Nokea
Which of the following medications is a bronchodilator?
- A. Albuterol
- B. Omeprazole
- C. Ondansetron
- D. Senna
Correct Answer: A
Rationale: Albuterol is classified as a bronchodilator, which is commonly used to treat conditions like asthma by relaxing the muscles in the airways and increasing airflow to the lungs. Omeprazole is a proton pump inhibitor used to reduce stomach acid production, while ondansetron is an anti-nausea medication, and senna is a laxative.
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The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution is correct for use with the PRBC transfusion?
- A. 5% dextrose in water (D5W)
- B. 0.9% sodium chloride (NS)
- C. 5% dextrose in 0.45% sodium chloride (D5NS)
- D. 5% dextrose in lactated Ringer™s solution (D5LR)
Correct Answer: B
Rationale: 0.9% sodium chloride (NS), also known as normal saline, is the correct intravenous solution to use with packed red blood cell (PRBC) transfusion. NS is isotonic and compatible with blood products, making it the preferred solution for blood transfusions to prevent hemolysis of red blood cells. Other solutions such as D5W, D5NS, and D5LR are not recommended for use with PRBC transfusions due to their potential to cause hemolysis or affect the stability of the blood product.
A healthcare professional is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion. Which of the following results indicates that the heparin infusion should be increased?
- A. aPTT of 90 seconds
- B. Platelet count of 150,000/mm³
- C. INR of 1.0
- D. Hgb of 15 g/dL
Correct Answer: A
Rationale: An aPTT of 90 seconds is above the therapeutic range for heparin, which typically falls between 60-80 seconds. This indicates that the current heparin dose is too high, and the infusion rate should be decreased to avoid excessive anticoagulation and the risk of bleeding. Monitoring aPTT is crucial in adjusting heparin therapy to maintain it within the therapeutic range.
A client with streptococcal pneumonia is receiving penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports itching at the IV site, dizziness, and shortness of breath. What should the nurse do first?
- A. Stop the infusion.
- B. Call the provider.
- C. Elevate the head of the bed.
- D. Auscultate breath sounds.
Correct Answer: A
Rationale: In this scenario, the client is exhibiting signs of anaphylaxis, a severe allergic reaction. The priority action for the nurse is to stop the infusion immediately to prevent further administration of the allergen and worsening symptoms. Once the infusion is stopped, the nurse can then proceed with additional interventions, such as calling the provider, assessing the client's respiratory status, and providing appropriate care as needed.
A client in a critical care unit is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?
- A. Prone
- B. On the nonoperative side
- C. Sims'
- D. Semi-Fowler's
Correct Answer: D
Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.
Regarding drugs used in the treatment of status epilepsy:
- A. phenytoin is useful in status for its sedating as well as anticonvulsant activity
- B. phenytoin may be diluted in both saline and dextrose
- C. the effect of diazepam is long lasting
- D. respiratory depression is a common complication of phenobarbitone
Correct Answer: D
Rationale: Phenytoin controls status epilepticus via anticonvulsant action, not sedation, so that's false. It precipitates in dextrose, only saline-compatible, making that false. Diazepam's effect is short-lived, not long-lasting, so that's incorrect. Phenobarbitone commonly causes respiratory depression, a true statement, due to CNS suppression. Phenytoin's rate is 50 mg/min max. This side effect limits phenobarbitone's use, requiring ventilatory support in status management.