Nokea
Your patient's asthma is poorly controlled. The patient reports using their rescue inhaler 4 times a week. In addition, the patient's asthma is not responding to other treatments. The physician orders the patient to take a medication that works by blocking the role of the immunoglobulin IgE. This describes which medication below?
- A. Montelukast
- B. Omalizumab
- C. Cromolyn
- D. Salmeterol
Correct Answer: B
Rationale: Omalizumab is a monoclonal antibody that binds to IgE, preventing it from triggering allergic responses in asthma.
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The nurse instructs the client's spouse to empty and thoroughly clean the vaporizer after each use. Which rationale provides the basis for the nurse's instruction?
- A. There is a potential for injury if the vaporizer is accidentally knocked off a nightstand.
- B. When the vaporizer is not cleaned, there is the growth of environmental pathogens.
- C. The vaporizer can collect dust, which could affect the client's breathing.
- D. Water evaporation causes calcium deposits that will obstruct the vaporizer.
Correct Answer: B
Rationale: A cool-mist vaporizer can harbor pathogens like bacteria and mold if not cleaned properly, potentially worsening respiratory symptoms.
Which laboratory tests should the client receive before prophylactic drug therapy for tuberculosis is started?
- A. Serum creatinine and blood urea nitrogen (BUN)
- B. Aspartate aminotransferase (AST; SGOT) and alanine aminotransferase (ALT; SGPT)
- C. Complete blood count (CBC) and hematocrit
- D. White blood cell (WBC) count and urinalysis
Correct Answer: B
Rationale: Liver function tests (AST and ALT) are essential before starting tuberculosis prophylaxis, as drugs like isoniazid can cause hepatotoxicity.
Which health measure is most important to emphasize when instructing the client on ways to prevent transmitting tuberculosis?
- A. Eat a nutritious diet.
- B. Get adequate sleep.
- C. Cover your nose and mouth when coughing.
- D. Wash your hands before and after meals.
Correct Answer: C
Rationale: Covering the nose and mouth when coughing prevents the spread of tuberculosis, an airborne disease, to others.
The unlicensed assistive personnel (UAP) is bathing the client diagnosed with acute respiratory distress syndrome (ARDS). The bed is in a high position with the opposite side rail in the low position. Which action should the nurse implement?
- A. Demonstrate the correct technique for giving a bed bath.
- B. Encourage the UAP to put the bed in the lowest position.
- C. Instruct the UAP to get another person to help with the bath.
- D. Provide praise for performing the bath safely for the client and the UAP.
Correct Answer: B
Rationale: Lowering the bed (B) prevents falls, critical for ARDS patients. Demonstration (A), extra help (C), and praise (D) are inappropriate given safety concerns.
If the client is typical of most others diagnosed with lung cancer, which early-warning sign was most likely ignored?
- A. Difficulty swallowing
- B. Gradual weight loss
- C. Persistent cough
- D. Coughing up blood
Correct Answer: C
Rationale: A persistent cough is a common early symptom of lung cancer that is often ignored, delaying diagnosis.