Nursing Elites

1. When using a metered-dose inhaler (MDI), which step is most important for ensuring effective medication delivery?

• A. Exhale completely before using the inhaler
• B. Inhale quickly while pressing down on the inhaler
• C. Shake the inhaler for 10 seconds before use
• D. Hold breath for 5 seconds after inhaling

Correct answer: A

Rationale: The correct step to ensure effective medication delivery when using a metered-dose inhaler (MDI) is to exhale completely before using the inhaler. This action helps create more space in the lungs for the medication to reach deeply into the airways. Inhaling quickly while pressing down on the inhaler (Choice B) may cause the medication to impact the throat rather than reaching the lungs. Shaking the inhaler for 10 seconds before use (Choice C) is important to mix the medication but not the most crucial step for effective delivery. While holding the breath for 5 seconds after inhaling (Choice D) can help the medication stay in the lungs momentarily, exhaling completely before inhalation is more critical for optimal drug deposition.

2. The nurse is teaching a client with hypertension about lifestyle modifications. Which recommendation is most effective for lowering blood pressure?

• A. Increase intake of red meat
• B. Engage in regular physical activity
• C. Consume a high-sodium diet
• D. Limit fluid intake to 1 liter per day

Correct answer: B

Rationale: Engaging in regular physical activity is a highly effective recommendation for lowering blood pressure and improving overall cardiovascular health. Regular exercise helps to strengthen the heart, improve blood circulation, and manage weight, all of which contribute to reducing blood pressure levels. Choices A, C, and D are incorrect. Increasing intake of red meat can lead to higher saturated fat consumption, which is detrimental to heart health. Consuming a high-sodium diet can exacerbate hypertension by increasing blood pressure. Limiting fluid intake to 1 liter per day may lead to dehydration and is not a recommended approach for managing hypertension.

3. A client with chronic obstructive pulmonary disease (COPD) is receiving home oxygen therapy. What is the most important instruction the nurse should provide?

• A. Use oxygen at the highest flow rate tolerated
• B. Avoid wearing oxygen during physical activity
• C. Do not smoke while using oxygen
• D. Store oxygen tanks in a cool, dark place

Correct answer: C

Rationale: The correct answer is C: 'Do not smoke while using oxygen.' Smoking while using oxygen can lead to a serious fire hazard, as oxygen supports combustion. This instruction is crucial to prevent potential harm to the client. Choices A, B, and D are incorrect. Using oxygen at the highest flow rate tolerated can be harmful, avoiding wearing oxygen during physical activity may limit the client's mobility unnecessarily, and storing oxygen tanks in a cool, dark place, although important, is not as critical as the instruction to avoid smoking while using oxygen.

4. A client is diagnosed with Angina Pectoris. Which factor in the client's history is likely related to the anginal pain?

• A. Smokes one pack of cigarettes daily
• B. Drinks two beers daily
• C. Works in a job that requires exposure to the sun
• D. Eats while lying in bed

Correct answer: A

Rationale: The correct answer is A: 'Smokes one pack of cigarettes daily.' Smoking is a major risk factor for angina and other cardiovascular diseases due to its impact on blood vessels. Choice B, 'Drinks two beers daily,' is not directly associated with angina pectoris. While excessive alcohol consumption can contribute to heart problems, it is not a primary risk factor for angina. Choice C, 'Works in a job that requires exposure to the sun,' is not typically related to angina pectoris. Sun exposure is more closely linked to skin-related conditions. Choice D, 'Eats while lying in bed,' is also not a common risk factor for angina. While certain eating habits can impact heart health, this specific behavior is not directly associated with angina pectoris.

5. A client is admitted with a diagnosis of pneumonia. Which intervention should the nurse implement to promote airway clearance?

• A. Administer bronchodilators as prescribed.
• B. Encourage increased fluid intake.
• C. Perform chest physiotherapy.
• D. Provide humidified oxygen.

Correct answer: B

Rationale: Encouraging increased fluid intake is the most appropriate intervention to promote airway clearance in a client with pneumonia. Adequate hydration helps to thin respiratory secretions, making it easier for the client to cough up and clear the airways. Administering bronchodilators (Choice A) may help with bronchospasm but does not directly promote airway clearance. Chest physiotherapy (Choice C) can be beneficial in certain cases but may not be the initial intervention for promoting airway clearance. Providing humidified oxygen (Choice D) can help improve oxygenation but does not specifically target airway clearance in pneumonia.

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