Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler.
Which of the following information should the nurse include in the teaching? (Select all that apply)
A. Rinse your child’s mouth following administration.
Fluticasone is an inhaled steroid that prevents the symptoms of asthma by decreasing inflammation in the airways. It is not used to treat a sudden asthma attack.
B. A spacer will make it easier to use the device.
Fluticasone is an inhaled steroid that prevents the symptoms of asthma by decreasing inflammation in the airways. It is not used to treat a sudden asthma attack.
C. Soak the inhaler in water after use.
Choice C is wrong because soaking the inhaler in water after use can damage the device and affect its performance.
D. Have your child take one inhalation as needed for shortness of breath.
Choice D is wrong because fluticasone is not a rescue inhaler that can be used as needed for shortness of breath.It is a controller inhaler that should be used regularly as prescribed by the doctor.
E. Shake the device prior to administration.
Choice E is wrong because shaking the device prior to administration is not necessary for a fluticasone metered-dose inhaler (MDI). However, it is recommended for fluticasone inhalation powder (Flovent Diskus). Some normal ranges that may be applicable are: The usual dose of fluticasone MDI for adults and children 12 years and older is 55 to 232 mcg twice a day. The usual dose of fluticasone MDI for children 4 to 11 years old is 30 mcg twice a day. The maximum dose of fluticasone MDI for adults and children 12 years and older is 1000 mcg twice a day.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
Fluticasone is an inhaled steroid that prevents the symptoms of asthma by decreasing inflammation in the airways. It is not used to treat a sudden asthma attack.
Some additional information to explain why the other choices are wrong are:
Choice C is wrong because soaking the inhaler in water after use can damage the device and affect its performance.
Choice D is wrong because fluticasone is not a rescue inhaler that can be used as needed for shortness of breath. It is a controller inhaler that should be used regularly as prescribed by the doctor.
Choice E is wrong because shaking the device prior to administration is not necessary for a fluticasone metered-dose inhaler (MDI). However, it is recommended for fluticasone inhalation powder (Flovent Diskus). Some normal ranges that may be applicable are:
The usual dose of fluticasone MDI for adults and children 12 years and older is 55 to 232 mcg twice a day. The usual dose of fluticasone MDI for children 4 to 11 years old is 30 mcg twice a day. The maximum dose of fluticasone MDI for adults and children 12 years and older is 1000 mcg twice a day.
Similar Questions
A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse.
Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (Select all that apply)
A. Decreased percentage of body fat.
Choice A is wrong because the decreased percentage of body fat does not increase the risk of adverse drug reactions in older adults. In fact, an increased percentage of body fat can alter the distribution and elimination of some drugs.
B. Multiple health problems.
Older adults are at higher risk of adverse drug reactions due to multiple health problems, polypharmacy, and decreased renal function. These factors can affect the pharmacokinetics and pharmacodynamics of pain medications and increase the likelihood of drug interactions, overdosage, or toxicity.
C. Increased rate of absorption.
Choice C is wrong because an increased rate of absorption does not increase the risk of adverse drug reactions in older adults. In fact, decreased rate of absorption can occur due to reduced gastric motility and blood flow.
D. Polypharmacy.
Older adults are at higher risk of adverse drug reactions due to multiple health problems, polypharmacy, and decreased renal function. These factors can affect the pharmacokinetics and pharmacodynamics of pain medications and increase the likelihood of drug interactions, overdosage, or toxicity.
E. Decreased renal function.
Older adults are at higher risk of adverse drug reactions due to multiple health problems, polypharmacy, and decreased renal function. These factors can affect the pharmacokinetics and pharmacodynamics of pain medications and increase the likelihood of drug interactions, overdosage, or toxicity.
Full Explanation
Older adults are at higher risk of adverse drug reactions due to multiple health problems, polypharmacy, and decreased renal function.
These factors can affect the pharmacokinetics and pharmacodynamics of pain medications and increase the likelihood of drug interactions, overdosage, or toxicity.
Choice A is wrong because the decreased percentage of body fat does not increase the risk of adverse drug reactions in older adults.
In fact, an increased percentage of body fat can alter the distribution and elimination of some drugs.
Choice C is wrong because an increased rate of absorption does not increase the risk of adverse drug reactions in older adults.
In fact, decreased rate of absorption can occur due to reduced gastric motility and blood flow.
A nurse is preparing to administer 4,000 units of heparin subcutaneously to a client who has deep-vein thrombosis.
Available is heparin 10,000 units/mL.
How many mL of heparin should the nurse administer? (Round the answer to the nearest) tenth.
Use a leading zero if it applies.
Do not use a trailing zero.) mL.
Full Explanation
To calculate the amount of heparin to administer, use the formula:
mL of heparin=units available units ordered×1mL available
Substituting the values given in the question, we get:
mL of heparin=100004000×11=0.4
Therefore, the nurse should administer 0.4 mL of heparin.
Normal ranges for heparin therapy vary depending on the condition being treated and the laboratory method used to measure APTT.
A general range is 60 to 80 seconds or 1.5 to 2.5 times the control value.
A nurse is assessing a client who is receiving heparin via continuous IV. The client has an aPTT of 90 seconds. The nurse should monitor the client for which of the following changes in their vital signs?
A. Increased pulse rate.
The correct answer is choice A. Increased pulse rate. An aPTT of 90 seconds is much higher than the normal range of 30-40 seconds, which means the blood takes longer to clot and the client is at risk of bleeding. An increased pulse rate is a sign of blood loss and shock.
B. Increased blood pressure.
B is wrong because increased blood pressure is not a sign of bleeding, but rather a sign of hypertension or stress.
C. Decreased temperature.
C is wrong because decreased temperature is not a sign of bleeding, but rather a sign of hypothermia or infection.
D. Decreased respiratory rate.
D is wrong because decreased respiratory rate is not a sign of bleeding, but rather a sign of respiratory depression or sedation.
Full Explanation
The correct answer is choice A. Increased pulse rate.
An aPTT of 90 seconds is much higher than the normal range of 30-40 seconds, which means the blood takes longer to clot and the client is at risk of bleeding. An increased pulse rate is a sign of blood loss and shock.
Choice B is wrong because increased blood pressure is not a sign of bleeding, but rather a sign of hypertension or stress.
Choice C is wrong because decreased temperature is not a sign of bleeding, but rather a sign of hypothermia or infection.
Choice D is wrong because decreased respiratory rate is not a sign of bleeding, but rather a sign of respiratory depression or sedation.