A client in the emergency room begins to experience an acute asthma attack. The nurse expects that which medication will be used as initial treatment?

A corticosteroid such as fluticasone

A long-acting beta 2 agonist such as salmeterol

A short-acting, beta 2 agonist such as albuterol

Methylxanthines such Theophylline

Answer and Explanation

The Correct Answer is C

A) A corticosteroid such as fluticasone:
While corticosteroids, such as fluticasone, are effective for managing chronic asthma and preventing inflammation over time, they are not the first-line treatment during an acute asthma attack. Corticosteroids are typically used for long-term control and maintenance therapy, not for rapid relief of symptoms in an acute exacerbation. Immediate relief is needed in acute situations, which corticosteroids alone do not provide.

B) A long-acting beta 2 agonist such as salmeterol:
Long-acting beta-2 agonists (LABAs), such as salmeterol, are used for maintenance therapy to prevent asthma attacks and should not be used for the immediate treatment of an acute asthma exacerbation. They take longer to start working, and their role is to provide prolonged bronchodilation over time, not to relieve sudden bronchoconstriction.

C) A short-acting beta 2 agonist such as albuterol:
During an acute asthma attack, the immediate goal is to relieve bronchoconstriction and improve airflow. Short-acting beta-2 agonists like albuterol are the first-line treatment because they quickly relax the smooth muscles of the airways, leading to bronchodilation. Albuterol works within minutes, providing rapid relief from the symptoms of wheezing, shortness of breath, and chest tightness.

D) Methylxanthines such as Theophylline:
Methylxanthines (e.g., theophylline) were once used for asthma management but are no longer considered the first-line treatment for acute exacerbations due to their narrow therapeutic range and the potential for toxicity. While theophylline can provide bronchodilation, its onset of action is slower than that of beta-agonists like albuterol, and it is generally reserved for more chronic management of asthma or severe cases where other medications are not effective.

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Correct Answer is C

Explanation

A) "Take one tablet every 15 minutes during an acute attack."
This is incorrect because the correct instruction is to take one tablet every 5 minutes for up to 3 doses during an acute angina attack, not every 15 minutes. If the chest pain persists after three doses, the client should seek immediate medical attention. Taking a tablet every 15 minutes would delay intervention and could be dangerous in an acute situation.

B) "Take this medication after each meal and at bedtime."
This is not the correct instruction for nitroglycerin use during an angina attack. Nitroglycerin tablets are typically used on an as-needed basis to relieve acute chest pain (angina). They are not intended for routine use after meals or at bedtime. If taken routinely for prevention of angina, the dosing regimen would be different, usually in the form of extended-release formulations.

C) "Take one tablet at the first indication of chest pain."
Nitroglycerin tablets are used to relieve chest pain (angina) by relaxing coronary arteries and improving blood flow to the heart. The client should take one tablet at the first sign of chest pain. If the pain does not resolve within 5 minutes, the client should take a second tablet, and a third if needed, with a total of 3 doses being the maximum before seeking emergency care. This allows for quick relief during an acute angina attack.

D) "Take this medication with 8 ounces of water."
Nitroglycerin tablets should not be taken with water. They are typically absorbed sublingually (under the tongue) and should not be swallowed or taken with water. Taking them with water could delay the absorption process and reduce their effectiveness.

A. Associated with recent vaccination B. Associated with tobacco use C. Recent surgical experience D. Presence of a thymus gland E. Associated with exposure to a recent viral infection

Correct Answer is ["A","C","E"]

Explanation

A) Associated with recent vaccination:
Vaccinations, particularly those for influenza and other viral infections, have been linked to an increased risk of GBS in some cases. This association is believed to be due to an immune response that may trigger the autoimmune attack on the peripheral nervous system, leading to GBS.

B) Associated with tobacco use:
While smoking has been associated with various health conditions, including respiratory and cardiovascular diseases, there is no established direct link between tobacco use and the development of GBS. The pathophysiology of GBS is more strongly related to infections and certain immune responses rather than lifestyle factors like smoking.

C) Recent surgical experience:
It is believed that the stress from surgery, particularly in the presence of an infection or immune response, may trigger the development of GBS. Infections, especially bacterial infections like those caused by Campylobacter jejuni, which is a common antecedent of GBS, can sometimes occur after surgery.

D) Presence of a thymus gland:

The thymus is involved in the immune system, particularly in the development of T-cells, but there is no direct correlation between the thymus gland and the onset of GBS. GBS is more closely related to infections (viral or bacterial), recent vaccinations, or surgery rather than anatomical features like the thymus.

E) Associated with exposure to a recent viral infection:
Viral infections such as Zika virus, Epstein-Barr virus, cytomegalovirus (CMV), influenza, and others can trigger an autoimmune response that leads to the development of GBS. Infections are the most common precipitating factor for GBS, and the immune system’s response to the viral infection may cause the body to mistakenly attack its own peripheral nerves, leading to the symptoms of GBS.

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A client in the emergency room begins to experience an acute asthma attack. The nurse expects that which medication will be used as initial treatment?

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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who has angina pectoris about starting therapy with nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication?

Correct Answer is C

Explanation

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Correct Answer is ["A","C","E"]

Explanation

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