The nurse is reviewing newly written prescriptions for a client diagnosed with acute bronchitis. The client has a productive cough with green sputum and shortness of breath. The nurse would question the primary care provider regarding which medication order?

Albuterol nebulizer 2.5 mg q 4 hours

Guaifenesin 1200 mg PO q 12 hours

Methylprednisolone 40 mg IV q 12 hours

Dextromethorphan 60 mg PO q 12 hours

Answer and Explanation

The Correct Answer is D

Choice A reason: Albuterol is a bronchodilator that helps to open up the airways, making it easier to breathe. It is commonly used in the treatment of acute bronchitis, especially if the patient is experiencing wheezing or shortness of breath. Albuterol works by relaxing the muscles around the airways, which helps to relieve symptoms of bronchospasm.

Choice B reason: Guaifenesin is an expectorant that helps to thin and loosen mucus in the airways, making it easier to cough up and clear out. This can be particularly helpful for a patient with a productive cough and green sputum, as it aids in clearing the respiratory passages. Guaifenesin is often used in the management of acute bronchitis to help alleviate symptoms.

Choice C reason: Methylprednisolone is a corticosteroid that helps to reduce inflammation in the airways. It can be beneficial in severe cases of acute bronchitis where there is significant inflammation and swelling of the bronchial tubes. Corticosteroids like methylprednisolone are used to decrease the inflammatory response and improve breathing.

Choice D reason: Dextromethorphan is a cough suppressant that works by affecting the signals in the brain that trigger the cough reflex. However, in the case of acute bronchitis with a productive cough, suppressing the cough can be counterproductive. The goal is to clear the mucus from the airways, and suppressing the cough can lead to mucus retention and potentially worsen the condition. Therefore, the use of a cough suppressant like dextromethorphan is not recommended in this scenario.

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Correct Answer is B

Explanation

Choice A reason: Lung sounds being clear bilaterally, both anterior and posterior, is a positive sign and indicates that there are no immediate obstructions or significant inflammation in the airways. However, it does not provide a comprehensive measure of asthma control over time. Asthma control is better assessed through objective measures like peak expiratory flow rate (PEFR) readings.

Choice B reason: Peak expiratory flow rate (PEFR) readings in the green zone indicate that the client’s asthma is well-controlled. The green zone typically represents 80-100% of the client’s personal best PEFR, suggesting that their airways are open and they are not experiencing significant bronchoconstriction. Regular monitoring of PEFR helps in assessing the effectiveness of the asthma management plan and making necessary adjustments to prevent exacerbations.

Choice C reason: Reporting shortness of breath when engaging in exercise suggests that the client’s asthma may not be fully controlled. Exercise-induced bronchoconstriction is a common issue in asthma, and experiencing symptoms during physical activity indicates that the current medication regimen may need adjustment.

Choice D reason: Having three occurrences of asthma exacerbations in the past month indicates poor asthma control. Frequent exacerbations suggest that the client’s asthma is not well-managed and that their medication regimen may need to be reviewed and adjusted.

A. Covers the mouth and nose when coughing. B. Reports daily to the public health department. C. Demonstrates correct use of the N95 mask. D. Washes dishes and personal items after use.

Correct Answer is A

Explanation

Choice A reason: Covering the mouth and nose when coughing is a critical measure to prevent the spread of tuberculosis (TB). TB is primarily transmitted through airborne particles when an infected person coughs, sneezes, or talks. By covering the mouth and nose, the client reduces the risk of spreading the bacteria to others, which is a fundamental goal of TB transmission education.

Choice B reason: Reporting daily to the public health department is important for monitoring and managing TB treatment, but it does not directly relate to preventing the transmission of TB. This action is more about ensuring adherence to treatment protocols and monitoring the client’s health status.

Choice C reason: Demonstrating correct use of the N95 mask is also crucial in preventing the spread of TB, especially in healthcare settings or when the client is in close contact with others. The N95 mask filters out airborne particles, including TB bacteria, thereby reducing the risk of transmission. However, this measure is typically emphasized in specific situations rather than as a general practice for all clients with TB.

Choice D reason: Washing dishes and personal items after use is good hygiene practice but is not specifically related to the transmission of TB. TB is not spread through contact with dishes or personal items but through airborne particles.

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The nurse is reviewing newly written prescriptions for a client diagnosed with acute bronchitis. The client has a productive cough with green sputum and shortness of breath. The nurse would question the primary care provider regarding which medication order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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