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A nurse is assisting in the care of a client.

Exhibits

Click to highlight the instructions the nurse should reinforce to the client.

Prescribed Medication

Nursing Instruction

Albuterol

Take your albuterol when you are having difficulty breathing.

Hold your breath for 20 seconds when taking your albuterol.

Salmeterol

Take the salmeterol 5 minutes before the albuterol when you need both medications.

Take the salmeterol 2 times each day.

Fluticasone

Rinse out your mouth after taking the fluticasone.

Take the fluticasone as needed for an asthma attack.

Take your albuterol when you are having difficulty breathing.

Hold your breath for 20 seconds when taking your albuterol.

Take the salmeterol 5 minutes before the albuterol when you need both medications.

Take the salmeterol 2 times each day.

Rinse out your mouth after taking the fluticasone.

Take the fluticasone as needed for an asthma attack.

Answer and Explanation

The Correct Answer is ["A","D","E"]

Albuterol

"Take your albuterol when you are having difficulty breathing.": Albuterol is a short-acting beta-agonist (SABA) used as a rescue inhaler for acute symptoms such as wheezing and shortness of breath.

"Hold your breath for 20 seconds when taking your albuterol.": This is incorrect as holding the breath for 10 seconds after inhalation is sufficient to allow the medication to reach the lungs. Holding it longer is unnecessary and impractical.

Salmeterol

"Take the salmeterol 2 times each day.": Salmeterol is a long-acting beta-agonist (LABA) intended for long-term control of asthma symptoms, not for acute attacks. It should be taken twice daily as prescribed.

"Take the salmeterol 5 minutes before the albuterol when you need both medications.": This is incorrect because salmeterol is not a rescue medication and should not be used for immediate relief. Albuterol should be taken first if both medications are prescribed together, allowing the airways to open for better absorption of salmeterol.

Fluticasone

"Rinse out your mouth after taking the fluticasone.": Fluticasone is an inhaled corticosteroid, and rinsing the mouth helps prevent oral thrush, a common side effect.

"Take the fluticasone as needed for an asthma attack.": This is incorrect because fluticasone is a maintenance medication for inflammation and is not effective for acute asthma attacks.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Inject 0.3 to 0.5 mL of the solution: The typical volume for a tuberculin skin test is 0.1 mL.
B. Select an injection site that is free of scar tissue: Scar tissue can interfere with the reading of the tuberculin skin test, so a site free of scars should be selected.
C. Hold the needle at a 30° angle during injection: The needle should be held at a 5–15° angle for intradermal injections.
D. Massage the site following the injection: Massaging the site is not recommended as it could affect the accuracy of the test.

A. Offer the client a cold compress. B. Play music in the client's room as a distraction. C. Check the client's current level of pain. D. Assist the client to reposition in bed.

Correct Answer is C

Explanation

A. Offer the client a cold compress: While a cold compress might help with swelling or discomfort, it is more important to assess the client's pain level first to understand the cause of the grimacing.
B. Play music in the client's room as a distraction: This could help later, but pain needs to be addressed first.
C. Check the client's current level of pain: Grimacing could indicate pain, which should be evaluated and addressed first to provide comfort and prevent complications like increased stress or decreased respiratory effort.
D. Assist the client to reposition in bed: Repositioning could help alleviate discomfort, but pain should be assessed first to ensure the client is not in severe pain.

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Prescribed Medication	Nursing Instruction
Albuterol	Take your albuterol when you are having difficulty breathing. Hold your breath for 20 seconds when taking your albuterol.
Salmeterol	Take the salmeterol 5 minutes before the albuterol when you need both medications. Take the salmeterol 2 times each day.
Fluticasone	Rinse out your mouth after taking the fluticasone. Take the fluticasone as needed for an asthma attack.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning to administer a tuberculin skin test to a client who has had an exposure to tuberculosis. Which of the following actions should the nurse plan to take?

Correct Answer is B

Explanation

A nurse is caring for a client who had abdominal surgery. The client is grimacing and has a respiratory rate of 24/min. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A nurse is collecting data from a client who is experiencing oxycodone toxicity. Which of the following findings should the nurse expect?

A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?

A nurse is monitoring a client who received naloxone to counteract the effects of an opioid overdose. Which of the following findings should indicate to the nurse that the medication is effective?

A nurse in an influenza clinic is collecting data from four clients. Which of the following clients should the nurse identify as having a contraindication for receiving the live attenuated form of the influenza vaccine?

A nurse is caring for a client who is receiving an oral solution of codeine to suppress a nonproductive cough. Which of the following is the nurse's data collection priority following administration of this medication?

A nurse is assisting in the care of a client admitted for an acetaminophen overdose. Which of the following prescriptions should the nurse anticipate implementing?

A nurse is preparing to administer 17,000 units heparin subcutaneously. Available is heparin 20,000 units/mL. How many mL should the nurse administer? (Round the answer to the nearest hundredth. Use a leading zero if applicable. Do not use a trailing zero.)