A client in the emergency department is experiencing an acute asthma exacerbation, which has not improved with albuterol nebulizer treatments. The client is obviously struggling to breathe. The nurse anticipates that intubation and mechanical ventilation will be needed based on which of the following assessment findings?

Tachycardia

Anxiety

Hypotension

Loud expiratory wheezing

Answer and Explanation

The Correct Answer is C

A.   Tachycardia (rapid heart rate) can occur in response to hypoxia (low oxygen levels), stress, or as a side effect of medications like albuterol. While tachycardia is a concerning sign in the context of an asthma exacerbation, it alone does not directly indicate the need for intubation and mechanical ventilation. It is often managed by addressing the underlying respiratory distress and improving oxygenation.
B.   Anxiety is common in patients struggling to breathe, as they may feel frightened or panicked due to their difficulty breathing. However, anxiety itself is not an indicator for intubation and mechanical ventilation. It is a symptom of respiratory distress but does not directly assess the severity of the physiological need for mechanical support.
C.   Hypotension (low blood pressure) in the context of an asthma exacerbation can be a sign of severe illness, possibly indicating shock or severe respiratory distress leading to reduced cardiac output. While hypotension is a serious concern, it is less directly related to the immediate need for intubation and mechanical ventilation compared to other indicators of respiratory failure.
D.   Loud expiratory wheezing indicates significant airway obstruction but does not necessarily reflect the need for intubation and mechanical ventilation. Wheezing can be a sign of severe asthma but may not be sufficient on its own to necessitate intubation if the patient can still maintain adequate oxygenation and ventilation.

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Correct Answer is D

Explanation

A. Hemoglobin levels measure the oxygen-carrying capacity of the blood. A reduced ejection fraction (30%) is more closely related to heart failure or significant cardiac dysfunction, which is not directly indicated by changes in hemoglobin levels.
B. Platelet levels are primarily involved in blood clotting and are less directly related to ejection fraction. Elevated or decreased platelet counts are not typically used as indicators of heart failure severity or reduced ejection fraction.
C. In cases of severe heart failure with a reduced ejection fraction, you may see elevated BUN levels due to these effects. However, it is not directly related to heart failure.
D. BNP is a hormone released by the heart in response to increased pressure and volume overload, typically seen in heart failure. Elevated BNP levels are associated with worsening heart failure and can be elevated in patients with a reduced ejection fraction. In heart failure, especially with an ejection fraction as low as 30%, BNP levels are often significantly elevated.

A. Atorvastatin B. Digoxin C. Furosemide D. Rituximab

Correct Answer is A

Explanation

A. Atorvastatin is a statin used to lower cholesterol levels in the blood. Reducing cholesterol levels helps to prevent the progression of atherosclerosis (plaque buildup in the arteries), which is a major cause of chronic stable angina. Statins are commonly prescribed to manage the underlying condition that leads to angina by stabilizing plaques and reducing the risk of heart attacks and strokes.
B. Digoxin is a medication used to treat heart failure and certain types of abnormal heart rhythms (arrhythmias). It works by increasing the force of heart contractions and controlling heart rate. While it can be helpful in specific cases of heart failure or arrhythmias, it is not typically used for the management of chronic stable angina.
C. Furosemide is a diuretic used to treat conditions such as heart failure and edema by removing excess fluid from the body. It helps to reduce fluid buildup but does not address the underlying cause of chronic stable angina or improve coronary artery function. It is not a primary medication for managing angina.
D. Rituximab is a monoclonal antibody used primarily to treat certain types of cancer and autoimmune diseases by targeting specific immune cells. It is not used to treat chronic stable angina or related cardiovascular conditions. It does not play a role in managing cholesterol levels or improving coronary artery health.

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Naxlex Comprehensive Predictor Exams

The nurse is reviewing the results of the client's echocardiogram and observes that the ejection fraction is 30%. Which lab result would the nurse expect to be elevated for a client with this ejection fraction?

Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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