Nokea
Select all the following that can trigger an asthma attack:
- A. Sulfites
- B. Smoke
- C. Caffeine
- D. GERD
- E. Cold, windy weather
- F. Beta agonist
- G. Cockroaches
Correct Answer: A,B,D,E,G
Rationale: Triggers include sulfites, smoke, GERD, cold weather, and cockroaches. Caffeine and beta agonists are not typical triggers; beta agonists are treatments.
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The nurse is discharging the client diagnosed with bronchiolitis obliterans. Which priority intervention should the nurse include?
- A. Refer the client to the American Lung Association.
- B. Notify the physical therapy department to arrange for activity training.
- C. Arrange for oxygen therapy to be used at home.
- D. Discuss advance directives with the client.
Correct Answer: C
Rationale: Bronchiolitis obliterans causes irreversible airway obstruction, often requiring home oxygen therapy (C) to manage hypoxemia, a priority for discharge planning. Referrals (A), physical therapy (B), and advance directives (D) are important but secondary to ensuring oxygenation.
A patient, who is receiving continuous IV Heparin for the treatment of a DVT, has an aPTT of 110 seconds. What is your next nursing action per protocol?
- A. Continue with the infusion because no change is needed based on this aPTT.
- B. Increase the drip rate per protocol because the aPTT is too low.
- C. Re-draw the aPTT STAT.
- D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.
Correct Answer: D
Rationale: The aPTT is 110 seconds, which is too high. Any aPTT value greater than 80 seconds places the patient at risk for bleeding. Most Heparin protocols dictate that the nurse would hold the infusion for 1 hour and to decrease the rate of infusion. If the aPTT is less than 60 seconds, the dose would need to be increased and a bolus may be needed. aPTT values should be around 60-80 seconds to achieve a therapeutic response for Heparin.
A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications?
- A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone.
- B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol.
- C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone.
- D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.
Correct Answer: A
Rationale: Salmeterol, a long-acting bronchodilator, should be inhaled first to open the airways, followed by Fluticasone, a corticosteroid, after a 5-minute wait to ensure optimal delivery and reduce inflammation.
Which position is best for the client to be in while the nurse prepares to assess breath sounds?
- A. Sitting
- B. Standing
- C. Lying on the back
- D. Lying on the side
Correct Answer: A
Rationale: Sitting upright allows optimal lung expansion, making it easier to assess breath sounds accurately in a client with asthma.
Your patient with a diagnosis of latent tuberculosis infection needs a bronchoscopy. During transport to endoscopy, the patient will need to wear?
- A. N95 mask
- B. Surgical mask
- C. No special PPE is needed
- D. Face mask with shield
Correct Answer: B
Rationale: Patients with latent tuberculosis are not contagious and have no symptoms, but during procedures like bronchoscopy that may generate aerosols, a surgical mask is worn to prevent potential spread if the infection is active.