A client has a new prescription for metoprolol. Which of the following instructions should the nurse include?

• A. Monitor your blood pressure daily.
• B. Take the medication with food.
• C. Increase your intake of potassium-rich foods.
• D. Avoid consuming grapefruit juice.

Correct answer: A

Rationale: The correct answer is A, 'Monitor your blood pressure daily.' When a client is prescribed metoprolol, it is important to monitor blood pressure daily because the medication can cause hypotension, leading to low blood pressure. Regular monitoring allows for the early detection of any potential issues and adjustment of treatment if necessary. Choices B, C, and D are incorrect. Taking metoprolol with food is not necessary, increasing potassium-rich foods is not directly related to metoprolol therapy, and avoiding grapefruit juice is more relevant for certain other medications that interact with grapefruit.

4. The LPN/LVN is assisting with the care of a client who has been diagnosed with a myocardial infarction (MI). Which laboratory test result would the nurse expect to see elevated within the first 24 hours of the client's admission?

• A. Serum troponin
• B. Serum creatinine
• C. Serum sodium
• D. Serum albumin

Correct answer: A

Rationale: Elevated serum troponin levels are indicative of myocardial damage and are commonly used as a diagnostic marker for myocardial infarction. Troponin levels typically rise within a few hours of an MI and remain elevated for several days, making it a crucial test for early detection and monitoring of cardiac injury. Serum creatinine is not typically elevated in the acute phase of a myocardial infarction. Serum sodium and serum albumin levels are not directly associated with myocardial infarction and are unlikely to be elevated in the first 24 hours following an MI.

5. A nurse is assessing a client who has been taking lithium carbonate. Which of the following findings should the nurse report to the provider?

• A. Increased urination
• B. Tremors
• C. Weight gain
• D. Blurred vision

Correct answer: B

Rationale: The correct answer is B: Tremors. Tremors are a sign of lithium toxicity and should be reported immediately. Increased urination is a common side effect of lithium but not an urgent concern requiring immediate reporting. Weight gain is also a common side effect of lithium but does not indicate toxicity. Blurred vision is not typically associated with lithium toxicity; therefore, it is not the priority finding to report.

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