A patient with asthma is prescribed a corticosteroid inhaler. What is the most important instruction to give to the patient?

Correct Answer: B

Rationale: The correct answer is B: Rinse the mouth after using the inhaler. This instruction is crucial because corticosteroid inhalers can lead to oral thrush, a fungal infection in the mouth. Rinsing the mouth helps prevent this side effect. A: Using the inhaler only during asthma attacks is incorrect as corticosteroid inhalers are typically used regularly to manage asthma symptoms. C: Taking a double dose if symptoms worsen is dangerous and can lead to overdose. Patients should follow the prescribed dosage. D: Avoiding using a spacer with the inhaler is not a universal instruction. Spacers can actually improve the effectiveness of the medication delivery.

Correct Answer: B

Rationale: The correct answer is B: Take the medication in the morning on an empty stomach. Levothyroxine should be taken on an empty stomach, preferably 30 minutes to 1 hour before breakfast, to ensure optimal absorption. Food can interfere with absorption, so taking it with meals (choice A) is not recommended. Discontinuing the medication if feeling better (choice C) is dangerous as it can lead to a relapse of hypothyroidism. Doubling the dose if a dose is missed (choice D) can result in overdose and adverse effects. Therefore, choice B is the best option for optimal effectiveness of levothyroxine therapy.

Correct Answer: C

Rationale: The correct answer is C: High Fowler's. This position helps improve lung expansion and breathing efficiency by maximizing chest expansion. Sitting upright reduces pressure on the diaphragm, allowing for better ventilation. Supine (A) position can worsen dyspnea by restricting lung expansion. Prone (B) position is not ideal for COPD patients as it can hinder breathing. Trendelenburg (D) position, where the patient's feet are elevated above the head, can increase pressure on the diaphragm and impair breathing, making it inappropriate for a patient experiencing severe dyspnea.

Correct Answer: A

Rationale: The correct answer is A. The rationale is that radioactive iodine therapy can harm a developing fetus, so patients should avoid close contact with pregnant women for one week. Choice B is incorrect as iodine supplements can interfere with the therapy. Choice C is incorrect as fluid intake should not be restricted unless specifically advised by the healthcare provider. Choice D is incorrect as there is no need to use disposable utensils for all meals.

Correct Answer: C

Rationale: The most appropriate tool for the nurse to use during the admission assessment of a 75-year-old patient admitted for pancreatitis is the Screening Test-Geriatric Version (SMAST-G). This tool is specifically designed to assess for alcohol abuse in older adults, which is relevant in this case as alcohol consumption can be a risk factor for pancreatitis. The SMAST-G helps identify potential alcohol-related issues in the elderly population, allowing for appropriate interventions and care planning. Rationale: A: The Drug Abuse Screening Test (DAST-10) is not the most appropriate tool in this scenario as it focuses on broader drug abuse rather than specifically alcohol abuse. B: The Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) is used to assess for alcohol withdrawal symptoms, not alcohol abuse itself. D: The Mini-Mental State Examination is used to assess cognitive function, which is not directly relevant to the admission assessment for pancreatitis in this case.

Correct Answer: C

Rationale: Step-by-step rationale: 1. Deep, rapid respirations in DKA indicate Kussmaul respirations, a compensatory mechanism for metabolic acidosis. 2. Immediate intervention is needed to prevent respiratory failure and further acidosis. 3. Administering IV fluids and insulin can help correct acidosis and stabilize breathing. 4. Fruity breath odor (A) and high blood glucose (B) are common in DKA but do not require immediate intervention. 5. Serum potassium of 5.2 mEq/L (D) is slightly elevated but not as urgent as addressing respiratory distress.

Correct Answer: B

Rationale: The correct answer is B: Gamma globulin. Gamma globulin contains antibodies that can provide immediate passive immunity against hepatitis B virus. Administering corticosteroids (A) would not protect against hepatitis B infection. Hepatitis B vaccine (C) is used for prevention, not immediate protection. Fresh frozen plasma (D) does not contain specific antibodies against hepatitis B.

Correct Answer: B

Rationale: The correct answer is B: Avoid intramuscular injections. Thrombocytopenia is a condition characterized by low platelet count, which can lead to impaired blood clotting. Intramuscular injections can cause bleeding and bruising due to the decreased ability of blood to clot. Therefore, it is crucial to avoid invasive procedures like intramuscular injections to prevent excessive bleeding in patients with thrombocytopenia. Encouraging light exercise (choice A) can be beneficial for overall health but may not directly address the risk of bleeding. Avoiding aspirin (choice C) is important as it can further increase the risk of bleeding. Using a soft toothbrush for oral care (choice D) is a good practice, but it does not directly address the risk associated with intramuscular injections in patients with thrombocytopenia.

Correct Answer: C

Rationale: The correct answer is C: Numbness and tingling around the mouth. This finding indicates potential hypocalcemia, a common complication post-thyroidectomy due to inadvertent removal of parathyroid glands. Immediate intervention is necessary to prevent severe hypocalcemia symptoms like tetany and seizures. Hoarse voice (A) and difficulty swallowing (B) are expected post-thyroidectomy due to surgical trauma, while sore throat (D) is common from intubation.