Which item should the nurse plan to omit from the meal tray of a client being treated with theophylline (Theo-Dur)?

Beans

Milk

Peas

Coffee

Answer and Explanation

The Correct Answer is D

Rationale:

A. Beans are a safe source of protein, fiber, and other nutrients and do not interfere with the absorption, metabolism, or excretion of theophylline. Including beans in the diet will not affect the drug’s therapeutic levels or increase the risk of toxicity. Therefore, there is no need to omit beans from the client’s meal tray.

B. Milk and other dairy products are also safe for clients taking theophylline. Calcium in milk does not impact the pharmacokinetics of theophylline or reduce its effectiveness. The client can safely consume milk as part of their regular diet without concern for interactions with the medication.

C. Peas are another safe and nutritious food that has no known interaction with theophylline. They provide vitamins, minerals, and fiber but do not affect drug levels or the risk of side effects. Including peas on the meal tray is appropriate and does not pose a safety concern.

D. Coffee contains caffeine, which belongs to the same pharmacologic class as theophylline, called methylxanthines. Consuming caffeine while taking theophylline can lead to additive stimulant effects, increasing central nervous system stimulation and causing restlessness, insomnia, or anxiety. It can also increase cardiac stimulation, leading to tachycardia, palpitations, and potentially dangerous arrhythmias. Additionally, caffeine may exacerbate gastrointestinal side effects such as nausea, vomiting, or abdominal discomfort. Because caffeine can potentiate theophylline toxicity even when the medication is at therapeutic levels, it is essential to avoid coffee and other caffeinated products, including tea, chocolate, energy drinks, and some sodas. The nurse should educate the client about reading labels and monitoring their total caffeine intake to ensure safe theophylline therapy.

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Correct Answer is A

Explanation

Rationale:

A. Preparing to assist with intubating the patient is correct. ARDS is characterized by severe hypoxemia that is often refractory to supplemental oxygen. Patients frequently require early airway management with endotracheal intubation and mechanical ventilation to maintain adequate oxygenation and prevent respiratory failure. Prompt anticipation of intubation is critical in preventing rapid deterioration.

B. Setting up oxygen at 5 L/minute by nasal cannula is incorrect because ARDS patients typically do not achieve adequate oxygenation with low-flow oxygen. They require higher oxygen delivery methods, often non-rebreather masks initially or mechanical ventilation.

C. Performing deep suctioning is incorrect as a first intervention. Suctioning may be needed to clear secretions, but it does not address the primary problem of hypoxemia in ARDS.

D. Setting up a nebulizer to administer corticosteroids is incorrect because corticosteroids are not the first-line intervention for acute ARDS and are not delivered via nebulizer in this scenario. Immediate focus is on airway and oxygenation support.

A. Pulse oximetry of 94% on room air B. A PaO2 level below 60 mmHg C. An ABG pH level of 7.35 D. An ABG CO2 level over 50 mmHg E. A respiratory rate of over 16/minute

Correct Answer is ["B","D"]

Explanation

Rationale:

A. Oxygen saturation of 94% is slightly below normal but not indicative of respiratory failure, which is defined by severe hypoxemia (PaO2 < 60 mmHg) or hypercapnia (PaCO2 > 50 mmHg).

B. PaO2 < 60 mmHg on room air indicates hypoxemic respiratory failure (Type I). This reflects inadequate oxygenation despite adequate ventilation.

C. A normal pH does not indicate respiratory failure. Respiratory failure is associated with acidemia when CO2 retention occurs or hypoxemia is severe enough to affect tissue perfusion.

D. PaCO2 > 50 mmHg indicates hypercapnic respiratory failure (Type II), which occurs when the patient cannot ventilate adequately to remove CO2, often leading to respiratory acidosis.

E. While tachypnea may be a sign of respiratory distress, a rate over 16/min is not sufficient to define respiratory failure. Many patients can compensate for hypoxemia or hypercapnia with an increased respiratory rate before failure occurs.

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Which item should the nurse plan to omit from the meal tray of a client being treated with theophylline (Theo-Dur)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been brought to the ED by the paramedics. The patient is suspected of having ARDS. What intervention should the nurse first anticipate?

Correct Answer is A

Explanation

A nurse is caring for a patient with respiratory distress. Which of the following clinical indicators would signify that this client is in respiratory failure? Select all that apply.

Correct Answer is ["B","D"]

Explanation

The client has a mediastinal chest tube. Which symptoms require the nurse's immediate intervention? Select all that apply.

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A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider?

The patient with acute respiratory failure may require a bronchodilator if which of the following occurs?

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A nurse is planning care for a client who has acute respiratory distress syndrome (ARDS). Which of the following interventions should the nurse include in the plan?