A patient with asthma has a prescription for salmeterol. What is the nurse's most important teaching point?

Correct Answer: B

Rationale: The correct answer is B) Take this medication twice daily as prescribed. Rationale: This is the most important teaching point because salmeterol is a long-acting beta agonist used for maintenance treatment of asthma, not for acute asthma attacks. Taking the medication as prescribed ensures optimal control of asthma symptoms and decreases the risk of exacerbations. Consistent dosing is crucial for the medication to be effective in managing asthma. Option A) Use the inhaler during an acute asthma attack is incorrect because salmeterol is not a rescue inhaler and should not be used for immediate relief during an asthma attack. Using it during an acute attack can be dangerous as it does not provide quick relief. Option C) Rinse your mouth after each use to prevent infections is important for corticosteroid inhalers, not for salmeterol. Salmeterol is a long-acting bronchodilator and does not typically cause oral infections. Option D) Shake the inhaler before each use is incorrect for salmeterol as it is not a requirement for this type of inhaler. Shaking the inhaler before use is typically necessary for metered-dose inhalers containing corticosteroids to ensure proper medication dispersion. Educational Context: This question highlights the importance of understanding the specific instructions for different asthma medications. Educating patients about their prescribed medications is essential for effective asthma management and improving patient outcomes. It is crucial for nurses to provide accurate information to patients to ensure they use their medications correctly and achieve optimal control of their asthma.

Correct Answer: A

Rationale: Rationale: The correct action for the nurse to take first in this scenario is option A, which is to administer prescribed pain medication. Pain management is crucial in post-operative care, especially in patients recovering from a thoracotomy. Severe pain can lead to physiological responses such as shallow breathing, which can compromise oxygenation. By addressing the pain promptly, the nurse can help the patient achieve adequate ventilation and oxygenation, promoting better recovery outcomes. Option B, assisting the patient with deep breathing exercises, is important for promoting lung expansion and preventing atelectasis. However, in this case, addressing the severe pain takes precedence as it can hinder the patient's ability to effectively participate in deep breathing exercises. Encouraging the use of the incentive spirometer, option C, is beneficial for improving lung function and preventing complications like pneumonia. However, if the patient is in severe pain, they may not be able to effectively utilize the spirometer due to discomfort. Repositioning the patient to relieve discomfort, option D, is a good nursing intervention for comfort. Still, in this situation, addressing the pain with medication is the priority to ensure the patient's overall well-being and ability to participate in other essential interventions for optimal oxygenation. In an educational context, this question highlights the importance of prioritizing nursing interventions based on the patient's immediate needs. It emphasizes the significance of pain management in post-operative care and the impact it can have on oxygenation and overall patient outcomes.

Correct Answer: A

Rationale: Rifampin (Rifadin) is a medication used to treat tuberculosis, and it is known to cause orange discoloration of bodily fluids, including urine and tears. Option A is the correct response because it addresses a potential side effect related to vision changes, particularly red-green color discrimination, which can occur with rifampin use. By asking about visual changes, the nurse can assess for a less common but serious side effect of the medication. Options B and D are incorrect because they do not address the specific side effect of orange discoloration associated with rifampin. Option C is also incorrect because it inaccurately states that the discoloration is normal. Providing this misinformation could lead to patient confusion or unnecessary concern. In an educational context, understanding the side effects of medications is crucial for nurses to provide safe and effective care. By knowing the expected side effects of rifampin, nurses can educate patients on what to expect and monitor for any potential complications. This question highlights the importance of thorough medication education and assessment to ensure patient safety and understanding.

Correct Answer: B

Rationale: The correct answer is B) Administer an intravenous antihypertensive in a hypertensive crisis for a patient with a history of hypertension and diabetes. In this scenario, the priority is to lower the dangerously high blood pressure to prevent complications like stroke, heart attack, or organ damage. Administering an intravenous antihypertensive medication provides a rapid onset of action to quickly lower blood pressure and stabilize the patient's condition. Option A) Administer antihypertensive medication is incorrect because in a hypertensive crisis, the need for immediate blood pressure reduction requires a faster route of administration like intravenous over oral medications. Option C) Monitor the patient's blood pressure is incorrect as it does not address the immediate need to lower the dangerously high blood pressure. Option D) Monitor the patient for signs of renal failure is incorrect as it is important but not the priority in this acute situation. The focus should be on stabilizing the blood pressure first. In an educational context, it is crucial for nurses and healthcare providers to understand the urgency and priority of interventions in critical situations like hypertensive crises to provide timely and effective care to prevent complications and ensure patient safety.

Correct Answer: A

Rationale: In this scenario, the priority intervention for a patient who has just had a coronary artery bypass graft (CABG) is to monitor cardiac output (Option A). This is the correct answer because after CABG surgery, ensuring adequate cardiac output is crucial for the patient's overall hemodynamic stability and recovery. By closely monitoring cardiac output, the nurse can assess the heart's ability to pump effectively and detect any signs of decreased perfusion or cardiac complications early on. Option B, administering intravenous fluids, is not the priority intervention in this case because blindly giving fluids without assessing the patient's cardiac function can potentially worsen the patient's condition, especially if there are underlying cardiac issues. Option C, monitoring the patient's INR level, is not the priority immediately after CABG surgery. While monitoring coagulation levels is important for patients on anticoagulant therapy, it is not the most critical intervention right after surgery when cardiac output and perfusion need to be closely monitored. Option D, monitoring for complications, is important but is not the priority over monitoring cardiac output in the immediate post-operative period. While complications need to be monitored for, ensuring adequate cardiac output takes precedence to prevent further complications related to inadequate perfusion. In an educational context, understanding the rationale behind prioritizing interventions post-CABG surgery is essential for nurses to provide safe and effective care to their patients. By prioritizing monitoring cardiac output, nurses can promptly identify and address any cardiac-related issues, ultimately contributing to better patient outcomes and recovery.