Patient Data

History and Physical

A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times, but he just could not catch his breath. The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.
The nurse reviews the client's history of the presenting illness in the electronic medical record.

Click to highlight the two pieces of key subjective data which indicate the client is in need of health interventions.

The client reports using a rescue inhaler three times, but he just could not catch his breath

The client reports that symptoms seem worse when outdoors and when exercising

episodes like this make him extremely nervous

it has been a couple of months since he had an asthma attack

noticed that his inhaler was expired and was worried the medication was not working

Answer and Explanation

The Correct Answer is ["A"]

Subjective data refers to the symptoms reported by the client while objective data refers to the information collected on assessment of the client. During asthmatic attack, the client reports of shortness of breath, audible wheezing, inability to speak in complete sentences and a feeling of nervousness.

The use of a reliever without relief during an asthmatic attack indicates the severity of the attack. This requires intervention including the introduction of inhaled corticosteroids to reduce airway inflammation and remodeling.

The recurrence of symptoms on exposure to exercise requires the need for further advise to avoid triggers and recurrence of symptoms.

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Free Nursing Study Resources

Correct Answer is D

Explanation

D Peritoneal dialysis involves using the peritoneum (the lining of the abdominal cavity) as a semipermeable membrane to remove waste products and excess fluid from the body. It requires a healthy peritoneal membrane for effective dialysis. Crohn's disease, especially if it has led to extensive inflammation or scarring of the peritoneum, can impair the function of the peritoneum and make peritoneal dialysis less effective or even contraindicated.
A While chronic viral hepatitis may affect the liver's ability to metabolize waste products, it is not necessarily a contraindication for peritoneal dialysis. However, active hepatitis or significant liver dysfunction may impact the choice of dialysis modality and require careful evaluation by the healthcare team.
B Nephrotic syndrome involves kidney damage that leads to excessive protein loss in the urine, fluid retention, and other complications. While nephrotic syndrome may necessitate dialysis as kidney function declines, it is not a contraindication for peritoneal dialysis per se.
C While diabetes-related complications can influence the choice of dialysis modality and require close monitoring, type 2 diabetes mellitus alone is not a contraindication for peritoneal dialysis.

A. Hydromorphone. B. Morphine. C. Oxycodone. D. Fentanyl.

Correct Answer is B

Explanation

B Morphine is commonly administered to individuals experiencing chest pain associated with a suspected heart attack. It helps relieve pain and reduces anxiety, thereby improving the comfort
of the patient. Additionally, morphine has vasodilatory effects, which can help reduce the workload on the heart and improve blood flow to the myocardium.
Hydromorphone is a potent opioid analgesic similar to morphine. While it may provide pain relief, it is not typically the first-line choice for managing chest pain associated with a myocardial infarction.
C Oxycodone is another opioid analgesic used for pain relief, but it is not commonly used in the acute management of myocardial infarction. It may be considered for other types of pain management but is not the preferred choice in this scenario.
D Fentanyl is a potent opioid analgesic often used for pain management, including in emergency situations. While it may provide pain relief, morphine is preferred in the acute setting of a myocardial infarction due to its vasodilatory effects and established efficacy in managing cardiac-related chest pain.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?

Correct Answer is D

Explanation

A client presents to the emergency department reporting chest pain that is radiating to the left arm, shortness of breath, and diaphoresis. Which medication should the nurse anticipate being prescribed by the healthcare provider?

Correct Answer is B

Explanation

A client receives a prescription for 1 L of lactated Ringers to be infused IV over 8 hours. The IV administration set delivers 15 gtt/mL. How many mL/hr should the nurse program the infusion pump to deliver? (Enter numerical value only.)

An adult client who was recently diagnosed with glaucoma tells the nurse, "It feels like I am driving through a tunnel." The client expresses great concern about going blind. Which nursing instruction is most important for the nurse to provide this client?

While caring for a client with amyotrophic lateral sclerosis (ALS), the nurse performs a neurological assessment every four hours. Which assessment finding warrants immediate intervention by the nurse?

A client with bilateral carpal tunnel syndrome reports to the nurse that the pain and tingling experienced worsens at night. Which client teaching should the nurse provide?

The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?

Patient Data Exhibits The nurse has identified the priority problem for the client and now must determine proper care interventions. Based on the client's history and the assessment data, what action(s) should the nurse anticipate? Select all that apply.