A patient with asthma is admitted with severe dyspnea and is unable to speak. The nurse finds that the patient looks drowsy and confused. Which other finding would the nurse expect?

Peak flow of more than 40%

Bradycardia

Loud and prominent wheezing

Arterial blood gas is deteriorating

Answer and Explanation

The Correct Answer is D

A. A peak flow of more than 40% would indicate that the patient's asthma is not in an acute exacerbation. This patient's symptoms, such as confusion and inability to speak, suggest a severe asthma attack, and the peak flow would likely be much lower.
B. Bradycardia is not typically associated with severe asthma exacerbations. Tachycardia is more commonly observed as the body attempts to compensate for hypoxia.
C. Loud and prominent wheezing is usually seen in less severe cases of asthma. In this case, the inability to speak and confusion suggest severe respiratory distress, where wheezing might be diminished or absent due to poor air movement.
D. Deteriorating arterial blood gas (ABG) results, with low oxygen levels (hypoxemia) and elevated carbon dioxide levels (hypercapnia), would be expected in a patient with severe asthma exacerbation. These signs indicate respiratory failure and the need for urgent intervention.

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Correct Answer is C

Explanation

A. The head of the bed should be elevated to at least 30-45 degrees to help prevent aspiration and reduce the risk of ventilator-associated pneumonia (VAP). Flat positioning increases the risk of aspiration and subsequent pneumonia.
B. Humidification is important for preventing drying of the respiratory passages but does not directly reduce the risk of VAP.
C. Turning the client every 2 hours (not just 4) is a key practice to prevent VAP by improving lung expansion, promoting drainage, and reducing the risk of ventilator-associated pneumonia.
D. Oral care, including brushing the teeth, should be done more frequently than every 12 hours. The current guidelines recommend brushing the client's teeth every 4-6 hours and using suctioning as needed to prevent oral bacterial buildup that can lead to VAP.

A. Maintain an IV of 0.45% sodium chloride. B. Restrict fluid intake to 1,000 mL per day. C. Provide a diet containing 2 g of sodium per day. D. Administer desmopressin acetate 0.2 mg orally.

Correct Answer is B

Explanation

A. Maintaining an IV of 0.45% sodium chloride would not be appropriate for SIADH because it is a hypotonic solution, and it could exacerbate the already low sodium levels in the patient, potentially worsening hyponatremia.
B. Fluid restriction is the primary treatment for SIADH as it helps reduce water retention, which is causing the dilution of sodium in the blood. Restricting fluid intake to 1,000 mL per day helps manage hyponatremia in these patients.
C. A diet containing 2 g of sodium per day is not typically indicated in SIADH. Restricting fluid is the main focus, and increasing sodium intake can often be counterproductive in SIADH, as the sodium imbalance is primarily due to excessive water retention.
D. Desmopressin acetate is typically used in diabetes insipidus, not SIADH. Desmopressin acts as an antidiuretic hormone (ADH) agonist, which would worsen the water retention in SIADH, not improve it.

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A patient with asthma is admitted with severe dyspnea and is unable to speak. The nurse finds that the patient looks drowsy and confused. Which other finding would the nurse expect?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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