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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This question is designed to assess for manic or hypomanic episodes, where decreased need for sleep is a hallmark symptom. While related to sleep, it is more specific to mood disorders and not a general sleep assessment.
Choice B reason: This question targets hallucinations and is part of the psychosis screening. It does not relate to sleep patterns or quality.
Choice C reason: This question assesses for dissociative symptoms, such as amnesia or identity disturbances. It is unrelated to sleep.
Choice D reason: This question directly addresses sleep adequacy and quality, making it the most appropriate for evaluating the sleep domain in a psychiatric ROS. It helps identify insomnia, hypersomnia, or other sleep disturbances.
Correct Answer is A
Explanation
Choice A reason: Excess dopamine activity in the mesolimbic pathway is strongly associated with the positive symptoms of schizophrenia, such as hallucinations and delusions. This theory forms the basis for the use of antipsychotic medications, which block dopamine receptors to reduce these symptoms.
Choice B reason: Decreased dopamine activity in the mesocortical pathway, not increased, is linked to the negative and cognitive symptoms of schizophrenia. This includes apathy, social withdrawal, and impaired executive function.
Choice C reason: While serotonin may play a modulatory role in schizophrenia, particularly in the mechanism of atypical antipsychotics, it is not the primary neurotransmitter implicated in the core pathophysiology of the disorder.
Choice D reason: Hypofunction of glutamate, particularly at NMDA receptors, has been proposed as a contributing factor to schizophrenia. However, this theory is still under investigation and is not as well-established as the dopamine hypothesis.
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