A patient with asthma presents with daily peak flow rates consistently at 45% of their personal best. What is the most appropriate action the nurse should take?

Instruct the patient to increase fluid intake.

Schedule a routine follow-up appointment in two weeks.

Advise the patient to avoid all physical activity.

Initiate an asthma action plan and provide oral corticosteroids.

Answer and Explanation

The Correct Answer is D

A. Increasing fluid intake may help with hydration, but it is not the most appropriate intervention for a patient whose peak flow rates are significantly low. The priority is to address the asthma exacerbation.

B. Scheduling a follow-up appointment in two weeks is not appropriate in this situation. The patient is experiencing significant symptoms, and immediate action is required to manage the exacerbation.

C. Advising the patient to avoid all physical activity may not be necessary. Physical activity can be adjusted based on the patient's condition, but the priority is to treat the asthma exacerbation and improve the patient's respiratory status.

D. Initiating an asthma action plan and providing oral corticosteroids is the correct approach. A peak flow rate consistently at 45% of the personal best indicates poor asthma control, and the patient likely requires additional treatment, such as oral corticosteroids, to manage the exacerbation. The asthma action plan should guide further management based on the patient's peak flow rate and symptoms.

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Correct Answer is D

Explanation

A. Active range-of-motion exercises of the left leg promote mobility in the unaffected limb but do not fully address the need for maintaining muscle strength in both legs.

B. Log rolling every 2 hours is a technique used for clients who require spinal precautions or have limited movement due to back injuries. It does not promote mobility for a client in Buck's traction.

C. Passive range of motion to the right leg may prevent joint stiffness but does not actively maintain or improve muscle strength. Additionally, movement of the affected limb should be minimized to maintain the alignment of the traction.

D. Isometric exercises of both legs are appropriate for promoting mobility and maintaining muscle strength without disrupting the traction. These exercises involve contracting the muscles without moving the joints, which is safe for the affected limb in Buck's traction.

A. Obtain intravenous access. B. Computed tomography (CT) of the chest C. Thoracentesis D. Obtain ABGS. E. Pulmonary Function Tests (PFTS) F. Prepare for insertion of a chest tube

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"}}

Explanation

Potential Prescription	Anticipated	Non- essential	Contraindicated
Obtain intravenous access.	✓
Computed tomography (CT) of the chest	✓
Thoracentesis		✓
Obtain ABGS.	✓
Pulmonary Function Tests (PFTS)			✓
Prepare for insertion of a chest tube	✓

Rationale

Obtain intravenous access: Anticipated. IV access is crucial for administering fluids, medications (like pain management), and potentially blood products if needed.
Computed tomography (CT) of the chest: Anticipated. A CT scan provides a detailed image of the chest cavity and can confirm the diagnosis of pneumothorax, as well as identify the size and location of the air accumulation.
Thoracentesis: Non-essential. A thoracentesis is a procedure to remove fluid from the pleural space. In a pneumothorax, the issue is air accumulation, not fluid. While a hemothorax (blood in the pleural space) can sometimes accompany a pneumothorax, the provided information does not indicate this. A chest tube is the appropriate intervention for air.
Obtain ABGs (Arterial Blood Gases): Anticipated. ABGs provide essential information about the client's oxygenation, ventilation, and acid-base balance. Given the client's low O2 saturation and respiratory distress, ABGs are necessary to assess the severity of respiratory compromise.
Pulmonary Function Tests (PFTs): Contraindicated. Pulmonary function tests are not appropriate in the acute setting of a pneumothorax as they can exacerbate the condition and are not useful for immediate management.
Prepare for insertion of a chest tube: Anticipated. A chest tube is the definitive treatment for a pneumothorax. It allows for the evacuation of air from the pleural space and re-expansion of the lung. Given the client's symptoms (dyspnea, low O2 saturation, absent lung sounds), a chest tube is highly likely to be required

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A patient with asthma presents with daily peak flow rates consistently at 45% of their personal best. What is the most appropriate action the nurse should take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for an adolescent client whose right leg is in Buck's traction. Which of the following interventions should the nurse implement to promote the client's mobility?

Correct Answer is D

Explanation

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"}}

Explanation

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