A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include?

"Skip the morning dose if you do not have any symptoms."

"Use this medication to relieve an acute attack."

"Check your heart rate before each dose."

"Inspect your mouth for lesions daily."

Answer and Explanation

The Correct Answer is D

A. Fluticasone should be used regularly to prevent symptoms, not skipped based on symptom presence.
B. Fluticasone is a maintenance medication and is not effective for acute attacks.
C. Checking heart rate is not necessary with fluticasone use.
D. Inspecting the mouth for lesions daily is important to detect oral thrush, a potential side effect of inhaled corticosteroids.

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Correct Answer is A

Explanation

A. Propranolol is a beta-blocker used to control blood pressure and heart rate. However, the nurse has a hold order for propranolol if the apical pulse (heart rate) is less than 50 beats per minute. The nurse documented a heart rate of 42 bpm at 0815, which falls below the hold parameter for propranolol. Administering propranolol in this case could worsen the client's bradycardia (slow heart rate) and therefore requires an incident report.
B. Pantoprazole is a proton pump inhibitor and doesn't have a direct impact on heart rate within the usual therapeutic range.
C. Lovastatin is a cholesterol medication and wouldn't cause a significant drop in heart rate at this dosage.
D. While morphine can slow the heart rate, it's typically used for pain management and may be necessary for the client's comfort. However, the nurse should monitor the respiratory rate closely due to potential respiratory depression.
E. Cefuroxime is an antibiotic and wouldn't significantly affect heart rate.

A. A client who requests to obtain information on the adverse effects of antidepressant medication therapy. B. A client who requests to get school assignments while hospitalized on a pediatric unit. C. A client who requests to secure an emergency notification system in the home. D. A client who requests to receive additional instructions on breastfeeding prior to discharge. E. A client who requires placement in an assisted living facility.

Correct Answer is ["B","C","E"]

Explanation

A. Providing information on medication effects is within the nurse's scope of practice and does not typically require social work involvement.
B. Client B, who is hospitalized and wishes to keep up with school assignments, may need assistance with educational continuity plans.
C. Securing an emergency notification system involves social services to assess and arrange appropriate services.
D. Providing breastfeeding instructions is part of nursing care and does not typically require social work involvement.
E. Placement in an assisted living facility requires social work assistance to coordinate appropriate care and transition.

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A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client. Exhibits The nurse reviews the medication administration record following the 0815 assessment findings. Which of the following administered medications would require an incident report?

Correct Answer is A

Explanation

A nurse is caring for a group of clients. Which of the following clients should the nurse refer to a social worker? (Select all that apply.)

Correct Answer is ["B","C","E"]

Explanation

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A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include?