A patient has prescriptions for two inhalers. One inhaler is albuterol, and the other is fluticasone. Which instruction regarding these inhalers will the nurse give to the patient?

Take the corticosteroid inhaler first.

It does not matter which inhaler you use first.

Take the bronchodilator inhaler first.

Take these two drugs at least 2 hours apart.

Answer and Explanation

The Correct Answer is C

Choice A reason: Taking fluticasone (corticosteroid) before albuterol (bronchodilator) is incorrect. Corticosteroids reduce inflammation but do not open airways immediately. Using albuterol first maximizes lung deposition of fluticasone by improving airflow, ensuring the corticosteroid reaches deeper airways for optimal anti-inflammatory effect.

Choice B reason: The order of inhaler use matters. Albuterol, a bronchodilator, opens airways, enhancing the delivery of fluticasone, a corticosteroid, to the lungs. Using fluticasone first may result in suboptimal deposition if airways are constricted, reducing its effectiveness in controlling asthma inflammation.

Choice C reason: Albuterol, a short-acting beta-2 agonist, should be used first to relax airway smooth muscle, improving airflow. This enhances the delivery of fluticasone, which reduces inflammation over time. The bronchodilator’s rapid action ensures the corticosteroid reaches targeted lung tissue, optimizing asthma control.

Choice D reason: Taking albuterol and fluticasone 2 hours apart is unnecessary. Administering them sequentially (albuterol first, followed by fluticasone after a few minutes) maximizes efficacy without requiring a long interval. Timing is based on immediate bronchodilation needs, not arbitrary separation, for effective asthma management.

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Correct Answer is A

Explanation

Choice A reason: Warfarin overdose causes excessive anticoagulation, increasing bleeding risk by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Vitamin K reverses this by restoring clotting factor synthesis, correcting INR and stopping gastrointestinal bleeding, making it the standard treatment for warfarin toxicity.

Choice B reason: Vitamin E has no role in reversing warfarin toxicity. It is an antioxidant with no effect on clotting factor synthesis or warfarin’s mechanism. Its use may be associated with bleeding risk in high doses, making it inappropriate for managing warfarin-induced gastrointestinal bleeding.

Choice C reason: Protamine sulfate reverses heparin, not warfarin. Heparin enhances antithrombin activity, and protamine neutralizes it. Warfarin’s effect on vitamin K-dependent factors is unrelated, and protamine has no impact on warfarin toxicity or gastrointestinal bleeding, making it an incorrect choice.

Choice D reason: Potassium chloride treats hypokalemia, not warfarin toxicity. Warfarin’s bleeding complications result from inhibited clotting factor synthesis, not electrolyte imbalances. Potassium chloride is irrelevant to reversing anticoagulation or managing gastrointestinal bleeding caused by excessive warfarin, making this an inappropriate treatment.

A. Taking antibiotics that are prescribed according to culture and sensitivity reports. B. Antibiotics that are prescribed to treat a viral infection. C. Taking an antibiotic and an antiviral medication at the same time. D. Microorganisms arriving from foreign countries and overseas ports. E. Patients stop taking an antibiotic when they feel better.

Correct Answer is ["B","E"]

Explanation

Choice A reason: Antibiotics prescribed based on culture and sensitivity reports target specific bacterial susceptibilities, minimizing resistance. Appropriate use ensures effective bacterial killing, reducing the survival of resistant mutants. This practice aligns with antimicrobial stewardship, preventing the selection pressure that drives resistance development.

Choice B reason: Prescribing antibiotics for viral infections promotes resistance, as antibiotics do not affect viruses. Unnecessary exposure allows bacteria to develop resistance mechanisms, like beta-lactamase production, reducing future antibiotic efficacy. This misuse is a major contributor to the global rise of resistant bacterial strains.

Choice C reason: Taking antibiotics and antivirals together does not inherently cause resistance. Antibiotics target bacteria, and antivirals target viruses, with no direct interaction promoting bacterial resistance. Resistance arises from inappropriate antibiotic use, not combination with antivirals, making this situation irrelevant to resistance development.

Choice D reason: Microorganisms from foreign countries may carry resistance genes, but this describes transmission, not the mechanism of resistance development. Resistance occurs due to antibiotic misuse or overuse, not solely from geographic spread, making this less directly related to the situations causing resistance.

Choice E reason: Stopping antibiotics prematurely allows surviving bacteria to develop resistance. Incomplete treatment reduces antibiotic pressure, enabling bacteria to adapt through mutations or gene transfer, like plasmid-mediated resistance. Full-course adherence ensures bacterial eradication, preventing the emergence of resistant strains, making this a critical factor.

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A patient has prescriptions for two inhalers. One inhaler is albuterol, and the other is fluticasone. Which instruction regarding these inhalers will the nurse give to the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who has been anticoagulated with warfarin has been admitted for gastrointestinal bleeding. The history and physical examination indicate that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive what treatment?

Correct Answer is A

Explanation

Bacterial resistance to antibiotics can occur with which situations? (Select all that apply)

Correct Answer is ["B","E"]

Explanation

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The nurse is administering an amphotericin B infusion. Which actions by the nurse are appropriate? (Select all that apply)

A patient on a heparin infusion has an aPTT of 90 and is showing signs of excessive bleeding. What prescription will the nurse anticipate administering?

The nurse is providing instructions about the fluticasone propionate and salmeterol combination inhaler. Which statement about this inhaler is accurate?

A patient is taking a combination of antiviral drugs as treatment for early stages of a viral infection. While discussing the drug therapy, the patient asks the nurse if the drugs will kill the virus. When answering, the nurse keeps in mind which fact about antiviral drugs?

The nurse is educating a client about an inhaled corticosteroid. What statement will the nurse include?

Which time frame describes the onset of action for intravenous (IV) heparin?

When educating a client who was recently prescribed inhaled corticosteroids, the nurse will discuss which potential adverse effects?