A nurse is teaching a 12yearold child who is newly diagnosed with asthma about managing the condition to prevent asthma attacks. Which of the following statements by the child should indicate to the nurse that the teaching has been effective?

"Eliminating allergens that irritate my lungs can help me avoid getting an asthma attack."

"If I control my asthma, I will miss fewer days of school."

"Even if I control my asthma well, I won't be able to participate in sports or physical activities."

"Coughing and shortness of breath in the morning can be a sign that my asthma is well controlled."

Answer and Explanation

The Correct Answer is A

Choice A reason: This statement indicates that the child understands the role of allergens in triggering asthma symptoms and the importance of avoiding or reducing exposure to them. Allergens such as dust mites, animal dander, mold, and pollen can cause inflammation and constriction of the airways, leading to wheezing, coughing, and shortness of breath. The nurse should teach the child how to identify and eliminate or minimize allergens in the home, school, and outdoor environments.
Choice B reason: This statement is true, but it does not indicate that the child has learned how to manage the condition to prevent asthma attacks. Missing school days is a consequence of poorly controlled asthma, not a cause or a trigger¹². The nurse should teach the child how to use a written asthma action plan, which includes daily medications, peak flow monitoring, and rescue medications, to achieve good asthma control and reduce the risk of exacerbations.
Choice C reason: This statement is false and indicates that the child has a misconception about the impact of asthma on physical activity. Physical activity is beneficial for children with asthma, as it can improve lung function, cardiovascular fitness, and quality of life. The nurse should teach the child how to prevent exercise-induced bronchoconstriction, which is a common trigger of asthma symptoms, by using a short-acting bronchodilator before exercise, warming up and cooling down, and avoiding exercise in cold or polluted air.
Choice D reason: This statement is false and indicates that the child does not recognize the signs of poor asthma control. Coughing and shortness of breath in the morning are common symptoms of nocturnal asthma, which is a sign of uncontrolled asthma and a risk factor for severe asthma attacks. The nurse should teach the child how to monitor and record asthma symptoms and peak flow readings, and how to adjust medications according to the asthma action plan.

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Correct Answer is B

Explanation

Choice A reason: "My wife tries to get me to go to the grocery store, but I don't like to go out much." This statement indicates that the client is not adapting well, as they are avoiding social activities and isolating themselves. The client may have low self-esteem, depression, or anxiety.

Choice B reason: "I am using the modified feeding utensils at every meal. I still spill, but I'm getting better." This statement indicates that the client is adapting well, as they are using adaptive devices and practicing their skills. The client also expresses a positive attitude and a sense of improvement.

Choice C reason: "My greatest pleasure each day is having a few beers every day." This statement indicates that the client is not adapting well, as they are abusing alcohol and possibly selfmedicating. The client may have emotional distress, chronic pain, or addiction.

Choice D reason: "I have all the equipment to take a shower, but I prefer a bed bath, because it is easier." This statement indicates that the client is not adapting well, as they are not using the available resources and opting for a less independent option. The client may have low motivation, poor selfcare, or learned helplessness.

A. History of neurologic deficits lasting less than 1 hr B. Manifestations preceded by a severe headache C. Gradual onset of several hours D. Maintains consciousness

Correct Answer is B

Explanation

Choice A reason: A history of neurologic deficits lasting less than 1 hr is not a typical manifestation of a hemorrhagic stroke. This could be a sign of a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain that causes stroke like symptoms. A TIA is different from a hemorrhagic stroke, which is caused by bleeding in the brain due to a ruptured blood vessel.

Choice B reason: Manifestations preceded by a severe headache is a common manifestation of a hemorrhagic stroke. A ruptured cerebral aneurysm can cause sudden and intense pain in the head, often described as the worst headache of one's life. This is due to the increased pressure and irritation of the brain tissue and nerves by the blood leaking from the aneurysm.

Choice C reason: A gradual onset of several hours is not a usual manifestation of a hemorrhagic stroke. A hemorrhagic stroke is a medical emergency that requires immediate treatment, as the bleeding can cause rapid damage to the brain and increase the risk of death or disability. The symptoms of a hemorrhagic stroke usually develop suddenly and worsen quickly.

Choice D reason: Maintaining consciousness is not a likely manifestation of a hemorrhagic stroke. A hemorrhagic stroke can cause loss of consciousness, confusion, drowsiness, or coma due to the reduced blood flow and oxygen to the brain. The level of consciousness can also be affected by the location and extent of the bleeding, as well as the presence of complications such as hydrocephalus or vasospasm.

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A nurse is teaching a 12yearold child who is newly diagnosed with asthma about managing the condition to prevent asthma attacks. Which of the following statements by the child should indicate to the nurse that the teaching has been effective?

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