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 B
Explanation
Choice A reason: For 40 mg at 25 mg/mL: 40 ÷ 25 = 1.6 mL. Choice A (0.6 mL) delivers 15 mg (0.6 × 25), underdosing Benadryl, which could fail to relieve allergic symptoms or sedation needs, making this choice incorrect for the prescribed dose.
Choice B reason: Calculating 40 mg ÷ 25 mg/mL = 1.6 mL accurately delivers the ordered 40 mg of Benadryl (diphenhydramine) for allergy or sedation. This ensures therapeutic efficacy without overdose, aligning with safe administration for intramuscular delivery, making this the correct choice.
Choice C reason: For 40 mg, the volume is 40 ÷ 25 = 1.6 mL. Choice C (2 mL) delivers 50 mg (2 × 25), overdosing Benadryl, risking excessive sedation or anticholinergic effects like dry mouth or confusion, making this choice incorrect and potentially unsafe.
Choice D reason: The correct volume is 1.6 mL (40 ÷ 25). Choice D (1 mL) delivers 25 mg (1 × 25), underdosing Benadryl, which may not achieve therapeutic effects for allergies or sedation, making this choice inadequate for the prescribed dose.
Correct Answer is C
Explanation
Choice A reason: A 25-year-old man typically has mature liver and kidney function, efficiently metabolizing and excreting CNS depressants like benzodiazepines. Toxicity risk is lower compared to neonates, whose immature systems impair drug clearance, making this choice less critical for close toxicity monitoring.
Choice B reason: A 15-year-old boy has relatively mature metabolic pathways, though not fully adult-like. CNS depressants are cleared more effectively than in neonates, reducing toxicity risk. Adolescents are less vulnerable than infants to accumulation, making this choice less concerning for drug toxicity observation.
Choice C reason: A 3-week-old neonate has immature liver enzymes (e.g., CYP450) and reduced renal clearance, increasing the risk of CNS depressant toxicity (e.g., respiratory depression, sedation). Their low body mass and underdeveloped metabolism necessitate close monitoring, making this the correct choice for heightened toxicity vigilance.
Choice D reason: A 25-year-old woman, like men of the same age, typically has efficient drug metabolism and excretion. CNS depressants pose lower toxicity risk compared to neonates, whose immature systems lead to drug accumulation, making this choice less critical for close toxicity monitoring.
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