A patient with a history of asthma enters the Emergency department with severe dyspnea, accessory muscle involvement, neck vein distention, and severe inspiratory/expiratory wheezing. The nurse should prepare to assist the physician with which procedure if the patient does not respond to initial interventions?
Emergency needle thoracentesis
Emergency intubation
Emergency pleurodesis
Emergency chest tube insertion
The Correct Answer is B
A. Needle thoracentesis is typically performed in cases of pneumothorax or pleural effusion, not asthma exacerbation. The symptoms described do not indicate a pleural space issue that would require thoracentesis.
B. Emergency intubation may be necessary if the asthma exacerbation is severe and unresponsive to initial interventions such as bronchodilators, corticosteroids, and oxygen therapy. The patient's symptoms of severe dyspnea, accessory muscle use, and wheezing suggest respiratory distress, and intubation may be required to secure the airway and assist with ventilation.
C. Pleurodesis is a procedure used to treat recurrent pleural effusions, not asthma exacerbations. It involves the obliteration of the pleural space, which is not relevant to the current situation.
D. Chest tube insertion is typically performed for pneumothorax or other issues involving the pleural space, not for asthma exacerbation. The described symptoms do not suggest the need for a chest tube.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dehydration is a major risk factor for renal calculi (kidney stones). When there is insufficient fluid intake, urine becomes concentrated, allowing substances like calcium, oxalate, and uric acid to crystallize and form stones.
B. A sedentary lifestyle can contribute to weight gain and other health issues, but it is not directly linked to the formation of kidney stones.
C. Drinking 32 ounces of milk per day is not a significant risk factor for kidney stones. In fact, moderate calcium intake from food can help prevent certain types of stones. Excessive calcium intake from supplements, however, can increase the risk.
D. Running 5 miles does not directly increase the risk of kidney stones. Regular physical activity, in general, helps promote overall health and hydration, which can reduce the risk of stone formation.
Correct Answer is C
Explanation
A. In diabetic ketoacidosis (DKA), serum bicarbonate is typically decreased, not increased. The decrease is due to metabolic acidosis resulting from the accumulation of ketones.
B. Serum potassium is often elevated in DKA initially due to the shift of potassium from inside the cells to the bloodstream as a result of acidosis. However, potassium levels may drop with treatment, especially with insulin administration, which drives potassium back into cells.
C. Urine pH in DKA is often acidic due to the presence of ketones, which are acidic byproducts of fat metabolism. A urine pH of 4.0 indicates aciduria, which is consistent with ketoacidosis.
D. Serum pH in DKA is typically low (below 7.35), indicating acidosis. A serum pH of 7.5 would suggest alkalosis, which is not typical of DKA.
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