A client in the emergency department is experiencing an acute asthma exacerbation, which has not improved with albuterol nebulizer treatments. The client is obviously struggling to breathe. The nurse anticipates that intubation and mechanical ventilation will be needed based on which of the following assessment findings?

Tachycardia

Anxiety

Hypotension

Loud expiratory wheezing

Answer and Explanation

The Correct Answer is C

A.   Tachycardia (rapid heart rate) can occur in response to hypoxia (low oxygen levels), stress, or as a side effect of medications like albuterol. While tachycardia is a concerning sign in the context of an asthma exacerbation, it alone does not directly indicate the need for intubation and mechanical ventilation. It is often managed by addressing the underlying respiratory distress and improving oxygenation.
B.   Anxiety is common in patients struggling to breathe, as they may feel frightened or panicked due to their difficulty breathing. However, anxiety itself is not an indicator for intubation and mechanical ventilation. It is a symptom of respiratory distress but does not directly assess the severity of the physiological need for mechanical support.
C.   Hypotension (low blood pressure) in the context of an asthma exacerbation can be a sign of severe illness, possibly indicating shock or severe respiratory distress leading to reduced cardiac output. While hypotension is a serious concern, it is less directly related to the immediate need for intubation and mechanical ventilation compared to other indicators of respiratory failure.
D.   Loud expiratory wheezing indicates significant airway obstruction but does not necessarily reflect the need for intubation and mechanical ventilation. Wheezing can be a sign of severe asthma but may not be sufficient on its own to necessitate intubation if the patient can still maintain adequate oxygenation and ventilation.

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

Explanation

Muscle hypertrophy (increase in muscle size) is not a typical manifestation of ALS. In fact, ALS leads to muscle atrophy (wasting) rather than hypertrophy. As motor neurons degenerate, muscles become weaker and smaller because they are no longer receiving adequate nerve signals to maintain strength.
B.A Tinnitus (ringing in the ears) is not a common manifestation of ALS. ALS primarily affects motor neurons and does not usually cause auditory symptoms. Tinnitus is more related to other conditions such as ear infections, exposure to loud noises, or certain neurological conditions, but it is not associated with ALS.
C. Tripping or stumbling is a common manifestation of ALS. As the disease progresses, it causes weakness in the muscles responsible for maintaining balance and coordination. This can lead to difficulties with walking and increased risk of tripping or falling.
D. Confusion is not a typical symptom of ALS. ALS primarily affects motor neurons, leading to muscle weakness and atrophy, but it does not usually affect cognitive function. However, in rare cases, some patients with ALS may develop cognitive or behavioral changes, but these are not the primary symptoms and are less common.
E. Dropping objects is a common manifestation of ALS. Muscle weakness and loss of fine motor control in the hands and arms can make it difficult to hold or manipulate objects, leading to frequent dropping.

A. The late-phase response occurs due to an influx of additional inflammatory cells B. The symptoms of the late-phase response tend to respond better to a rescue inhaler than the symptoms of the early-phase response C. The late-phase response occurs because the client did not use their rescue inhaler properly D. The late-phase response only occurs if the client continues to be exposed to their trigger after the initial attack

Correct Answer is A

Explanation

A. The late-phase response in asthma is characterized by a delayed and prolonged inflammatory reaction that can occur 4 to 6 hours after exposure to a trigger. It involves the recruitment of additional inflammatory cells, such as eosinophils and T cells, which contribute to ongoing airway inflammation, increased mucus production, and bronchoconstriction. This phase often leads to a return of symptoms or worsening of symptoms after the initial relief provided by a rescue inhaler.
B. The late-phase response does not typically respond as well to rescue inhalers (such as albuterol) as the early-phase response does. Rescue inhalers are primarily effective for the immediate, bronchospastic component of asthma (early-phase response).
C. The late-phase response occurs as part of the natural progression of asthma inflammation and is not necessarily related to improper use of a rescue inhaler. Even with proper use of a rescue inhaler, the late-phase response can still occur due to the underlying inflammatory processes.
D. The late-phase response can occur even if the trigger is no longer present. It is related to the ongoing inflammatory process rather than continued exposure to the trigger. Although continued exposure to triggers can exacerbate symptoms, the late-phase response can still occur independently of further exposure.

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Naxlex Comprehensive Predictor Exams

A client with multiple complaints has been referred to a neurologist for further evaluation. Which of the following complaints are common manifestations of amyotrophic lateral sclerosis? (Select all that apply.)

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

Explanation

Correct Answer is A

Explanation

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