Exhibits

A nurse is reviewing the medical record of a school-age child who has asthma. Which of the following prescriptions should the nurse anticipate administering? (Click on the "Exhibit" button for additional information about the client. There are three tabs that contain separate categories of data.)

Chest physiotherapy four times per day

Ice packs to the groin

A cough suppressant

Corticosteroid via intermittent IV bolus

Answer and Explanation

The Correct Answer is D

A. Chest physiotherapy four times per day: While chest physiotherapy can help with clearing mucus, it is not indicated as the first-line intervention for asthma exacerbation. The child’s primary issue is difficulty with airway constriction and inflammation, not just mucus buildup.

B. Ice packs to the groin: Ice packs are not appropriate for this child’s asthma exacerbation. Ice packs are generally used for managing inflammation or injury, not for asthma exacerbations.

C. A cough suppressant: The cough is a symptom of the underlying asthma exacerbation and needs to be managed with bronchodilators and anti-inflammatory medications to treat the underlying cause, not suppressed.

D. Corticosteroid via intermittent IV bolus: The child has signs of a moderate to severe asthma exacerbation, including wheezing, intercostal retractions, a decreased peak flow, and oxygen saturation of 88%, which indicates poor ventilation. Corticosteroids are used to reduce inflammation and improve airway function.

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Correct Answer is A

Explanation

A. A diuretic: The client’s potassium level of 6.4 mEq/L indicates hyperkalemia. One of the treatments for hyperkalemia is the administration of a diuretic, specifically a potassium-wasting diuretic, which helps lower potassium levels by increasing urine output.

B. An anticonvulsant: Anticonvulsants are used to manage seizures, not hyperkalemia. While seizures can occur in severe hyperkalemia, the first line of treatment is to address the elevated potassium level, not administer an anticonvulsant.

C. A fiber supplement: Fiber supplements are used for constipation, not for managing electrolyte imbalances. In fact, some types of fiber supplements may increase potassium absorption, which could worsen hyperkalemia.

D. A potassium supplement: Potassium supplements should never be given in cases of hyperkalemia, as they would further elevate potassium levels, worsening the imbalance. Potassium supplements are only indicated when potassium levels are low.

A. A school-age child who is 2 days postoperative following an appendectomy and has a nasogastric tube B. A school-age child who reports nausea following chemotherapy C. A preschooler awaiting discharge instructions prior to leaving the hospital D. A toddler who has a respiratory rate of 54/min

Correct Answer is D

Explanation

A. A school-age child who is 2 days postoperative following an appendectomy and has a nasogastric tube: While this child may need attention, there is no indication that they are in immediate distress. This client is stable and does not require immediate assessment.

B. A school-age child who reports nausea following chemotherapy: Nausea following chemotherapy is a common side effect, and the child is likely to be managed with antiemetic medications. Although this is an important concern, it is not immediately life-threatening.

C. A preschooler awaiting discharge instructions prior to leaving the hospital: This child is stable, and the priority is to ensure that discharge instructions are properly understood. However, this situation is not urgent or emergent.

D. A toddler who has a respiratory rate of 54/min: A respiratory rate of 54/min in a toddler is above the normal range (normal: 24–40/min). This may indicate respiratory distress or other complications, making this client the highest priority for immediate assessment.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an electrolyte imbalance with a potassium level of 6.4 mEq/L. Which of the following should the nurse administer?

Correct Answer is A

Explanation

A nurse is planning care for a group of clients following change-of-shift report. When using clinical decision making, which of the following clients should the nurse assess first?

Correct Answer is D

Explanation

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