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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","F","G"]
Explanation
A. Assuming the episode was a migraine and scheduling a follow-up is not appropriate. TIAs are serious warning signs of potential future strokes and require immediate attention and evaluation.
B. Discharging the patient immediately after symptoms resolve is not appropriate. Even though symptoms resolve, TIAs are medical emergencies, and further evaluation is necessary to reduce the risk of a full-blown stroke.
C. Initiating antiplatelet therapy, such as aspirin, is an appropriate action to reduce the risk of future strokes in patients who have had a TIA.
D. Ordering a CT scan of the head is appropriate to rule out an intracranial hemorrhage and other causes of the symptoms.
E. Starting anticoagulation therapy immediately without further evaluation is not recommended. The patient must be properly assessed before starting anticoagulation to determine the cause of the TIA and if anticoagulation is appropriate.
F. Conducting a carotid ultrasound is appropriate to assess for stenosis, which could be contributing to the TIA.
G. Referring the patient for lifestyle modifications, including smoking cessation and diet changes, is crucial to reduce future stroke risk. These interventions help prevent the recurrence of TIAs and strokes.
Correct Answer is ["A","B","D"]
Explanation
A. Genetics play a significant role in the development of multiple sclerosis (MS). Having a family history of MS increases the risk, suggesting a hereditary component to the condition.
B. Environmental factors, such as living in areas with low sunlight or viral infections like Epstein-Barr virus, have been linked to a higher incidence of MS, suggesting environmental triggers may contribute to disease onset.
C. Upper respiratory infections are not directly associated with the development of multiple sclerosis. While infections may trigger MS flare-ups, they are not primary contributors to its development.
D. Autoimmune factors are central to the pathophysiology of MS, where the body’s immune system mistakenly attacks the central nervous system, causing the characteristic lesions and nerve damage seen in MS.
E. Urinary tract infections are common complications in individuals with MS, but they do not contribute to the disease's development itself.
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