Answer to Question 1
Correct Answer: 4
Rationale 1: The medications can be used on the same day.
Rationale 2: It is imperative for the client to understand that the steroid inhaler is not a rescue inhaler and should not be used for immediate relief.
Rationale 3: While the client should be taught to use both inhalers as infrequently as possible, the client should be taught to use the inhaler when necessary. When the inhalers are used together, the bronchodilator is used first, followed by the steroid.
Rationale 4: Both of these medications have the possible side effect of increased heart rate.
Answer to Question 2
Correct Answer: 4
Rationale 1: Hyperventilating the client will likely serve to force secretions back into the respiratory tract.
Rationale 2: Hyperventilating the client will likely serve to force secretions back into the respiratory tract.
Rationale 3: There is no need to instill normal saline into the tube of a client with copious frothy secretions.
Rationale 4: The nurse should avoid hyperventilation and should increase the oxygen to 100 for several breaths prior to initiating suction.
Injecting an IV push (bolus) medication; B, into a primary infusion line
The nurse uses a noninvasive bladder ultrasound to measure the client’s bladder volume.
NCC MERP Index for Categorizing Medication Errors
Drugs Commonly Prescribed According to Classification
Positioning the client
Testing the client’s ability to feel vibrations, the toe