An 82-year-old client with COPD presents with restlessness, dyspnea, pursed lips, and tripod position complaining of "not being able to breathe". The nurse should question which of the following orders?

Rescue inhaler

Diazepam

Ipratropium

Hydromorphone

Oxygen via nasal cannula 2 L/min

Answer and Explanation

Correct Answer : B,D

A.   Rescue inhaler is appropriate for a COPD exacerbation as it helps to dilate the airways and improve breathing.
B.   Diazepam is a benzodiazepine, which is a sedative. Sedating a patient with severe respiratory distress is contraindicated as it can further depress respiratory drive.
C.   Ipratropium is a bronchodilator and is appropriate for COPD exacerbations.
D.   Hydromorphone is an opioid analgesic. Opioids can depress respiratory drive, which is especially dangerous for patients with respiratory compromise such as COPD.
E.   Oxygen is essential for patients with COPD exacerbations.

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

Explanation

A. Pink mucous membranes indicates adequate oxygenation, which is a positive sign.
B. SpO2 of 97% is a normal oxygen saturation level and does not indicate respiratory decline.
C. While wheezing is a common symptom of an asthma attack, it doesn't necessarily indicate worsening respiratory status. It can be present even in mild to moderate attacks.
D. Retraction of sternal muscles is a sign of severe respiratory distress, indicating that the patient is working extremely hard to breathe.
E. An increased heart rate can be a sign of the body trying to compensate for decreased oxygen levels, indicating worsening respiratory status.

A. Hypernatremia, and subsequent seizures B. Hyponatremia, and subsequent water intoxication C. Hyperkalemia, and subsequent seizures D. Fluid volume overload, and subsequent crackles in the lungs

Correct Answer is A

Explanation

A. Hypernatremia is a condition where the sodium level in the blood is abnormally high. This occurs in DI due to excessive water loss without adequate replacement. Seizures can be a serious complication of severe hypernatremia as it disrupts the normal function of the brain.
B. Hyponatremia is low sodium levels, which is opposite to what happens in DI.
C. Hyperkalemia is high potassium levels, unrelated to DI.
D. Fluid volume overload is also opposite to what happens in DI, as patients with DI lose excessive fluids.

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An 82-year-old client with COPD presents with restlessness, dyspnea, pursed lips, and tripod position complaining of "not being able to breathe". The nurse should question which of the following orders?

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Naxlex Comprehensive Predictor Exams

A nurse in the emergency department is caring for a client who is experiencing an acute asthma attack. Which of the following statements indicates that the respiratory status is declining?

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

Explanation

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Correct Answer is A

Explanation

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