A client in the emergency room begins to experience an acute asthma attack. The nurse expects that which medication will be used as initial treatment?

A) Women should start yearly mammograms at age 40:
Mammography is a key screening tool for breast cancer detection. According to guidelines from the American Cancer Society (ACS) and other leading health organizations, women should begin annual mammograms at age 40. This recommendation applies to average-risk women who are not showing any symptoms of breast cancer. Mammograms are effective in detecting early-stage breast cancer, which is crucial for better treatment outcomes.

B) Women should have a yearly clinical breast examination starting at age 50:
The clinical breast examination (CBE) is a physical exam performed by a healthcare provider to check for breast cancer. However, the recommendation is to have a clinical breast examination every 1-3 years for women in their 20s and 30s and annually for women 40 and older, not just beginning at age 50. It is not necessary to wait until age 50 to start yearly CBEs.

C) Clients should have fecal occult blood test every other year:
The fecal occult blood test (FOBT) is used to detect hidden blood in the stool, which may be a sign of colon cancer. However, this test is not typically performed every other year for all clients. The recommended schedule for colorectal cancer screening depends on risk factors. The American Cancer Society recommends annual FOBT or fecal immunochemical test (FIT) for clients over the age of 45 who are at average risk for colon cancer. More invasive tests, such as colonoscopy, are generally recommended for people at higher risk or after positive results from non-invasive tests like FOBT.

D) Clients should have a colonoscopy at age 40 and every 10 years thereafter:
The recommended age for the first colonoscopy is age 45 for individuals at average risk of colorectal cancer, not 40. Colonoscopies are typically performed every 10 years after the initial screening unless there are risk factors (e.g., family history, genetic conditions) that require earlier or more frequent screenings.

A) A corticosteroid such as fluticasone:
While corticosteroids, such as fluticasone, are effective for managing chronic asthma and preventing inflammation over time, they are not the first-line treatment during an acute asthma attack. Corticosteroids are typically used for long-term control and maintenance therapy, not for rapid relief of symptoms in an acute exacerbation. Immediate relief is needed in acute situations, which corticosteroids alone do not provide.

B) A long-acting beta 2 agonist such as salmeterol:
Long-acting beta-2 agonists (LABAs), such as salmeterol, are used for maintenance therapy to prevent asthma attacks and should not be used for the immediate treatment of an acute asthma exacerbation. They take longer to start working, and their role is to provide prolonged bronchodilation over time, not to relieve sudden bronchoconstriction.

C) A short-acting beta 2 agonist such as albuterol:
During an acute asthma attack, the immediate goal is to relieve bronchoconstriction and improve airflow. Short-acting beta-2 agonists like albuterol are the first-line treatment because they quickly relax the smooth muscles of the airways, leading to bronchodilation. Albuterol works within minutes, providing rapid relief from the symptoms of wheezing, shortness of breath, and chest tightness.

D) Methylxanthines such as Theophylline:
Methylxanthines (e.g., theophylline) were once used for asthma management but are no longer considered the first-line treatment for acute exacerbations due to their narrow therapeutic range and the potential for toxicity. While theophylline can provide bronchodilation, its onset of action is slower than that of beta-agonists like albuterol, and it is generally reserved for more chronic management of asthma or severe cases where other medications are not effective.