A nurse admits a patient who has a diagnosis of acute asthma.
Which statement indicates that the patient may need teaching regarding medication use?
I became short of breath an hour before coming to the hospital.
I have been taking acetaminophen every 6 hours for chest wall pain.
I have been using my albuterol inhaler frequently over the last 4 days.
I have not had any acute asthma attacks during the past year.
The Correct Answer is C
Choice A rationale
This statement describes the onset of the patient's current symptoms, which is important information for assessment but does not indicate a knowledge deficit about medication use. It simply provides context for the acute asthma exacerbation they are experiencing, assisting in understanding the disease progression.
Choice B rationale
Taking acetaminophen for chest wall pain is a symptomatic treatment and does not necessarily indicate a lack of understanding about asthma medications. Chest wall pain can be a secondary symptom of asthma exacerbation due to increased respiratory effort, and acetaminophen is a common analgesic for such discomfort.
Choice C rationale
Frequent use of a rescue inhaler, such as albuterol, over several days indicates inadequate control of asthma and a potential over-reliance on a short-acting bronchodilator. This suggests a need for teaching about proper medication use, including the role of maintenance medications and when to seek medical attention for worsening symptoms.
Choice D rationale
This statement indicates good asthma control over the past year, which is a positive outcome. It does not suggest a need for medication teaching; rather, it implies adherence to a successful management plan or a period of disease remission. This patient's statement is reassuring, not concerning.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Atenolol is a beta-blocker primarily used to treat hypertension, angina, and certain arrhythmias. It acts by blocking beta-adrenergic receptors, reducing heart rate and blood pressure. It is not indicated for the acute management of status epilepticus, which requires rapid cessation of seizure activity.
Choice B rationale
Lorazepam is a benzodiazepine that enhances the effect of the inhibitory neurotransmitter GABA in the brain. This leads to generalized central nervous system depression, effectively terminating ongoing seizure activity. Its rapid onset of action makes it a first-line medication for status epilepticus.
Choice C rationale
Phenytoin is an anticonvulsant commonly used for long-term seizure control. While it can be used to prevent recurrence of seizures after initial control of status epilepticus, its onset of action is slower compared to benzodiazepines, making it less suitable for immediate termination of ongoing status epilepticus.
Choice D rationale
Lisinopril is an ACE inhibitor used to treat hypertension and heart failure. It works by inhibiting the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced blood pressure. It has no direct antiepileptic properties and is not indicated for the management of status epilepticus.
Correct Answer is ["C","E"]
Explanation
Choice A rationale
Instructing the client to blow their nose should be avoided during epistaxis, as it can dislodge any forming clots, exacerbate bleeding, and potentially increase intracranial pressure temporarily, particularly if associated with hypertension. The primary goal is to promote vasoconstriction and clot formation.
Choice B rationale
Tilting the client's head backward is contraindicated during epistaxis because it can cause blood to flow down the posterior pharynx, leading to swallowing of blood, which can irritate the stomach and induce nausea or vomiting. Aspiration of blood is also a potential risk.
Choice C rationale
Applying ice to the bridge of the client's nose causes local vasoconstriction, which helps to reduce blood flow to the area and promote hemostasis. The cold temperature induces reflex vasoconstriction in the nasal vasculature, thereby helping to slow or stop the bleeding.
Choice D rationale
Moving the client into a high-Fowler's position is beneficial as it reduces venous pressure in the head and neck, thereby decreasing blood flow to the nasal vasculature and minimizing bleeding. Gravity assists in lowering hydrostatic pressure in the affected vessels, facilitating clot formation.
Choice E rationale
Applying direct pressure to the nares (soft part of the nose) for at least 10-15 minutes is a fundamental and highly effective first-line intervention for epistaxis. This direct pressure helps to compress the bleeding vessels, allowing for clot formation and cessation of hemorrhage.
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