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Which of the following findings in a patient who has received omalizumab is considered an adverse effect?
- A. Pain at injection site.
- B. Flushing and dizziness.
- C. Respiratory rate 22 breaths/minute.
- D. Peak flow reading 75% of normal.
Correct Answer: A
Rationale: Reaction at injection site is the only adverse effect of omalizumab. The other information is not related to omalizumab therapy.
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Which of the following actions should be included in the plan of care for a patient with cystic fibrosis (CF) who is admitted to the hospital with increased dyspnea?
- A. Schedule a sweat chloride test.
- B. Arrange for a hospice nurse visit.
- C. Place the patient on a low-sodium diet.
- D. Perform chest physiotherapy every 4 hours.
Correct Answer: D
Rationale: Routine scheduling of airway clearance techniques is an essential intervention for patients with CF. A sweat chloride test is used to diagnose CF, but it does not provide any information about the effectiveness of therapy. There is no indication that the patient is terminally ill. Patients with CF lose excessive sodium in their sweat and require high amounts of dietary sodium.
The nurse is teaching a patient with chronic obstructive pulmonary disease (COPD) about exercise. Which of the following information should the nurse include?
- A. Stop exercising if you start to feel short of breath.'
- B. Use the bronchodilator before you start to exercise.'
- C. Breathe in and out through the mouth while you exercise.'
- D. Upper body exercise should be avoided to prevent dyspnea.'
Correct Answer: B
Rationale: Use of a bronchodilator before exercise improves airflow for some patients and is recommended. Shortness of breath is normal with exercise and not a reason to stop. Patients should be taught to breathe in through the nose and out through the mouth (using a pursed lip technique). Upper-body exercise can improve the mechanics of breathing in patients with COPD.
The nurse is caring for a patient with cystic fibrosis (CF) who has blood glucose levels that are consistently 11-14 mmol/L. Which of the following nursing actions should the nurse plan to implement?
- A. Discuss the role of diet in blood glucose control.
- B. Educate the patient about administration of insulin.
- C. Give oral hypoglycemic medications before meals.
- D. Evaluate the patient's home use of pancreatic enzymes.
Correct Answer: B
Rationale: The glucose levels indicate that the patient has developed CF-related diabetes; insulin therapy will be required. Since the etiology of diabetes in CF is inadequate insulin production, oral hypoglycemic agents are not effective. Patients with CF need a high-calorie diet. Inappropriate use of pancreatic enzymes would not be a cause of hyperglycemia in a patient with CF.
Which of the following topics should the nurse include in medication teaching for a patient with newly diagnosed persistent asthma?
- A. Use of long-acting β-adrenergic medications.
- B. Adverse effects of sustained-release theophylline.
- C. Self-administration of inhaled corticosteroids.
- D. Complications associated with oxygen therapy.
Correct Answer: C
Rationale: Inhaled corticosteroids are more effective in improving asthma than any other drug and are indicated for all patients with persistent asthma. The other therapies would not typically be first-line treatments for newly diagnosed asthma.
After the nurse has finished teaching a patient about pursed lip breathing, which of the following patient actions indicate that more teaching is needed?
- A. The patient inhales slowly through the nose.
- B. The patient tenses the neck muscles while exhaling.
- C. The patient practises by blowing through a straw.
- D. The patient's ratio of inhalation to exhalation is 1:3.
Correct Answer: B
Rationale: The patient should relax the neck and shoulder muscles while doing pursed lip breathing. The other actions by the patient indicate a good understanding of pursed lip breathing.