You're assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and chest tightness. You auscultate the patient's lung fields and note expiratory wheezes. The patient's peak flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with the fastest relief from these signs and symptoms of an asthma attack?
- A. Theophylline
- B. Tiotropium
- C. Albuterol
- D. Cromolyn
Correct Answer: C
Rationale: Albuterol is a short-acting beta-agonist that provides rapid bronchodilation, making it the fastest-acting medication for acute asthma symptoms.
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The charge nurse is making client assignments on a medical floor. Which client should the charge nurse assign to the licensed practical nurse (LPN)?
- A. The client with pneumonia who has a pulse oximeter reading of 91%.
- B. The client with a hemothorax who has Hb of 9 g/dL and Hct of 20%.
- C. The client with chest tubes who has jugular vein distention and BP of 96/60.
- D. The client who is two (2) hours post-bronchoscopy procedure.
Correct Answer: D
Rationale: Post-bronchoscopy (D) is stable for LPN care. Hypoxia (A), anemia (B), and JVD/hypotension (C) require RN assessment.
The nurse is caring for the client diagnosed with bacterial pneumonia. Which priority intervention should the nurse implement?
- A. Assess respiratory rate and depth.
- B. Provide for adequate rest period.
- C. Administer oxygen as prescribed.
- D. Teach slow abdominal breathing.
Correct Answer: C
Rationale: Administering oxygen as prescribed (C) is the priority for bacterial pneumonia to address hypoxemia, a common issue due to impaired gas exchange. Assessing respiratory rate (A) is important but secondary to ensuring oxygenation. Rest (B) and breathing techniques (D) support recovery but are not the first priority.
A patient receiving medical treatment for an active tuberculosis infection asks when she can starting going out in public again. You respond that she is no longer contagious when:
- A. She has 3 negative sputum cultures
- B. Her signs and symptoms improve
- C. She has completed the full medication regime
- D. Her chest x-ray is normal
- E. She has been on tuberculosis medications for about 3 weeks
Correct Answer: A
Rationale: A patient with active TB is considered non-contagious after three consecutive negative sputum cultures, indicating no viable bacteria. Symptom improvement, medication duration, or normal X-rays alone do not confirm non-contagiousness.
The term 'blue bloaters' is used to describe patients with?
- A. Pulmonary hypertension
- B. Left-sided heart failure
- C. Chronic Bronchitis
- D. Emphysema
Correct Answer: C
Rationale: Blue bloaters' describes chronic bronchitis patients, who present with cyanosis ('blue') and edema ('bloating') due to hypoxemia and right heart failure. Emphysema patients are often called 'pink puffers.'
You're educating a patient about Warfarin (Coumadin) and how it is used to treat blood clots. Which statements by the patient require you to re-educate them about how this medication works? Select all that apply:
- A. This medication will help dissolve the blood clot.
- B. This medication will prevent another blood clot from forming.
- C. This medication will help prevent the blood clot from becoming bigger in size.
- D. This medication starts working immediately after the first dose.
Correct Answer: A,D
Rationale: Warfarin (Coumadin) does NOT dissolve blood clots. It prevents blood clots from forming, and if one is present, it will help prevent it from becoming bigger. If the blood clot becomes bigger it may break off and travel in blood circulation. This can lead to a pulmonary embolism, heart attack, or stroke. Warfarin (Coumadin) does NOT start working immediately. It takes about 3-5 days of scheduled doses to start achieving a therapeutic INR level. It is very common that a patient will be on Heparin while taking Warfarin until INR levels are therapeutic.