A patient with a history of asthma is admitted to the emergency department with severe wheezing, shortness of breath, and retractions. After initial administration of albuterol via nebulizer, the patient's symptoms persist. What is the next best course of action for managing this patient's asthma exacerbation?

Initiate intravenous corticosteroids

Provide supplemental oxygen and reassess in 30 minutes.

Administer a second dose of albuterol immediately.

Administer an oral antihistamine to reduce airway inflammation.

Answer and Explanation

The Correct Answer is A

A.   Intravenous corticosteroids are the next appropriate step to reduce inflammation in the airways and improve symptoms of asthma exacerbation.
B.   Providing supplemental oxygen and reassessing in 30 minutes might be necessary, but corticosteroids are the priority in this case to address the underlying inflammation.
C.   A second dose of albuterol may be considered, but corticosteroids should be administered as soon as possible to treat the inflammation in the airways.
D.   An oral antihistamine is not indicated for asthma exacerbations, as it does not target the underlying inflammation in the airways.

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Correct Answer is D

Explanation

A. Administering feeding solution directly from the refrigerator can cause discomfort to the patient and increase the risk of gastric upset.
B. Flushing the tube with cold water is not appropriate, as it may irritate the stomach and cause discomfort.
C. Positioning the patient supine at 30 degrees is unsafe, as it increases the risk of aspiration. The patient should be at a higher angle, typically 30-45 degrees.
D. Verifying the pH of gastric aspirate is crucial to ensure the feeding tube is in the correct position and to prevent aspiration of feeding material into the lungs.

A. Advise the patient to take antacids only when severe pain occurs. B. Instruct the patient to eat three large meals per day. C. Encourage the patient to smoke to reduce stress. D. Recommend increased intake of spicy foods to boost metabolism. E. Suggest the patient use NSAIDS for pain relief. F. Advise the patient to drink coffee to help with digestion. G. Administer proton pump inhibitors as prescribed. H. Encourage the patient to consume a bland diet.

Correct Answer is ["G","H"]

Explanation

A. Advising the patient to take antacids only when severe pain occurs may not be effective. Antacids should be used regularly or as prescribed for consistent symptom relief.
B. Instructing the patient to eat three large meals per day may exacerbate symptoms; smaller, more frequent meals are often better for managing gastritis.
C. Encouraging smoking to reduce stress is harmful, as smoking can exacerbate gastritis and increase stomach acid production.
D. Spicy foods should be avoided in gastritis, as they can irritate the stomach lining.
E. NSAIDs should be avoided in gastritis because they can irritate the gastric mucosa and worsen symptoms.
F. Coffee can stimulate acid production and may irritate the stomach lining, so it should be avoided.
G. Proton pump inhibitors (PPIs) help reduce gastric acid secretion and are a mainstay treatment for gastritis.
H. A bland diet is recommended, as it avoids irritating foods and allows the stomach lining to heal.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer an enteral feeding to a patient with a gastrostomy tube. Before starting the feeding, which of the following actions should the nurse take to ensure patient safety?

Correct Answer is D

Explanation

A patient is diagnosed with gastritis after presenting with abdominal discomfort and nausea. As a nurse, which interventions would be appropriate for managing this patient's condition? (Select All that Apply.)

Correct Answer is ["G","H"]

Explanation

A nurse is caring for a client who has multiple sclerosis and is experiencing progressive multifocal leukoencephalopathy (PML). Which of the following medications should the nurse recognize is associated with the development of PML?

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A nurse is educating a client about the risk factors for GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include?

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A patient with COPD is receiving oxygen therapy. Which considerations are important to ensure safe and effective oxygen administration for this patient? (Select All that Apply.)