Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 that their albuterol MDI (Proventil) is used:
If nighttime awakenings occur more than 2 days per week
Twice daily combined with an inhaled glucocorticoid
Only with a long-acting beta2 agonist (LABA)
As a rescue inhaler as needed for asthma symptoms
The Correct Answer is D
Choice A reason: Nighttime awakenings more than twice weekly indicate step 2, requiring maintenance therapy. Step 1 uses albuterol as needed, so this is incorrect.
Choice B reason: Twice-daily glucocorticoids are for step 2 or higher, not step 1, where albuterol is used as needed. This is incorrect for step 1 management.
Choice C reason: LABAs are used in step 3 or higher, not step 1, where albuterol alone is sufficient as needed. This is incorrect for the asthma step.
Choice D reason: At step 1, albuterol is used as a rescue inhaler for acute asthma symptoms. This is the standard approach, making it the correct choice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Inhaled glucocorticoids are used daily in COPD to reduce inflammation and prevent exacerbations. This shows correct understanding, making it the correct choice.
Choice B reason: Glucocorticoids are for daily maintenance, not as-needed use, which is for beta2-agonists. This misunderstanding is incorrect for the medication regimen.
Choice C reason: Beta2-agonists are used as needed for symptom relief, not daily, in stable COPD. This is incorrect, as daily use is for maintenance drugs.
Choice D reason: Beta2-agonists relax airways, not suppress inflammation; that’s the glucocorticoid’s role. This incorrect mechanism shows misunderstanding, so it’s incorrect.
Correct Answer is C
Explanation
Choice A reason: Uncompensated respiratory alkalosis requires low PaCO2 (<35 mm Hg) and high pH (>7.45). Here, PaCO2 is 48 mm Hg (high) and HCO3- is 29 mEq/L (high), indicating a metabolic cause with respiratory compensation, making this choice incorrect.
Choice B reason: Partially compensated respiratory alkalosis involves low PaCO2 and high HCO3- with high pH. With PaCO2 at 48 mm Hg (high) and HCO3- at 29 mEq/L, the alkalosis is metabolic, with elevated PaCO2 as compensation, making this choice incorrect.
Choice C reason: pH 7.48 (alkalotic), PaCO2 48 mm Hg (high), and HCO3- 29 mEq/L (high) indicate metabolic alkalosis (high HCO3-), with elevated PaCO2 showing partial respiratory compensation (hypoventilation to retain CO2). This matches partially compensated metabolic alkalosis, making it the correct choice.
Choice D reason: Uncompensated metabolic alkalosis requires high pH and high HCO3- with normal PaCO2. Here, PaCO2 is 48 mm Hg (high), indicating respiratory compensation, not an uncompensated state. This makes the condition partially compensated, so this choice is less accurate than C.
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