A 41-year-old woman with a history of persistent asthma presents to the nurse practitioner with a chief complaint of an increase in exacerbations. Why would a long-acting beta agonist (LABA) NOT be prescribed as monotherapy for this patient?
LABAs improve lung function and quality of life.
LABAs are recommended at step 3 of the national guidelines for the management of asthma.
Studies have shown an increased risk of sudden death in patients treated with LABA monotherapy only.
LABAs are currently recommended for the management of asthma for rescue situations.
The Correct Answer is C
Choice A reason: LABAs do improve lung function and quality of life when used appropriately, but this statement does not address the safety concerns of monotherapy. LABAs must be combined with inhaled corticosteroids (ICS) to mitigate risks.
Choice B reason: LABAs are indeed recommended at step 3 of asthma management guidelines, but only in combination with ICS. Monotherapy with LABAs is contraindicated due to safety concerns.
Choice C reason: Monotherapy with LABAs has been associated with an increased risk of asthma-related deaths. This risk is mitigated when LABAs are used in combination with ICS, which address the underlying inflammation. Therefore, LABA monotherapy is not recommended.
Choice D reason: LABAs are not used for rescue therapy. Short-acting beta agonists (SABAs), such as albuterol, are the standard rescue medications for acute asthma symptoms. LABAs are used for maintenance therapy.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Schizophrenia requires symptoms to persist for at least six months, including at least one month of active-phase symptoms such as delusions, hallucinations, or disorganized speech. Since the boy’s symptoms have lasted only two months, this diagnosis is premature.
Choice B reason: Brief psychotic disorder involves sudden onset of psychotic symptoms lasting more than one day but less than one month, followed by full recovery. The boy’s symptoms have persisted for two months, which exceeds the duration criteria for this diagnosis.
Choice C reason: Schizoaffective disorder includes symptoms of schizophrenia along with prominent mood episodes (either depressive or manic). There is no mention of mood symptoms in this case, making schizoaffective disorder unlikely.
Choice D reason: Schizophreniform disorder is diagnosed when symptoms of schizophrenia are present for more than one month but less than six months. The boy’s delusions, social withdrawal, and communication difficulties over two months fit this timeframe, making this the most appropriate diagnosis.
Correct Answer is C
Explanation
Choice A reason: Malignant prostatic hyperplasia is not a recognized medical term. Malignancy of the prostate refers to prostate cancer, which typically presents with elevated PSA levels and may include systemic symptoms or nodular findings on examination. This patient’s normal PSA and obstructive urinary symptoms point away from malignancy.
Choice B reason: Malignant prostatic hypertrophy is also not a standard diagnosis. Hypertrophy refers to enlargement, but when paired with “malignant,” it implies cancer. Again, the absence of elevated PSA and systemic signs makes this unlikely.
Choice C reason: Benign prostatic hyperplasia (BPH) is the most common cause of urinary symptoms in older men. It involves non-cancerous enlargement of the prostate gland, which compresses the urethra and impairs urine flow. Symptoms include frequency, hesitancy, weak stream, and incomplete emptying—all present in this case.
Choice D reason: Benign prostatic hypoplasia refers to underdevelopment of the prostate, which is rare and not associated with obstructive urinary symptoms. It does not fit the clinical presentation.
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