The nurse recognizes the assessment data which best indicates that the client diagnosed with asthma is achieving good control with the prescribed medication regimen is when:
Lung sounds are clear bilaterally, both anterior and posterior.
Peak expiratory flow rate readings are in the green zone.
Client reports shortness of breath when engaging in exercise.
There were three occurrences of asthma exacerbations in the past month.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
A sputum culture of Mycobacterium tuberculosis is the definitive test for diagnosing tuberculosis (TB). This test involves collecting a sputum sample and culturing it to detect the presence of Mycobacterium tuberculosis, the bacteria that cause TB. It is considered the gold standard for confirming active TB infection.
Choice B reason:
The Tuberculin (PPD) skin test, also known as the Mantoux test, is used to screen for TB infection. It can indicate whether a person has been exposed to TB bacteria, but it cannot confirm active TB disease. A positive result requires further testing, such as a sputum culture, to confirm the diagnosis.
Choice C reason:
An acid-fast bacillus (AFB) smear is a quick test that can detect the presence of mycobacteria in a sputum sample. While it can provide a preliminary indication of TB, it is not definitive. A positive AFB smear must be followed by a sputum culture to confirm the diagnosis.
Choice D reason:
A chest X-ray can show abnormalities in the lungs that are suggestive of TB, such as cavities or infiltrates. However, it cannot confirm the diagnosis on its own. Chest X-rays are used in conjunction with other tests, such as sputum culture and AFB smear, to diagnose TB.
Correct Answer is D
Explanation
Choice A reason:
A 36-year-old male who had a minimally invasive appendectomy and a history of community-acquired pneumonia a year ago is at relatively low risk for postoperative respiratory complications. Minimally invasive surgeries typically have fewer complications, and a past episode of pneumonia does not significantly increase the risk unless there are ongoing respiratory issues.
Choice B reason:
A 58-year-old female with type 1 diabetes who had an incision and drainage of an abscess with procedural sedation has some risk factors for complications, such as diabetes, which can impair healing and immune response. However, the procedure was minor and performed under sedation, which poses less risk compared to general anesthesia.
Choice C reason:
A 19-year-old male undergoing arthroscopic knee surgery under regional anesthesia with a history of exercise-induced asthma has a low risk of respiratory complications. Regional anesthesia does not affect the respiratory system as much as general anesthesia, and exercise-induced asthma is generally well-controlled and less likely to cause complications in this context.
Choice D reason:
A 65-year-old female with a BMI of 32 and a long history of tobacco use who underwent upper abdominal surgery under general anesthesia is at the greatest risk for respiratory complications. Factors such as advanced age, obesity, smoking history, and the type of surgery (upper abdominal) significantly increase the risk of postoperative pulmonary complications. General anesthesia further exacerbates this risk due to its effects on respiratory function.
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