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 {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

Myasthenia Gravis

Myasthenia Gravis (MG) is an autoimmune disorder characterized by weakness and rapid fatigue of voluntary muscles. Key features include fluctuating muscle weakness that typically worsens with activity and improves with rest, bilateral ptosis (drooping of the eyelids), and difficulty with swallowing and speaking. The fact that the client's facial muscle strength is better in the morning and worsens throughout the day is a hallmark of MG. The edrophonium (Tensilon) test is specifically used to diagnose MG by temporarily improving muscle strength.

Antibodies at the neuromuscular junction

Myasthenia Gravis is caused by the presence of autoantibodies that target acetylcholine receptors at the neuromuscular junction, leading to impaired communication between nerves and muscles. This is consistent with the described symptoms and the use of the edrophonium (Tensilon) test to diagnose the condition.

A. Atorvastatin B. Furosemide C. Methimazole D. Apixaban

Correct Answer is ["B","E"]

Explanation

A. Atorvastatin is a statin used primarily to manage hyperlipidemia (high cholesterol levels) and reduce cardiovascular risk. However, it is not specifically used to treat heart failure symptoms or manage acute exacerbations.
B. Furosemide is a loop diuretic commonly used to manage heart failure. It helps reduce fluid overload by promoting diuresis (increased urine production), which can help alleviate symptoms of heart failure such as edema and pulmonary congestion.
C. Methimazole is an antithyroid medication used to manage hyperthyroidism. It is not used to treat heart failure. Thyroid disorders can impact heart failure, but methimazole itself does not address the acute symptoms or underlying mechanisms of heart failure.
D. Apixaban is an anticoagulant (blood thinner) used to prevent blood clots in conditions like atrial fibrillation. However, it is not used specifically to manage acute heart failure symptoms.
E. Digoxin is a cardiac glycoside that can be used to manage heart failure, especially in patients with atrial fibrillation. It helps improve cardiac output and control heart rate. Digoxin can be useful in managing heart failure symptoms by enhancing the heart's contractility and controlling the heart rate.

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Naxlex Comprehensive Predictor Exams

A nurse is assigned to care for a client on a medical-surgical unit. Exhibits Complete the following sentence by using the list of options. Based on the information provided, the client is likely experiencing which is caused by

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}

Explanation

A nurse is caring for a client with an acute heart failure exacerbation. Which of the following medications are commonly prescribed to manage heart failure? (Select all that apply.)

Correct Answer is ["B","E"]

Explanation

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