Exhibits

Which of the following is the most appropriate initial management for this patient?

Perform needle decompression of the pleural space followed by chest tube insertion.

Prescribe bronchodilators and schedule a pulmonary function test.

Administer oral antibiotics and arrange follow-up in a week.

Initiate high-flow oxygen therapy and monitor the patient.

Answer and Explanation

The Correct Answer is C

A. Nasal saline irrigation alone: While nasal saline irrigation can help to clear out mucus and congestion, it is often not sufficient to treat bacterial sinusitis.

B. Oral decongestants alone: Decongestants may provide temporary relief of symptoms but are not effective against bacterial infections.

C. Oral antibiotics: Antibiotics are the most appropriate treatment for acute bacterial sinusitis, as they can target the underlying infection.

D. Intranasal corticosteroids alone: Corticosteroids can be helpful for managing allergic rhinitis but are not effective against bacterial infections.

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Correct Answer is C

Explanation

A. Dry oral mucous membranes can occur with the use of inhalers but are not a serious adverse effect of beclomethasone. It can be managed with proper hydration and is not typically a cause for concern.
B. Tremors are more commonly associated with bronchodilators, such as beta-agonists, rather than corticosteroids like beclomethasone. They are not a typical side effect of beclomethasone MDI.
C. A white coating in the mouth may indicate oral thrush, a fungal infection caused by Candida species, which is a known adverse effect of inhaled corticosteroids like beclomethasone. The client should be instructed to rinse their mouth after each use to prevent this complication and report any signs of oral thrush to the provider.
D. Nausea is not a common adverse effect of inhaled corticosteroids. It is more often associated with systemic medications rather than inhaled therapies.

A. Impaired carbon dioxide elimination due to shunting B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch C. Hypoxemia due to dead space D. Decreased pulmonary compliance due to stiffness

Correct Answer is D

Explanation

A. Impaired carbon dioxide elimination due to shunting: Shunting in ARDS affects oxygenation rather than carbon dioxide elimination. ARDS primarily results in impaired gas exchange due to inflammation and fluid accumulation in the alveoli, affecting oxygen rather than CO2.

B. Decreased pulmonary arterial pressure due to ventilation-perfusion (V/Q) mismatch: ARDS typically leads to increased pulmonary arterial pressure due to inflammation and decreased lung compliance. The V/Q mismatch contributes to impaired gas exchange, often resulting in elevated pulmonary arterial pressure rather than decreased.

C. Hypoxemia due to dead space: In ARDS, hypoxemia is primarily due to impaired gas exchange from damaged alveoli, not due to dead space. Dead space refers to areas where ventilation occurs without adequate blood flow, which is not the main issue in ARDS.

D. Decreased pulmonary compliance due to stiffness: ARDS is characterized by decreased pulmonary compliance due to the stiffness of the lung tissue caused by inflammation and edema. This decreased compliance makes lung expansion more difficult, which is a central feature of ARDS.

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Exhibits Which of the following is the most appropriate initial management for this patient?

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using beclomethasone MDI. For which of the following findings should the nurse instruct the client to monitor and report to the provider as an adverse effect of the medication?

Correct Answer is C

Explanation

A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

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Exhibits

Which of the following is the most appropriate initial management for this patient?