The family of a client, stung by a bee, has rushed the client to the emergency room. The client is experiencing hives and redness at the site. Upon arrival, the client states, "I feel a lump in my throat, and I am sweating. I can't breathe! I think I am going to die." The nurse anticipates which emergency treatment next?

Administer Albuterol 2 puffs stat.

Administer an injection of epinephrine stat.

Administer high-residual cannula.

Administer 5 mg prescription of the bee.

Answer and Explanation

The Correct Answer is B

Choice A reason : Albuterol is a bronchodilator often used in asthma to relieve symptoms of bronchospasm. While it can help open airways, in a case of anaphylaxis, it does not address the systemic histamine release and is not the first-line treatment¹.

Choice B reason : Epinephrine is the primary treatment for anaphylaxis, which is a severe allergic reaction that can occur after a bee sting. It works rapidly to improve breathing, stimulate the heart, reverse hives, and reduce swelling of the face, lips, and throat¹³. In an emergency situation where a patient is experiencing anaphylactic symptoms such as difficulty breathing and a feeling of a lump in the throat, immediate administration of epinephrine is critical to counteract the reaction.

Choice C reason : The term "high-residual cannula" does not correspond to a recognized medical treatment or device. In the context of anaphylaxis, oxygen may be administered via a high-flow nasal cannula if the patient is experiencing respiratory distress, but this would be secondary to the administration of epinephrine.

Choice D reason : The option "Administer 5 mg prescription of the bee" is nonsensical as it does not refer to a legitimate medical treatment. In the context of bee stings, no medication is prescribed as "prescription of the bee."

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Correct Answer is C

Explanation

Choice A reason : This statement is misleading. While heparin does need to reach a therapeutic level to be effective, it does not directly dissolve existing clots. Heparin's primary action is to prevent the formation of new clots and the extension of existing clots by inhibiting certain factors in the coagulation cascade.

Choice B reason : While a pharmacist can provide detailed information about medications, it is the nurse's responsibility to educate and inform the client about the effects of their treatment. Therefore, this response would not be appropriate.

Choice C reason : This is the most accurate response. Heparin works by inhibiting the formation of fibrin, which is essential for clot formation. It does not have the ability to dissolve existing clots but can prevent new ones from forming and existing ones from getting larger.

Choice D reason : Oral medications such as warfarin or direct oral anticoagulants (DOACs) may be used after heparin to maintain anticoagulation; however, they also do not dissolve clots. The body's natural fibrinolytic system is responsible for breaking down clots over time.

A. Abdominal distension B. Jugular venous distention C. Dependent edema D. Hacking cough

Correct Answer is D

Explanation

Choice A reason : Abdominal distension is more commonly associated with right-sided heart failure due to fluid accumulation in the abdominal cavity. Left-sided heart failure primarily affects the lungs, leading to respiratory symptoms¹.

Choice B reason : Jugular venous distention is typically a sign of right-sided heart failure, indicating increased pressure in the right atrium and venous system. It is not a primary symptom of left-sided heart failure¹.

Choice C reason : Dependent edema, or swelling in the lower extremities, is also more indicative of right-sided heart failure, where fluid accumulates due to poor venous return. In left-sided heart failure, fluid backs up into the lungs rather than the extremities¹.

Choice D reason : A hacking cough, especially when lying down, is a symptom of left-sided heart failure, as fluid backs up into the lungs causing pulmonary congestion. This can lead to coughing and shortness of breath, particularly during exertion or when lying flat¹.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

Correct Answer is C

Explanation

A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A patient has been taking oral prednisone for a few weeks after having a severe reaction to poison sumac. What would be an educational point the nurse would want to tell the patient regarding the sudden cessation of the drug?

A nurse is planning care for a client who has cirrhosis and ascites. Which of the following interventions should the nurse include in the plan of care?

A nurse is preparing a client who is to receive chemotherapy for the treatment of breast cancer. Which of the following actions should the nurse plan to take?

A nurse is teaching a client who has fibromyalgia about self-care strategies for managing the disorder. Which of the following information should the nurse include in the teaching?

A nurse is caring for a client who has heart failure and a potassium level of 2.4 mEq/L. The nurse should identify which of the following medications as contributing to this lab value?

A nurse is providing discharge instructions for a client who has congestive heart failure. Which of the following client statements indicates to the nurse that the teaching was effective?

A nurse is monitoring a client who has a leaking cerebral aneurysm. Which of the following manifestations should indicate to the nurse that the client is experiencing an increase in intracranial pressure (ICP)? (Select all that apply.)