A nurse assesses a client who presents to the provider's office to evaluate multiple nevi. Which finding should the nurse identify to the provider as possible sign of malignancy?

A) Prednisone:
Prednisone is a corticosteroid commonly used to reduce inflammation in conditions such as asthma. It is appropriate in this case for managing the asthma exacerbation, as steroids help to decrease airway inflammation and improve breathing. There is no immediate concern about prednisone in this client with both asthma and a history of heart failure.

B) Metoprolol:
Metoprolol is a beta-blocker, typically used for managing heart failure, hypertension, and arrhythmias. However, beta-blockers are generally avoided in asthma patients because they can exacerbate bronchospasm. In patients with asthma, beta-blockers can block beta-2 receptors in the lungs, leading to constriction of the airways and worsening respiratory symptoms.

C) Labetolol:
Labetolol is a beta-blocker with both alpha- and beta-blocking effects, which can help lower blood pressure and manage heart failure. While labetalol can also block beta-2 receptors, it has a relatively lower risk of causing bronchospasm compared to non-selective beta-blockers like metoprolol. However, it still poses some risk to patients with asthma. Given the patient's history of asthma, labetolol may still require caution, but it is generally considered safer than other beta-blockers.

D) Albuterol:
Albuterol is a bronchodilator used to relieve acute asthma symptoms and is commonly prescribed for asthma exacerbations. It works by stimulating beta-2 receptors in the lungs, leading to the relaxation of bronchial smooth muscles and improved airflow. In this case, albuterol is an appropriate medication for managing asthma exacerbation and should be used to relieve symptoms of shortness of breath and wheezing.

A) Normal saline 1 liter to client who is dehydrated:
Administering normal saline to a dehydrated client is an important task, as it helps to restore fluid balance and improve circulatory volume. However, while rehydration is critical, it is not an immediate, life-threatening priority compared to other interventions. The nurse should begin this infusion after addressing more urgent needs such as severe chest pain, which could indicate a cardiac emergency.

B) Morphine sulfate 4mg intravenously (IV) now for the client experiencing incisional pain:
Morphine is a potent analgesic, and relieving pain for postoperative patients is essential for comfort and recovery. However, incisional pain, although important to address, is not life-threatening in this scenario. The client with chest pain should be prioritized because chest pain could indicate a myocardial infarction (MI) or other serious cardiac event that requires immediate intervention.

C) Nitroglycerin (Nitrostat) 0.4 mg sublingually (SL) stat for the client experiencing crushing chest pain:
Crushing chest pain is a classic symptom of acute myocardial infarction (MI), a life-threatening condition that requires immediate intervention. Nitroglycerin is used to relieve chest pain associated with angina or MI by dilating the coronary arteries and improving blood flow to the heart. In this case, chest pain is the most critical symptom, and immediate treatment is necessary to reduce the risk of further cardiac damage or complications.

D) Lorazepam 2 mg IV now for the client who is anxious and restless:
While lorazepam is an effective medication for anxiety and restlessness, it is not the most urgent medication in this case. The client’s anxiety should be addressed, but it does not pose an immediate threat to life. Anxiety can generally be managed after more acute, life-threatening conditions (such as chest pain) are stabilized.