A client is in the emergency department after being rescued from a house fire. After the initial assessment, the client develops a loud, brassy cough. What intervention by the nurse takes priority?

Allow the client to suck on small quantities of ice chips.

Apply oxygen and continuous pulse oximetry.

Have the respiratory therapist provide humidified room air.

Request an antitussive medication from the physician.

Answer and Explanation

The Correct Answer is B

A. Sucking on small quantities of ice chips is not appropriate in this case as it may worsen the airway obstruction or cause further irritation.

B. Applying oxygen and continuously monitoring the client's pulse oximetry will help ensure that the client's oxygen saturation remains adequate and that they do not experience respiratory distress or hypoxemia due to inhalation injury. Early intervention is crucial to prevent worsening of respiratory status.

C. Humidified room air can help in cases of airway irritation, but the priority is to ensure oxygenation and avoid hypoxia.

D. Antitussive medications may be indicated later, but airway management and oxygenation take precedence.

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Correct Answer is D

Explanation

A. Increasing IV fluids would exacerbate the client's fluid overload and worsen heart failure symptoms.

B. Trendelenburg positioning is typically used for shock management, but this client’s fluid overload needs to be addressed first.

C. Monitoring is important but does not address the immediate need to manage fluid overload.

D. The client's elevated CVP, PAWP, and BNP levels indicate fluid overload and heart failure with reduced ejection fraction. The priority is to reduce fluid overload by administering IV diuretics, which will help reduce the pressure in the heart and lungs, improving oxygenation and decreasing the risk of pulmonary edema.

A. The medication must be given slow intravenous IV push. B. Asystole may occur for a few seconds after administration. C. The medication has a long half life, and therefore the duration of action is very long. D. The onset of action occurs in 5 minutes.

Correct Answer is B

Explanation

A. The medication must be given as a rapid intravenous IV push due to its short half-life not slowly.

B. Asystole is a common and expected response after adenosine administration.

C. Adenosine has a very short half-life, contrary to this statement.

D. The onset of action is immediate, not in 5 minutes.

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A client is in the emergency department after being rescued from a house fire. After the initial assessment, the client develops a loud, brassy cough. What intervention by the nurse takes priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

The nurse is preparing to administer adenosine (Adenocard) to a client experiencing supraventricular tachycardia. When giving this medication, what is important to remember?

Correct Answer is B

Explanation

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