An adult patient is admitted for an asthma attack. Which assessment obtained by the nurse would support that beta2 adrenergic agonist albuterol was effective?
Decrease in wheezing present on auscultation
Respiratory rate increased to 38 breaths/min
Sputum production is clear and watery
Use of neck muscles
The Correct Answer is A
Choice A reason: Decrease in wheezing present on auscultation indicates that albuterol was effective. Albuterol is a bronchodilator that relaxes the smooth muscles of the airways and reduces the airway resistance. This improves the airflow and reduces the wheezing sound that is caused by the turbulent flow of air through the narrowed airways.
Choice B reason: Respiratory rate increased to 38 breaths/min does not indicate that albuterol was effective. It indicates that the patient is still experiencing respiratory distress and hypoxia. The normal respiratory rate for adults is 12 to 20 breaths/min. A high respiratory rate can also be a side effect of albuterol, as it can stimulate the sympathetic nervous system and increase the heart rate and blood pressure.
Choice C reason: Sputum production is clear and watery does not indicate that albuterol was effective. It indicates that the patient has a productive cough and is expelling mucus from the lungs. Sputum production is not directly affected by albuterol, as it does not have anti-inflammatory or mucolytic properties.
Choice D reason: Use of neck muscles does not indicate that albuterol was effective. It indicates that the patient is using accessory muscles to breathe and is exerting more effort to inhale. This is a sign of severe respiratory distress and airway obstruction. Albuterol should relieve the bronchospasm and reduce the need for accessory muscle use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not the cause of airway obstruction in asthma. Collapse of the cartilaginous rings in the bronchi is a feature of tracheobronchomalacia, a condition in which the airways are weak and floppy.
Choice B reason: This is not the cause of airway obstruction in asthma. Type II alveolar cell injury and decreased surfactant are associated with acute respiratory distress syndrome (ARDS), a condition in which the alveoli are damaged and filled with fluid.
Choice C reason: This is not the cause of airway obstruction in asthma. Alveolar changes and pulmonary congestion are seen in chronic obstructive pulmonary disease (COPD), a condition in which the alveoli are enlarged and lose their elasticity.
Choice D reason: This is the correct cause of airway obstruction in asthma. Asthma is a chronic inflammatory disorder of the airways, characterized by mucus secretion, bronchoconstriction, and airway edema. These factors reduce the diameter of the airways and increase the resistance to airflow.
Correct Answer is ["B","C"]
Explanation
Choice A reason: Oliguria is not a forward effect of left ventricular heart failure. It is a backward effect that occurs due to reduced renal perfusion and activation of the renin-angiotensin-aldosterone system.
Choice B reason: Increased heart rate is a forward effect of left ventricular heart failure. It is a compensatory mechanism that occurs due to reduced cardiac output and sympathetic stimulation.
Choice C reason: Wet cough is a forward effect of left ventricular heart failure. It is a sign of pulmonary congestion and edema that result from increased pressure in the pulmonary veins and capillaries.
Choice D reason: Confusion is not a forward effect of left ventricular heart failure. It is a backward effect that occurs due to reduced cerebral perfusion and hypoxia.
Choice E reason: Jugular venous distention is not a forward effect of left ventricular heart failure. It is a backward effect that occurs due to increased pressure in the right atrium and vena cava.
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