Nursing Elites

1. When assessing a male client who is receiving a unit of packed red blood cells (PRBCs), the nurse notes that the infusion was started 30 minutes ago, and 50 ml of blood is left to be infused. The client's vital signs are within normal limits. He reports feeling 'out of breath' but denies any other complaints. What action should the nurse take at this time?

• A. Administer a PRN prescription for diphenhydramine (Benadryl).
• B. Start the normal saline attached to the Y-tubing at the same rate.
• C. Decrease the intravenous flow rate of the PRBC transfusion.
• D. Ask the respiratory therapist to administer PRN albuterol (Ventolin).

Correct answer: C

Rationale: In this scenario, the client is experiencing symptoms of shortness of breath, which could indicate fluid overload from the PRBC transfusion. By decreasing the intravenous flow rate of the transfusion, the nurse can slow down the rate of blood being infused, potentially alleviating the symptoms of fluid overload and shortness of breath. This intervention can help prevent further complications and promote the client's comfort and safety.

2. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?

• A. Reduce mucus production
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.

3. A 45-year-old woman presents with fatigue, pruritus, and jaundice. Laboratory tests reveal elevated bilirubin and alkaline phosphatase levels. Imaging shows a normal common bile duct but dilated intrahepatic bile ducts. What is the most likely diagnosis?

• A. Primary biliary cirrhosis
• B. Primary sclerosing cholangitis
• C. Gallstones
• D. Pancreatic cancer

Correct answer: A

Rationale: Based on the symptoms of fatigue, pruritus, and jaundice, along with elevated bilirubin and alkaline phosphatase levels, and imaging findings of a normal common bile duct but dilated intrahepatic bile ducts, the most likely diagnosis is primary biliary cirrhosis. Primary sclerosing cholangitis presents with different imaging findings, often showing strictures and beading of the bile ducts. Gallstones typically cause obstruction in the biliary system, leading to different symptoms and imaging findings. Pancreatic cancer would present with different clinical features and imaging characteristics.

4. A patient with chronic pain is prescribed gabapentin. What is the primary purpose of this medication?

• A. Relieve neuropathic pain
• B. Reduce inflammation
• C. Enhance opioid analgesia
• D. Suppress cough

Correct answer: A

Rationale: Gabapentin is primarily prescribed to relieve neuropathic pain. It works by stabilizing electrical activity in the nerves, making it effective in managing conditions such as diabetic neuropathy, postherpetic neuralgia, and other forms of chronic pain originating from nerve damage.

5. The client has been prescribed metformin (Glucophage) for type 2 diabetes. Which instruction should the nurse include in discharge teaching?

• A. Take the medication at bedtime.
• B. Take the medication with meals.
• C. Take the medication on an empty stomach.
• D. Take the medication as needed for high blood sugar.

Correct answer: B

Rationale: The correct instruction for taking metformin (Glucophage) is with meals. This helps reduce gastrointestinal side effects and improves the medication's absorption. Taking it on an empty stomach can lead to more adverse effects, so it is essential to take it with food. Option A ('Take the medication at bedtime') is incorrect because metformin should be taken with meals to enhance its effectiveness and reduce side effects. Option C ('Take the medication on an empty stomach') is incorrect as taking metformin on an empty stomach can increase the likelihood of experiencing gastrointestinal issues. Option D ('Take the medication as needed for high blood sugar') is incorrect because metformin is typically taken regularly as prescribed, not just as needed for high blood sugar.

Similar Questions