A 25-year-old patient with a history of asthma presents to the emergency department with severe shortness of breath, wheezing, and accessory muscle use. Despite initial treatment with albuterol and oxygen, the patient's condition has not improved. Which of the following is the most appropriate next step in the management of this patient's asthma exacerbation?

Initiate broad-spectrum antibiotics

Increase the frequency of albuterol nebulizations

Administer intravenous magnesium sulfate

Administer subcutaneous epinephrine

Answer and Explanation

The Correct Answer is C

A.   Antibiotics are not indicated in the treatment of an asthma exacerbation unless there is a confirmed bacterial infection, which is not suggested here.

B.   Increasing the frequency of albuterol nebulizations may be appropriate, but more aggressive interventions are required, as the patient has not improved with initial treatment.
C.   Intravenous magnesium sulfate is often used in severe asthma exacerbations to help relax the muscles around the airways, making it a more appropriate next step for this patient.
D.   Subcutaneous epinephrine can be used for anaphylaxis but is not the first-line treatment for asthma exacerbations.

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Correct Answer is D

Explanation

A. Peptic ulcer disease is possible, but the patient's NSAID use and positive H. pylori antibodies suggest a more specific cause related to gastritis.
B. Acute gastritis due to NSAID use is likely since NSAIDs can irritate the stomach lining and increase the risk of ulcers.
C. Functional dyspepsia is less likely given the presence of H. pylori antibodies, which typically indicate an active infection.
D. Chronic gastritis due to Helicobacter pylori infection is the most likely diagnosis, especially with the combination of NSAID use and positive H. pylori antibodies.

A. Administer the feeding solution directly from the refrigerator. B. Flush the tube with 10 mL of cold water C. Position the patient supine at 30 degrees. D. Verify the pH of gastric aspirate is less than 5.0.

Correct Answer is D

Explanation

A. Administering feeding solution directly from the refrigerator can cause discomfort to the patient and increase the risk of gastric upset.
B. Flushing the tube with cold water is not appropriate, as it may irritate the stomach and cause discomfort.
C. Positioning the patient supine at 30 degrees is unsafe, as it increases the risk of aspiration. The patient should be at a higher angle, typically 30-45 degrees.
D. Verifying the pH of gastric aspirate is crucial to ensure the feeding tube is in the correct position and to prevent aspiration of feeding material into the lungs.

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is preparing to administer an enteral feeding to a patient with a gastrostomy tube. Before starting the feeding, which of the following actions should the nurse take to ensure patient safety?

Correct Answer is D

Explanation

A nurse is caring for a client who has multiple sclerosis. Which of the following factors should the nurse anticipate have been identified as contributing to the development of multiple sclerosis? (Select All that Apply)

A patient presents with numbness and tingling in the thumb, index, and middle fingers, and a positive Phalen's test. Which of the following interventions would be most appropriate to address the underlying cause of these symptoms?

A 25-year-old female patient presents with fever, chills, and a productive cough. Sputum culture reveals Gram-positive cocci in clusters. Which of the following bacterial organisms is most likely responsible for this infection?

A 65-year-old adult patient weighing 80 kg is prescribed a continuous heparin infusion. The order is for 18 units/kg/hour. The pharmacy supplies heparin in a concentration of 25,000 units/500 mL. Determine the total units of heparin the patient should receive per hour.

A 65-year-old patient with a history of osteoarthritis reports increased pain and stiffness in the knees, particularly in the morning and after prolonged inactivity. Which intervention is most appropriate to recommend to this patient to help alleviate these symptoms?

A nurse is preparing to administer oxygen therapy to a patient who has just undergone abdominal surgery. Which of the following interventions is most important to ensure proper oxygenation?

A 68-year-old male patient is presenting with urinary incontinence. Which characteristics are commonly associated with overflow incontinence and functional incontinence? (Select All that Apply.)

A 68-year-old male patient presents with symptoms of benign prostatic hyperplasia (BPH). Which findings are consistent with BPH? (Select All that Apply.)