After change of shift, the nurse has the following patients on her assignment. Which one should she see first?

A 50-year-old with COPD and a Spo2 of 90%

A 72-year-old with pneumonia who needs his antibiotic

A 37-year-old with asthma who reported that he is still having shortness of breath after using his inhaler

A68-year-old on a CPAP who needs a sputum specimen sent to the lab

Answer and Explanation

The Correct Answer is C

C. Persistent shortness of breath after using an inhaler could indicate an inadequate response to treatment or worsening asthma exacerbation. The nurse should therefore see this patient first.
A. In COPD patients pulse oximetry oxygen saturations of more than 90% are acceptable. In the treatment of exacerbations of chronic obstructive pulmonary disease (COPD), oxygen should be titrated to achieve a target oxygen saturation range of 88-92%. This results in a greater than twofold reduction in mortality, compared with the routine administration of high-concentration oxygen therapy.
B. Administering antibiotics can be prioritized, but it may not require immediate attention compared to addressing acute respiratory distress or hypoxemia.
D. Collecting a sputum specimen for laboratory analysis is important for diagnosing and managing respiratory infections, but it may not be as time-sensitive as addressing acute respiratory distress or hypoxemia.

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Correct Answer is ["B","C","D","E"]

Explanation

B. Beta-blocking medications, such as propranolol and metoprolol, can worsen asthma symptoms in some individuals by constricting the airways. Patients with asthma should avoid or use caution with beta-blockers, especially non-selective ones, as they can trigger or exacerbate asthma attacks.
C. Exposure to secondhand smoke is a well-established trigger for asthma symptoms and can exacerbate respiratory inflammation and airway hyperresponsiveness. Patients with asthma should avoid exposure to secondhand smoke whenever possible to reduce the risk of asthma exacerbations.
D. Carpeting and drapes can harbor dust mites, pet dander, and other allergens that can trigger asthma symptoms in susceptible individuals. Patients with asthma may benefit from removing carpeting and minimizing soft furnishings in the bedroom to reduce exposure to allergens and improve air quality.
E. Pets, particularly those with fur or feathers, can be potent allergens for individuals with asthma. Patients with asthma should consider removing pets from the home or at least keeping them out of the bedroom to minimize exposure to pet dander.
A. Cardiovascular exercise can trigger asthma symptoms in some individuals but it is not typically recommended to eliminate exercise altogether. Instead, patients with asthma should be encouraged to engage in physical activities that are well-tolerated and to use appropriate preventive measures, such as pre-exercise bronchodilator therapy and warm-up exercises, to minimize symptoms.

A. diminished breath sounds B. ruddy skin color C. use of accessory muscles D. excess mucus production E. barrel shaped chest

Correct Answer is ["A","C","E"]

Explanation

A. Diminished breath sounds can occur in emphysema due to decreased air movement through damaged and enlarged air sacs (alveoli). The destruction of alveolar walls reduces the surface area available for gas exchange and can result in decreased breath sounds.
C. Patients with emphysema may use accessory muscles, such as neck and shoulder muscles, to assist with breathing during periods of respiratory distress. These muscles are recruited to help increase the size of the thoracic cavity and improve airflow.
E. A barrel-shaped chest is a common physical finding in patients with emphysema. It results from hyperinflation of the lungs and is characterized by an increased anterior-posterior diameter of the chest. This change in chest shape is due to air trapping in the lungs, leading to overinflation of the alveoli and increased residual volume.
B. Ruddy skin color, which refers to a reddish or flushed complexion, is not typically associated with emphysema. Instead, patients with emphysema may exhibit cyanosis (bluish discoloration of the skin) during periods of hypoxemia (low oxygen levels).
D. Excess mucus production (mucus hypersecretion) is a characteristic feature of chronic bronchitis, which is often present alongside emphysema in chronic obstructive pulmonary disease (COPD) but it is not typically a primary feature of emphysema itself.

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After change of shift, the nurse has the following patients on her assignment. Which one should she see first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate? Select all that apply. (Select All that Apply.)

Correct Answer is ["B","C","D","E"]

Explanation

The patient with emphysema comes to the emergency department with difficulty breathing. What finding should the nurse anticipate during data collection? Select all that apply

Correct Answer is ["A","C","E"]

Explanation

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