To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

To abort an asthma attack

Only in an emergency

On a daily basis

2 weeks on, 2 weeks off

Answer and Explanation

The Correct Answer is C

Choice A reason: Inhaled glucocorticoids, like budesonide, reduce airway inflammation over time but don’t act quickly enough to abort acute asthma attacks. Short-acting beta-agonists (e.g., albuterol) are used for acute relief, as glucocorticoids lack immediate bronchodilatory effects, making this choice incorrect for chronic asthma management.

Choice B reason: Using inhaled glucocorticoids only in emergencies is ineffective for chronic asthma. These drugs prevent inflammation and exacerbations through consistent use, not acute intervention. Emergency use is reserved for rescue inhalers like albuterol, making this choice inappropriate for long-term asthma control.

Choice C reason: Inhaled glucocorticoids require daily use to maintain anti-inflammatory effects, reducing airway hyperresponsiveness and preventing asthma exacerbations. Consistent dosing ensures steady suppression of chronic inflammation, improving lung function and reducing symptoms, making this the correct choice for managing chronic asthma effectively.

Choice D reason: A 2-week on/off schedule disrupts the consistent anti-inflammatory action of inhaled glucocorticoids needed for chronic asthma control. Intermittent use reduces efficacy, allowing inflammation to rebound, increasing exacerbation risk. Daily use is standard to maintain therapeutic benefits, making this choice incorrect.

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Correct Answer is D

Explanation

Choice A reason: NPH insulin is not mixed with insulin glargine, as glargine’s pH and formulation cause precipitation or altered pharmacokinetics when combined. NPH can be mixed with regular insulin, as they are compatible, making this choice incorrect for the patient’s reported practice.

Choice B reason: NPH and regular insulin are compatible and routinely mixed in one syringe to provide both intermediate and short-acting coverage. They don’t react chemically or lose efficacy when combined properly, making this choice incorrect, as mixing is a standard practice in diabetes management.

Choice C reason: Mixing NPH and regular insulin does not increase potency; it combines their pharmacokinetics for basal and prandial glucose control. The mixture delivers the additive effects of each insulin’s profile without enhancing overall potency, making this choice inaccurate for their combined action.

Choice D reason: Mixing NPH (intermediate-acting) and regular insulin (short-acting) is an accepted practice to manage type 1 diabetes with one injection, covering basal and prandial needs. Proper technique (drawing regular insulin first) ensures stability, making this the correct choice for the patient’s reported insulin administration.

A. Poor medication compliance B. Increased force of ventricular contraction C. Decreased force of ventricular contraction D. Lack of exercise

Correct Answer is C

Explanation

Choice A reason: Poor medication compliance may worsen heart failure but isn’t directly linked to crackles and shortness of breath. These symptoms result from fluid overload due to reduced cardiac output, not solely non-adherence. This choice is less specific to the physiological cause described.

Choice B reason: Increased ventricular contraction force, as with inotropes like digoxin, improves cardiac output, reducing fluid backup. Crackles and shortness of breath indicate fluid overload from poor heart function, not enhanced contraction, making this choice incorrect for the symptoms’ cause.

Choice C reason: Decreased ventricular contraction force in heart failure reduces cardiac output, causing blood to back up into the lungs, leading to pulmonary edema. This manifests as crackles and shortness of breath due to fluid accumulation, making this the correct physiological explanation for the symptoms.

Choice D reason: Lack of exercise may contribute to overall heart failure progression but doesn’t directly cause crackles and shortness of breath. These symptoms stem from acute fluid overload due to impaired cardiac pumping, not deconditioning, making this choice incorrect for the immediate cause.

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To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

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Naxlex Comprehensive Predictor Exams

A patient with type 1 diabetes reports mixing NPH and regular insulin to allow for one injection. The nurse knows:

Correct Answer is D

Explanation

A patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in the lungs. The nurse understands that these symptoms are the result of

Correct Answer is C

Explanation

The healthcare provider orders Benadryl 40 mg IM now. The available concentration is 25 mg/mL. How many mL will the patient receive?

A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply?

A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest?

Insulin glargine is prescribed for a hospitalized patient who has diabetes. When will the nurse expect to administer this drug?

A nurse is reviewing a patient’s medications before administration. Which drug-to-drug interactions will most concern the nurse in a patient with a history of heart failure and a potassium level of 5.5 mEq/L?

A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?

Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 that their albuterol MDI (Proventil) is used:

The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding would indicate a severe adverse effect of ibuprofen therapy?