Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
A. Attaches spacer device to the inhaler.
B. Stores the medication at room temperature.
C. Primes the inhaler with 7 pumps.
Ipratropium is a medication used to treat chronic obstructive pulmonary disease (COPD)1. When using an ipratropium inhaler for the first time or if it has not been used for a while, it is important to prime the inhaler by spraying it into the air away from your face1. However, the inhaler only needs to be primed with 2 sprays, not 71. If the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.
D. Rinses mouth after each use.
This question is an excerpt from Nurse Dive's nursing test bank - HESI Pharmacology Proctored Exam. Take the full exam now
Full Explanation
Ipratropium is a medication used to treat chronic obstructive pulmonary disease (COPD)1. When using an ipratropium inhaler for the first time or if it has not been used for a while, it is important to prime the inhaler by spraying it into the air away from your face1. However, the inhaler only needs to be primed with 2 sprays, not 71. If the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.

Similar Questions
Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the total level of calcium is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?
A. Administer both prescribed medications as scheduled.
B. Hold the calcitriol but administer the calcium carbonate as scheduled.
C. Hold the calcium carbonate but administer the calcitriol as scheduled.
D. Hold both medications until contacting the healthcare provider.
A total calcium level of 14 mg/dL (3.5 mmol/L) is higher than the normal range of 2.2 to 2.6 millimoles per liter (mmol/L)1. Calcitriol and calcium carbonate are both medications used to increase calcium levels in the blood2. Since the client’s calcium level is already high, it would be important for the nurse to hold both medications and contact the healthcare provider for further instructions.
Full Explanation
A total calcium level of 14 mg/dL (3.5 mmol/L) is higher than the normal range of 2.2 to 2.6 millimoles per liter (mmol/L)1. Calcitriol and calcium carbonate are both medications used to increase calcium levels in the blood2. Since the client’s calcium level is already high, it would be important for the nurse to hold both medications and contact the healthcare provider for further instructions.

The health care provider prescribes the antilipemic lovastatin for a client who has exhibited a consistently elevated serum cholesterol level. In evaluating the client’s treatment regimen, which remark by the client indicates to the nurse that the client understands the drug’s treatment protocol?
A. As soon as my cholesterol is lowered, I can stop taking this drug.
B. I will avoid taking alcoholic beverages while am taking this medication.
Lovastatin is an antilipemic medication used to lower cholesterol levels in the blood1. It is important for clients taking lovastatin to avoid drinking alcohol as it can increase the risk of liver problems. If the client remarks that they will avoid taking alcoholic beverages while taking this medication, it indicates that they understand the drug’s treatment protocol.
C. Taking this drug will enable me to have more choices about what can eat.
D. I will have a white blood count drawn monthly to monitor tor development of an infection.
Full Explanation
Lovastatin is an antilipemic medication used to lower cholesterol levels in the blood1. It is important for clients taking lovastatin to avoid drinking alcohol as it can increase the risk of liver problems. If the client remarks that they will avoid taking alcoholic beverages while taking this medication, it indicates that they understand the drug’s treatment protocol.

Which nursing action had the highest priority when administering a dose of codeine with acetaminophen to a client?
A. Advice the client that the medication should start to work in about 30 minutes.
Advise the client that the medication should start to work in about 30 minutes. While it is important to inform the client about the onset of action of the medication, this is not the highest priority. Codeine, an opioid, can cause dizziness and sedation, which increases the risk of falls. Therefore, safety measures take precedence over informing the client about the medication’s onset time.
B. Administer a stool softener/laxative at the same time as the analgesic.
Administer a stool softener/laxative at the same time as the analgesic. Opioids like codeine can cause constipation, so administering a stool softener or laxative is a good practice. However, this action is not the highest priority when considering the immediate safety of the client. Ensuring the client’s safety from potential falls due to dizziness or sedation is more urgent.
C. Instruct the client to request assistance when ambulating to the bathroom.
Instruct the client to request assistance when ambulating to the bathroom. This is the correct answer because codeine can cause dizziness, sedation, and orthostatic hypotension, increasing the risk of falls. Ensuring the client requests assistance when moving can prevent potential injuries, making it the highest priority nursing action.
D. Tell the client to notify the nurse if the pain is not relieved.
Tell the client to notify the nurse if the pain is not relieved. While it is important for the client to communicate about the effectiveness of pain relief, this is not the highest priority. The immediate concern is the client’s safety due to the sedative effects of codeine. Therefore, preventing falls and injuries takes precedence.
Full Explanation
The correct answer is C. Instruct the client to request assistance when ambulating to the bathroom.
Choice A reason:
Advise the client that the medication should start to work in about 30 minutes.
While it is important to inform the client about the onset of action of the medication, this is not the highest priority. Codeine, an opioid, can cause dizziness and sedation, which increases the risk of falls. Therefore, safety measures take precedence over informing the client about the medication’s onset time.
Choice B reason:
Administer a stool softener/laxative at the same time as the analgesic.
Opioids like codeine can cause constipation, so administering a stool softener or laxative is a good practice. However, this action is not the highest priority when considering the immediate safety of the client. Ensuring the client’s safety from potential falls due to dizziness or sedation is more urgent.
Choice C reason:
Instruct the client to request assistance when ambulating to the bathroom.
This is the correct answer because codeine can cause dizziness, sedation, and orthostatic hypotension, increasing the risk of falls. Ensuring the client requests assistance when moving can prevent potential injuries, making it the highest priority nursing action.
Choice D reason:
Tell the client to notify the nurse if the pain is not relieved.
While it is important for the client to communicate about the effectiveness of pain relief, this is not the highest priority. The immediate concern is the client’s safety due to the sedative effects of codeine. Therefore, preventing falls and injuries takes precedence.