A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

Asking the provider to repeat another radiograph of the chest

Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client

Requesting the pharmacy to dispense 10 mL of dextromethorphan PO

Instructing respiratory therapy to administer a PRN albuterol aerosol

Answer and Explanation

The Correct Answer is D

A. Asking the provider to repeat another radiograph of the chest.

This option is not the most appropriate action in this scenario. While a chest radiograph may be useful in certain situations to assess for complications such as pneumothorax or pneumonia, it is not typically the first intervention for an asthma exacerbation with increased wheezing and decreased oxygen saturation. In this acute situation, the priority is to provide immediate treatment to alleviate the client's symptoms and improve oxygenation.

B. Increasing oxygen to maintain an oxygen saturation of 95% or greater in the client.

While maintaining adequate oxygenation is important, especially in a client with asthma exacerbation, it is not the first-line intervention in this scenario. Oxygen supplementation may be necessary, but the priority is to address the underlying bronchospasm causing the decreased oxygen saturation. Therefore, this option may be considered after initiating appropriate bronchodilator therapy.

C. Requesting the pharmacy to dispense 10 mL of dextromethorphan PO.

This option is not appropriate for managing an asthma exacerbation. Dextromethorphan is a cough suppressant and does not address the underlying bronchospasm characteristic of asthma exacerbations. In fact, suppressing cough may hinder the clearance of mucus and exacerbate respiratory distress. Therefore, this intervention is not indicated and may delay appropriate treatment.

D. Instructing respiratory therapy to administer a PRN albuterol aerosol.

This is the correct action in this scenario. Albuterol is a short-acting bronchodilator commonly used to relieve bronchospasm and improve airflow in clients experiencing asthma exacerbations. Administering albuterol via aerosolized inhalation helps to quickly deliver the medication directly to the airways, providing rapid relief of symptoms such as wheezing and improving oxygenation. Therefore, instructing respiratory therapy to administer a PRN albuterol aerosol is the most appropriate intervention to address the client's acute symptoms.

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Correct Answer is D

Explanation

A. Place tissue soiled with respiratory secretions in a paper bag for later disposal:

This instruction is not accurate or recommended for managing tissue soiled with respiratory secretions, particularly in the context of tuberculosis (TB) infection. TB is transmitted through the air via respiratory droplets, so proper disposal of contaminated materials is crucial to prevent the spread of the infection. Instead of placing tissue in a paper bag, it should be disposed of in a sealed plastic bag to minimize the risk of transmission. Additionally, individuals with TB should be instructed on proper respiratory hygiene practices, such as covering their mouth and nose with a tissue or their elbow when coughing or sneezing, to prevent the spread of infectious droplets.

B. Provide samples for sputum cultures every 6 weeks:

Sputum cultures are an essential component of monitoring and managing tuberculosis (TB) treatment. However, obtaining samples every 6 weeks is not frequent enough, especially during the initial phase of treatment. In the early stages of TB treatment, sputum cultures are typically obtained more frequently, often weekly or biweekly, to monitor the response to treatment, assess for drug resistance, and ensure treatment effectiveness. As treatment progresses and the patient's condition stabilizes, the frequency of sputum cultures may be adjusted based on clinical judgment and guidelines.

C. Consume alcohol in moderation while taking antituberculosis medications:

Alcohol consumption is generally discouraged while taking antituberculosis medications. Some antituberculosis drugs, such as isoniazid and rifampin, can interact with alcohol and cause adverse effects, such as liver toxicity or drug metabolism issues. Therefore, individuals undergoing treatment for tuberculosis should be advised to abstain from alcohol consumption or limit it to a minimum to avoid potential complications. Providing instructions on alcohol consumption is an important aspect of tuberculosis management and medication adherence.

D. Wear a mask while out or around crowds of people:

This instruction is crucial for individuals with pulmonary tuberculosis to prevent the spread of the infection to others. Tuberculosis is transmitted through the air via respiratory droplets, particularly when an infected person coughs, sneezes, or talks. Wearing a mask while out or in crowded settings helps reduce the risk of transmitting infectious droplets to others and is an important infection control measure. It is especially important during the early stages of treatment when the individual is still infectious and shedding bacteria. Proper mask use, along with other respiratory hygiene practices, can help protect both the individual with tuberculosis and those around them from the spread of infection.

A. 24 year old woman with allergic rhinitis B. 18 year old man with cold symptoms C. 64 year old woman with a history of heart disease D. 70 year old woman with glaucoma E. 56 year old man with prostatic hypertrophy

Correct Answer is ["B"]

Explanation

A. 24-year-old woman with allergic rhinitis:

Likely safe to take an alpha-adrenergic decongestant as allergic rhinitis is a common indication for decongestant use in young, healthy individuals.

B. 18-year-old man with cold symptoms:

Likely safe to take an alpha-adrenergic decongestant as it's a common indication for decongestant use in young, healthy individuals.

C. 64-year-old woman with a history of heart disease:

Should avoid alpha-adrenergic decongestants due to the risk of increasing blood pressure and potentially worsening heart conditions.

D. 70-year-old woman with glaucoma:

Should avoid alpha-adrenergic decongestants due to the risk of exacerbating glaucoma by causing pupil dilation and increasing intraocular pressure.

E. 56-year-old man with prostatic hypertrophy:

Should avoid alpha-adrenergic decongestants due to the risk of worsening urinary symptoms caused by prostatic hypertrophy, such as urinary retention.

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A nurse is caring for a client who has been admitted with asthma exacerbation and is experiencing increased wheezing and has an oxygen saturation of 91%. The client is scheduled for his next breathing treatment in 1hr. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to review discharge instructions with a client who has pulmonary tuberculosis. Which of the following information should the nurse include?

Correct Answer is D

Explanation

Which patient(s) would be able to take an alpha-adrenergic decongestant safely? (SELECT ALL THAT APPLY)

Correct Answer is ["B"]

Explanation

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