A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve nasal congestion caused by seasonal allergies. What instructions should the nurse provide to the client to avoid complications?

Do not overuse the medication as rebound congestion can occur.

Report white patches in the mouth because the medication can cause a fungal infection.

Taper the dose when discontinuing the medication.

Do not operate machinery or drive while using the medication.

Answer and Explanation

The Correct Answer is A

A. Do not overuse the medication as rebound congestion can occur: Oxymetazoline is a topical nasal decongestant that can cause rebound congestion (rhinitis medicamentosa) if used for more than 3 consecutive days. The nasal passages become more congested once the medication wears off, leading to a cycle of dependency.
B. Report white patches in the mouth because the medication can cause a fungal infection: This instruction is more appropriate for inhaled corticosteroids, which can lead to oral thrush. Oxymetazoline does not carry a significant risk for oral fungal infections.
C. Taper the dose when discontinuing the medication: Tapering is generally used for systemic corticosteroids or certain long-term medications. Oxymetazoline should be stopped after short-term use rather than tapered, to prevent rebound symptoms.
D. Do not operate machinery or drive while using the medication: Oxymetazoline typically causes minimal systemic effects and is unlikely to impair mental alertness or motor function. It does not carry significant sedative properties.

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Correct Answer is D

Explanation

A. Transfer the client to the emergency department: Transferring the client delays immediate airway management, which is critical. This action is not appropriate as the first step because airway patency must be addressed on the spot to prevent respiratory distress.
B. Call for the registered nurse to reinsert the tube: While notifying the RN is important, maintaining the airway takes precedence. Waiting for another provider before taking action risks closure of the stoma and airway compromise.
C. Cover the tracheostomy site with a sterile gauze to prevent infection: Covering the site without maintaining patency could cause the stoma to close rapidly. Infection control is important, but it is secondary to preserving the airway.
D. Place a dilator in the stoma to maintain the opening: Inserting a tracheostomy dilator prevents the stoma from closing and buys time for reinsertion of the tube. This is the immediate priority to ensure the airway remains open and the client can breathe effectively.

A. Maintain activity restriction to bedrest. B. Limit interaction with visitors. C. Avoid heavy meals. D. Arrange personal care supplies nearby.

Correct Answer is A

Explanation

A. Maintain activity restriction to bedrest: Bedrest reduces the heart's workload by minimizing physical exertion, thereby decreasing myocardial oxygen demand. This is crucial in cardiogenic shock, where the heart's pumping ability is severely compromised.
B. Limit interaction with visitors: While excessive stimulation can be stressful, limiting social interaction has a minimal impact on myocardial oxygen consumption compared to physical activity. Emotional support from visitors can actually benefit the client’s overall well-being.
C. Avoid heavy meals: Heavy meals may cause postprandial increases in metabolic demand, but they are not as directly impactful on cardiac workload as restricting physical activity. Meal composition should still be considered, but it's not the most immediate priority.
D. Arrange personal care supplies nearby: Placing supplies within reach helps minimize exertion during ADLs, but this is a supportive measure. Complete activity restriction is a more direct and effective intervention to reduce cardiac oxygen demand in the acute phase.

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A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve nasal congestion caused by seasonal allergies. What instructions should the nurse provide to the client to avoid complications?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A graduate practical nurse is caring for a client who has a tracheostomy tube. A seasoned nurse is assisting in providing guidance for completing tracheostomy care. When changing the ties, the client moves and dislodges the tube. Which of the following does the seasoned nurse do first?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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