A. Propranolol is a non-selective beta-blocker that can cause bronchoconstriction, making it contraindicated for patients with asthma. It can worsen asthma symptoms by blocking beta-2 adrenergic receptors, which are important for bronchodilation.
B. Theophylline is a bronchodilator that can be used in asthma management, especially in chronic cases. While it has a narrow therapeutic index and can have side effects, it is not contraindicated in acute exacerbations. However, it’s less commonly used today due to better alternatives.
C. Prednisone is a corticosteroid used to reduce inflammation during asthma exacerbations. It is a common and appropriate medication for managing acute asthma attacks, so it does not require clarification.
D. Montelukast is a leukotriene receptor antagonist used for long-term asthma control. It helps reduce inflammation and bronchoconstriction. While it’s not a first-line treatment for acute exacerbations, it is appropriate for ongoing management and doesn’t need clarification.

A. Long-acting beta2-adrenergic agonists (LABAs) are used for the maintenance treatment of asthma but are not suitable for immediate relief during an acute exacerbation. They take longer to take effect and are used as part of a long-term management plan rather than a rescue plan.
B. Short-acting beta2-adrenergic agonists (SABAs), such as albuterol, are the first-line treatment for acute asthma exacerbations. They work quickly to relax the muscles around the airways, providing immediate relief of bronchospasm and improving airflow. This is why they are referred to as "rescue" medications.
C. Mucolytics are used to thin and loosen mucus in the airways, which can be helpful for conditions involving thick mucus. However, they are not used for immediate relief of asthma symptoms and do not address bronchospasm directly. They are not appropriate as a first-line treatment in an acute asthma attack.
D. Inhaled corticosteroids are used for long-term control of asthma by reducing inflammation in the airways. While they are important for ongoing management, they do not provide immediate relief during an acute asthma exacerbation and should not be used as rescue medication.

A. Rinsing the mouth and spitting after using a steroid inhaler is essential to prevent oral thrush, a common side effect of inhaled corticosteroids. This practice helps clear residual medication from the mouth and throat, reducing the risk of fungal infections.
B. Bronchodilators, such as short-acting beta-agonists (SABAs), should be used before steroid inhalers. The bronchodilator opens the airways, allowing the steroid to reach deeper into the lungs for better efficacy.
C. While some inhalers (like rescue inhalers) may be used on a PRN basis, steroid inhalers are typically prescribed for regular, daily use to manage inflammation and control chronic conditions like asthma or COPD. They are not intended for PRN use only.
D. Frequent oral hygiene helps to reduce the risk of oral thrush and other oral health issues associated with steroid use. Patients should be encouraged to maintain good oral hygiene practices while using inhaled steroids.
E. Holding the breath for about 10 seconds after inhalation allows for better medication absorption in the lungs. This practice helps maximize the efficacy of the inhaled medication.

A. Hypertension, or high blood pressure, is a common condition in older adults but is not a specific indicator of pneumonia. While blood pressure can fluctuate with illness, it does not directly relate to the diagnosis of pneumonia.
B. Acute confusion is a critical and relevant sign in older adults with pneumonia. This demographic may experience altered mental status due to factors like hypoxia (low oxygen levels), fever, or dehydration. Confusion is often one of the first signs of infection in older patients, making it a significant assessment finding.
C. Hematemesis, which is the vomiting of blood, is not associated with pneumonia. It typically indicates a gastrointestinal issue, such as bleeding from ulcers or varices, rather than respiratory problems. Therefore, this finding would not be relevant to a pneumonia diagnosis.
D. While a cough is indeed a symptom of pneumonia, a dry hacking cough is less typical. Pneumonia generally presents with a productive cough (producing sputum) rather than a dry cough. A dry cough might suggest conditions like bronchitis or asthma.

A. This statement indicates a good understanding of environmental control for asthma management. Carpets can trap dust, allergens, and mold, which can trigger asthma attacks. Replacing the carpet with tile can help to reduce exposure to these allergens.
B. While dusting plants can help to reduce exposure to allergens, it is not as effective as removing potential allergens from the environment altogether. Plants themselves can also be sources of allergens, so it might be best to remove them from the home, especially the bedroom.
C. Pets, especially dogs and cats, can be a significant source of allergens for people with asthma. Keeping a pet in the bedroom can increase exposure to allergens and trigger asthma attacks.
D. Burning wood in a fireplace can produce smoke and other pollutants that can irritate the airways and trigger asthma attacks. It is best to avoid using fireplaces, especially during the winter months.

A. Beta-adrenergic agents (often called bronchodilators) work by stimulating beta-2 adrenergic receptors in the airway smooth muscle, leading to relaxation of the muscles and dilation of the airways. This helps improve airflow and relieve symptoms of asthma.
B. A beta-adrenergic agent should ideally increase peak expiratory flow (PEF) by dilating the airways and improving airflow, not decrease it.
C. This is not a direct action of beta-adrenergic agents. While some medications (like mucolytics or certain expectorants) can thin secretions, beta-adrenergic agents primarily focus on bronchodilation and do not significantly affect the viscosity of respiratory secretions.
D. While beta-adrenergic agents can sometimes cause mild tachycardia (increased heart rate) as a side effect, they are not intended to increase the respiratory rate directly. The primary goal of these medications is to improve airway patency rather than change the rate of breathing.

A. Infectious mononucleosis is caused by the Epstein-Barr virus, not by streptococcal bacteria. Therefore, antibiotics for streptococcal pharyngitis would not prevent this illness.
B. Rheumatic fever is a serious complication that can occur after an untreated streptococcal infection. It can affect the heart, joints, and nervous system. Treating streptococcal pharyngitis with antibiotics effectively reduces the risk of developing rheumatic fever.
C. While streptococcal bacteria can cause pneumonia, the primary concern with acute streptococcal pharyngitis is rheumatic fever. Pneumonia can be a complication, but it is not the most critical disease to prevent with antibiotics in this context.
D. Nasopharyngitis, often referred to as the common cold, is typically caused by viruses. Antibiotics would not prevent this condition, as it is not related to streptococcal infections.

A. While yogurt is a nutritious food, it is not a significant source of iron.
B. Oranges are rich in vitamin C, which can help the body absorb iron from other foods. However, they are not a significant source of iron themselves.
C. Red meat, such as beef, lamb, and pork, is an excellent source of heme iron, which is easily absorbed by the body. This makes red meat a highly recommended food for people with iron deficiency.
D. Cashews are a good source of plant-based iron, but they also contain phytates, which can interfere with iron absorption. Therefore, while cashews can contribute to iron intake, they may not be as effective as red meat in addressing iron deficiency.

Convert infusion time to minutes:

2 hours * 60 minutes/hour = 120 minutes

Calculate the total number of drops:

250 mL * 10 gtt/mL = 2500 gtt

Calculate the flow rate:

Flow rate = Total number of drops / Infusion time Flow rate = 2500 gtt / 120 minutes

Flow rate ≈ 20.83 gtt/min

Rounding to the nearest drop, the flow rate for the infusion of packed red blood cells is 21 gtt/min.

A. While this information is important for understanding the cause of the asthma exacerbation, it is not the most critical piece of information needed for immediate treatment.
B. Knowing when the symptoms began can help determine the severity of the exacerbation and the need for additional interventions. However, it is not as important as knowing the last dose of medication.
C. This information is crucial for determining the appropriate treatment. If the child has not received their regular medications as prescribed, they may need additional doses to manage the exacerbation.
D. Knowing the child's history of asthma exacerbations is important for assessing the severity of the current episode and planning long-term management. However, it is not the most critical piece of information needed for immediate treatment.