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 ["A","C","D","G"]

Explanation

A. Smoking can exacerbate GERD symptoms. It weakens the lower esophageal sphincter (LES), increasing the likelihood of acid reflux.
B. GERD is not primarily caused by excessive production of stomach acid. It is usually due to a failure of the lower esophageal sphincter to prevent the backflow of stomach contents into the esophagus.
C. GERD is caused by the relaxation of the lower esophageal sphincter. When the LES is weakened or relaxes abnormally, acid can reflux into the esophagus, causing symptoms.
D. Elevating the head of the bed can help reduce GERD symptoms. It helps to prevent acid from moving back into the esophagus during sleep.
E. A diet high in citrus fruits is not recommended for GERD management. Citrus fruits can aggravate acid reflux symptoms.
F. Antibiotics are not the first-line treatment for GERD. Proton pump inhibitors (PPIs) or H2 blockers are typically used to manage GERD symptoms.
G. Obesity is a risk factor for GERD. It can increase intra-abdominal pressure, which may contribute to the reflux of acid into the esophagus.

A. Perform weight bearing exercises 2 times per week. B. Increase intake of caffeinated beverages. C. Take 400 IU of vitamin D per day. D. Limit calcium intake to 600 mg per dose.

Correct Answer is A

Explanation

A. Performing weight-bearing exercises, such as walking, jogging, or strength training, helps improve bone density and prevent osteoporosis-related fractures.
B. Caffeine can increase calcium excretion in the urine and may negatively affect bone health, so it is not recommended for clients at risk for osteoporosis.
C. Taking 400 IU of vitamin D per day may be insufficient for clients at risk for osteoporosis. Most guidelines recommend at least 800-1,000 IU of vitamin D daily.
D. Limiting calcium intake to 600 mg per dose is not recommended. Calcium should be taken in doses of 500-600 mg to improve absorption and bone health.

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Naxlex Comprehensive Predictor Exams

A nursing student is reviewing the pathophysiology and management of Gastroesophageal Reflux Disease (GERD). Which of the following statements are accurate regarding GERD? (Select All that Apply.)

Correct Answer is ["A","C","D","G"]

Explanation

A nurse is teaching a client who is at risk for osteoporosis. Which of the following instructions should the nurse include?

Correct Answer is A

Explanation

A 55-year-old patient with newly diagnosed Type II Diabetes Mellitus is being educated on lifestyle modifications to manage their condition. Which of the following dietary recommendations would be most effective in controlling their blood glucose levels?

A nurse is reviewing the potential complications associated with peptic ulcer disease (PUD). Which of the following conditions should the nurse recognize as possible complications of PUD? (Select All that Apply.)

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.)

A nurse is caring for a client who has metabolic alkalosis. Which of the following actions should the nurse take?

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?

A nurse is providing teaching to a client who has long-term symptoms of GERD (gastroesophageal reflux disease). Which of the following statements should the nurse include in the educational materials?

A 50-year-old male patient with a history of chronic alcoholism presents with fatigue, glossitis, and peripheral neuropathy. Laboratory findings show a hemoglobin level of 9.0 g/dL and mean corpuscular volume (MCV) of 110 fL. What type of anemia is most likely in this patient?