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Following the administration of albuterol and the subsequent assessment, what actions should the nurse plan for the rest of the shift?

Monitor the oxygen saturation

Prepare for deep tracheal suctioning

Discuss potential asthma triggers with the client

Obtain a sputum culture

Consider positive pressure ventilation

Allow the client to take a position of comfort

Discuss aggressive respiratory treatment options

Wean the supplemental oxygen .

Answer and Explanation

Correct Answer : A,C,F,H

Choice A rationale

Monitoring the oxygen saturation is an important nursing intervention following the administration of albuterol. Albuterol is a bronchodilator and should improve oxygen saturation by increasing airflow and oxygen delivery.

Choice B rationale

Deep tracheal suctioning is not typically required following the administration of albuterol unless the patient has excessive secretions or difficulty clearing secretions.

Choice C rationale

Discussing potential asthma triggers with the client is an important nursing intervention. Understanding and avoiding triggers can help prevent future asthma exacerbations.

Choice D rationale

Obtaining a sputum culture is not typically required following the administration of albuterol unless there is a suspicion of a respiratory infection.

Choice E rationale

Positive pressure ventilation is not typically required following the administration of albuterol unless the patient is in severe respiratory distress.

Choice F rationale

Allowing the client to take a position of comfort can help improve breathing and should be encouraged.

Choice G rationale

Discussing aggressive respiratory treatment options is not typically required following the administration of albuterol unless the patient’s condition is not improving or worsening.

Choice H rationale

Weaning the supplemental oxygen may be appropriate following the administration of albuterol if the patient’s oxygen saturation has improved.

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Correct Answer is ["A","B"]

Explanation

Choice A rationale

Fresh or frozen vegetables without sauce are a great choice for someone with hypertension. Vegetables are high in fiber and low in sodium, which can help lower blood pressure. They also contain potassium, which can help balance out the negative effects of sodium.

Choice B rationale

Fruits without sauce are also a good option. Like vegetables, fruits are high in fiber and potassium and low in sodium. They also contain other heart-healthy nutrients like antioxidants.

Choice C rationale

Cottage cheese is typically high in sodium, which can raise blood pressure. Therefore, it’s not the best choice for someone with hypertension.

Choice D rationale

Pickled olives are also high in sodium, making them a poor choice for someone with hypertension.

Choice E rationale

Canned soup is another food that’s typically high in sodium. While low-sodium versions are available, fresh soup made with low-sodium broth and plenty of vegetables would be a healthier choice.

A. Clarify reality with the client about delusional thoughts. B. Reduce the client’s interaction with others during the day. C. Awaken the client earlier for daily morning care. D. Use distraction and therapeutic communication skills.

Correct Answer is D

Explanation

Choice A rationale

Clarifying reality with the client about delusional thoughts is not the most effective approach when dealing with a client with dementia who is experiencing agitation and delusional thoughts. The cognitive impairment associated with dementia may make it difficult for the client to understand or accept the clarification, which could lead to increased frustration and agitation.

Choice B rationale

Reducing the client’s interaction with others during the day is not the most appropriate approach in this situation. It may lead to increased social isolation and could potentially worsen the client’s agitation and delusions. It does not directly address the client’s emotional distress.

Choice C rationale

Awakening the client earlier for daily morning care may further disrupt the client’s sleep patterns and potentially worsen agitation. It does not address the underlying issue of delusional thoughts and the client’s emotional distress.

Choice D rationale

Using distraction and therapeutic communication skills is the most suitable approach for a client with dementia who is experiencing agitation and delusional thoughts. Distraction techniques can help redirect the client’s focus away from distressing thoughts, and therapeutic communication skills, such as active listening and validation, can help the client feel understood and supported.

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Following the administration of albuterol and the subsequent assessment, what actions should the nurse plan for the rest of the shift?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When conducting diet teaching for a client who was diagnosed with hypertension, which food(s) should the nurse encourage the client to eat? Select all that apply.

Correct Answer is ["A","B"]

Explanation

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Correct Answer is D

Explanation

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