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Which medication should be administered first for a client with acute asthma exacerbation?
- A. Albuterol
- B. Epinephrine
- C. Levalbuterol
- D. IV corticosteroids
Correct Answer: A
Rationale: Step-by-step rationale for choosing Albuterol as the correct answer:
1. Albuterol is a rapid-acting bronchodilator that provides immediate relief by relaxing the airway muscles during asthma exacerbation.
2. It is the first-line medication recommended by guidelines for acute asthma attacks due to its quick onset of action.
3. Albuterol helps in opening the airways, improving airflow, and relieving symptoms like shortness of breath and wheezing.
4. Epinephrine is not the first choice for asthma exacerbation as it can have more systemic side effects.
5. Levalbuterol is a similar medication to Albuterol but may not be as widely available or cost-effective.
6. IV corticosteroids are important for long-term control but take longer to show effects, making them less suitable as the initial treatment for acute exacerbation.
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The major electrolytes in the extracellular fluid are:
- A. potassium and chloride
- B. potassium and phosphate
- C. sodium and chloride
- D. sodium and phosphate
Correct Answer: C
Rationale: The correct answer is C: sodium and chloride. In the extracellular fluid, sodium and chloride are the major electrolytes due to their roles in maintaining fluid balance, nerve function, and muscle contraction. Potassium and phosphate (choice B) are primarily found in intracellular fluid, while potassium and chloride (choice A) are not the major electrolytes in extracellular fluid. Similarly, sodium and phosphate (choice D) are not major extracellular electrolytes. Thus, choice C is the correct answer based on the significant presence and functions of sodium and chloride in the extracellular fluid.
What is the most important assessment for a client who has been receiving chemotherapy for several weeks?
- A. Check for signs of infection
- B. Monitor the client's weight
- C. Monitor the client's nutrition
- D. Check for skin changes
Correct Answer: A
Rationale: The correct answer is A: Check for signs of infection. This is crucial because chemotherapy weakens the immune system, increasing the risk of infections. Signs of infection such as fever, chills, sore throat, and cough should be closely monitored to prevent serious complications. Monitoring weight (B) and nutrition (C) are important but not as critical as detecting infections promptly. Checking for skin changes (D) is also important, but it is secondary to identifying and managing infections due to the immediate threat they pose to the client's health.
A patient is at the clinic to have her blood pressure checkeShe has been coming to the clinic weekly since her medications were changed 2 months ago. The nurse should:
- A. collect a follow-up database and then check the patient's blood pressure.
- B. ask the patient to read her health record and indicate any changes since her last visit.
- C. check only the blood pressure because the patient's complete health history was documented 2 months ago.
- D. obtain a complete health history before checking the blood pressure because much of the patient's information may have changed.
Correct Answer: A
Rationale: Rationale:
1. Collecting a follow-up database ensures up-to-date information.
2. It allows for monitoring of medication effectiveness and any new symptoms.
3. Checking the blood pressure is essential but needs current context.
4. Asking the patient to read her record may not provide all necessary updates.
5. The complete health history is crucial but obtaining it first may delay urgent blood pressure check.
What should be done for a client who is post-op and develops a fever within the first 48 hours?
- A. Administer antipyretics
- B. Monitor for signs of infection
- C. Administer fluids
- D. Perform an abdominal assessment
Correct Answer: B
Rationale: The correct answer is B: Monitor for signs of infection. Within the first 48 hours post-op, fever is often indicative of an infection. Monitoring for signs such as increased pain, redness, swelling, warmth at the surgical site, elevated white blood cell count, and changes in vital signs helps in early detection and prompt treatment of infections. Administering antipyretics (choice A) may help reduce fever but does not address the underlying cause. Administering fluids (choice C) is important for hydration but does not directly address the fever's cause. Performing an abdominal assessment (choice D) is not specific to addressing fever in a post-op client.
What is the most appropriate action when a client with suspected meningitis presents with a positive Brudzinski sign?
- A. Place the client on their back and administer pain medication
- B. Place the client on their side and administer antibiotics
- C. Administer IV fluids and antibiotics
- D. Perform a lumbar puncture
Correct Answer: D
Rationale: The correct answer is D, perform a lumbar puncture. A positive Brudzinski sign indicates meningeal irritation, a hallmark of meningitis. A lumbar puncture is the gold standard for diagnosing meningitis by analyzing cerebrospinal fluid. Placing the client on their back without proper diagnosis or treatment delays could lead to serious complications. Option B is incorrect as antibiotics should be given after confirming the diagnosis. Option C is partially correct but does not address the need for a definitive diagnostic test. Option A is incorrect as pain medication alone does not address the underlying cause of meningitis.