A nurse is assisting a provider with a sterile procedure and prepares to pour solution onto a piece of sterile gauze. In what order should the nurse perform the following steps when pouring sterile solution? (Move the steps on the left into the box on the right, placing them in the selected order. of performance. Use all the steps.)

Pour the solution onto the gauze.

Place the bottle cap face-up on a clean surface.

Perform hand hygiene.

Pick up the bottle with the label facing toward the palm.

Pour 1 to 2 mL into a receptacle.

Remove the bottle cap.

Answer and Explanation

The Correct Answer is C,B,D,F,E,A

A. Pour the solution onto the gauze: This is the final step, performed after the solution has been poured into a receptacle to control the amount and maintain sterility of the gauze.

B. Place the bottle cap face-up on a clean surface: After removing the cap, placing it face-up on a clean surface prevents contamination of the inside of the cap and the solution.

C. Perform hand hygiene: Hand hygiene is the first step to reduce the risk of introducing microorganisms and maintain a sterile environment throughout the procedure.

D. Pick up the bottle with the label facing toward the palm: Holding the bottle with the label toward the palm prevents the label from getting wet or smeared, ensuring that the solution’s identity remains visible and accurate.

E. Pour 1 to 2 mL into a receptacle: Pouring a small amount first into a separate receptacle, also called “flushing” the lip of the bottle, removes any contaminants that may be present on the bottle rim, maintaining sterility of the solution applied to the gauze.

F. Remove the bottle cap: Removing the cap is done just before pouring to maintain sterility and prevent exposure of the solution to potential contaminants on the surrounding surfaces.

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Correct Answer is C

Explanation

A. Hydrochlorothiazide: This thiazide diuretic is primarily associated with electrolyte imbalances and increased urination. It does not commonly cause a dry cough.

B. Aspirin: Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that can cause gastrointestinal irritation, bleeding, or hypersensitivity reactions, but a dry cough is not a typical side effect.

C. Ramipril: ACE inhibitors like ramipril are well known to cause a persistent dry cough due to accumulation of bradykinin in the respiratory tract. This is a common adverse effect and often leads to discontinuation of the medication.

D. Metoprolol: As a beta-blocker, metoprolol can cause bradycardia, hypotension, or fatigue, but it rarely causes a cough. It is not associated with the respiratory side effects seen with ACE inhibitors.

A. Stridor B. Wheezes C. Crackles D. Rhonchi

Correct Answer is B

Explanation

A. Stridor: Stridor is a harsh, high-pitched sound heard primarily during inspiration and is usually caused by upper airway obstruction, such as laryngeal edema or foreign body aspiration. It is not typically associated with asthma exacerbations.

B. Wheezes: Wheezes are continuous, high-pitched, musical sounds most often heard during expiration, caused by narrowing of the lower airways due to bronchospasm or inflammation. They are a hallmark finding in clients with asthma.

C. Crackles: Crackles are intermittent, non-musical sounds heard during inspiration and are caused by fluid, mucus, or collapsed alveoli popping open. They are more commonly associated with pneumonia, heart failure, or pulmonary fibrosis.

D. Rhonchi: Rhonchi are low-pitched, coarse, snoring-like sounds caused by secretions or obstruction in the larger airways. They often clear with coughing and are not the typical finding in asthma.

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Which of the following medications is most likely to cause a dry cough as a side effect?

Correct Answer is C

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Correct Answer is B

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