Patient Data

History and Physical

A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue inhaler three times, but he just couldn't catch his breath. The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.
The nurse reviews the client's history of the presenting illness in the electronic medical record.

Click to highlight the two pieces of key subjective data which indicate the client is in need of health interventions.

The client reports using a rescue inhaler three times, but he just couldn't catch his breath

The client reports that symptoms seem worse when outdoors and when exercising

episodes like this make him extremely nervous

it has been a couple of months since he had an asthma attack

noticed that his inhaler was expired and was worried the medication was not working

Answer and Explanation

The Correct Answer is ["A"]

Subjective data refers to the symptoms reported by the client while objective data refers to the information collected on assessment of the client. During asthmatic attack, the client reports of shortness of breath, audible wheezing, inability to speak in complete sentences and a feeling of nervousness.

The use of a reliever without relief during an asthmatic attack indicates the severity of the attack. This requires intervention including the introduction of inhaled corticosteroids to reduce airway inflammation and remodeling.

The recurrence of symptoms on exposure to exercise requires the need for further advise to avoid triggers and recurrence of symptoms.

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Correct Answer is B

Explanation

B Restricting protein intake can help reduce the workload on the kidneys and minimize proteinuria (excess protein in the urine), which is common in glomerulonephritis. Limiting high-

protein foods, especially animal proteins, can help slow the progression of kidney damage and preserve kidney function.
A Increasing potassium intake is generally not recommended in glomerulonephritis, especially if the client has hyperkalemia (elevated potassium levels). In kidney disease, potassium levels can become elevated due to decreased excretion by the kidneys.
C Limiting oral fluid intake to 500 mL/day is not a suitable recommendation for most clients with glomerulonephritis. Adequate hydration is important for maintaining kidney function and preventing complications such as dehydration and electrolyte imbalances.
D While increasing fiber intake is generally beneficial for overall health and gastrointestinal function, it is not a specific dietary recommendation for clients with glomerulonephritis.

A. Right-sided heart failure. B. Left ventricular dysfunction. C. Cardiac tamponade. D. Internal bleeding.

Correct Answer is A

Explanation

A. Right-sided heart failure can lead to systemic venous congestion, resulting in symptoms such as pitting edema in the lower extremities and jugular venous distention. Increased central venous pressure is also characteristic of right-sided heart failure.
B. Left ventricular dysfunction typically presents with symptoms of pulmonary congestion, such as dyspnea, orthopnea, and crackles on lung auscultation. While left ventricular dysfunction can lead to right-sided heart failure over time, it is not typically associated with pitting edema of the lower extremities or jugular venous distention.
C. Cardiac tamponade is a medical emergency characterized by compression of the heart due to fluid accumulation in the pericardial sac, leading to impaired cardiac filling and hemodynamic compromise. While jugular venous distention may be present in cardiac tamponade due to elevated central venous pressure, pitting edema of the lower extremities is not a typical finding.
D. Internal bleeding may cause hypovolemia and hemodynamic instability, but it typically does not present with the specific findings of pitting edema of the lower extremities and jugular venous distention with increased central venous pressure.

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a client with glomerulonephritis about self-care. Which dietary recommendation should the nurse encourage the client to follow?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

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