Nokea
The nurse in the emergency department is caring for a client who is experiencing an acute exacerbation of asthma. Which of the following medications should the nurse expect to administer?
- A. Nebulized albuterol
- B. PO montelukast sodium
- C. IV methylprednisolone succinate
- D. Inhaled ipratropium
- E. Inhaled salmeterol
Correct Answer: A
Rationale: Nebulized albuterol, a short-acting beta-agonist, rapidly relieves bronchospasm in acute asthma exacerbations. Montelukast is for maintenance, methylprednisolone is slower-acting, ipratropium is secondary, and salmeterol is long-acting, not for acute relief.
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A client’s partner asks the nurse if ‘staring off into space’ is a seizure because the client ‘does that sometimes when having a seizure.’ Which response from the nurse is the most helpful?
- A. No, absence seizures can look like daydreaming or staring off into space.
- B. No, you are wrong. Don’t worry about that.
- C. Yes, so please let me know if you see the client do that.
- D. You don’t have to monitor the client for seizures.
Correct Answer: A
Rationale: Explaining that absence seizures can appear as staring or daydreaming educates the partner accurately and encourages reporting without alarm. Dismissing the concern, assuming it’s a seizure, or discouraging monitoring is unhelpful and potentially unsafe.
The nurse is caring for an adult who was admitted for observation following an automobile accident. The client has several lacerations that were sutured in the emergency room and a fractured leg that has been casted. The baseline vital signs are BP=120/72, P=76, and R=16. One hour after arriving on the unit, the client's vital signs are BP=108/68, P=90, and R=22. The nurse most correctly interprets these results to mean that the client may be developing which condition?
- A. Shock
- B. Increased intracranial pressure
- C. Panic attack
- D. Autonomic hyperreflexia
Correct Answer: A
Rationale: Decreased BP, increased pulse, and respirations suggest shock, possibly from occult bleeding or trauma response, requiring urgent evaluation.
An adult who is being admitted to the medical floor with a bleeding ulcer exhibits all of the following. Which finding suggests that the client may be experiencing alcohol withdrawal symptoms?
- A. BP=90/60
- B. Dizziness
- C. Tremors
- D. Pallor
Correct Answer: C
Rationale: Tremors are a classic sign of alcohol withdrawal, distinguishing it from bleeding ulcer symptoms like hypotension, dizziness, or pallor.
The nurse detects blood-tinged fluid leaking from the nose and ears of a head trauma client. What is the appropriate nursing action?
- A. Pack the nose and ears with sterile gauze
- B. Apply pressure to the injury site
- C. Apply bulky, loose dressing to nose and ears
- D. Apply an ice pack to the back of the neck
Correct Answer: C
Rationale: Applying a bulky, loose dressing to the nose and ears permits the fluid to drain and provides a visual reference for the amount of drainage.
Narrow therapeutic index medications:
- A. are drug formulations with limited pharmacokinetic variability.
- B. have limited value and require no monitoring of blood levels.
- C. have less than a twofold difference in minimum toxic levels and minimum effective concentration in the blood.
- D. have limited potency and side effects.
Correct Answer: C
Rationale: Narrow therapeutic index drugs have a small margin between effective and toxic doses, requiring close monitoring. The other descriptions are inaccurate or irrelevant. Pharmacological Therapies