Which medication should the nurse question for a client admitted with an exacerbation of chronic obstructive pulmonary disease (COPD)?

Ceftriaxone, with a white blood cell count of 16,000 u/L.

Zafirlukast, with an AST of 30 units/L and ALT of 20 units/L.

Theophylline, with a theophylline level of 21 mg/dL.

Prednisone, with a glucose level of 110 mg/dL.

Answer and Explanation

The Correct Answer is C

Choice A Reason
Ceftriaxone is an antibiotic that may be prescribed during COPD exacerbations to treat or prevent infection. A white blood cell count of 16,000 u/L indicates an elevated level, which could be a response to infection. Therefore, ceftriaxone would be appropriate, and there is no need to question this medication based on the white blood cell count.

Choice B Reason
Zafirlukast is a leukotriene receptor antagonist used for the prophylactic treatment of asthma, and it may be used off-label for COPD. AST and ALT levels are liver enzymes, and the values provided (AST of 30 units/L and ALT of 20 units/L) are within normal ranges. Thus, there is no immediate concern regarding liver function that would prompt the nurse to question the use of zafirlukast.

Choice C Reason
Theophylline is a bronchodilator used in the treatment of COPD. However, a theophylline level of 21 mg/dL is above the therapeutic range, which is generally considered to be 5-15 mg/dL. Levels above 20 mg/dL are associated with toxicity and can lead to serious side effects such as seizures or arrhythmias. Therefore, the nurse should question this medication due to the high theophylline level.

Choice D Reason
Prednisone is a corticosteroid that may be used to reduce inflammation during COPD exacerbations. A glucose level of 110 mg/dL is slightly elevated but may be expected as corticosteroids can increase blood sugar levels. This would not typically be a reason to question the use of prednisone unless the patient has poorly controlled diabetes or other specific contraindications.

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Correct Answer is D

Explanation

Choice A reason:

While polyhydramnios can be associated with congenital anomalies or fetal distress, it is not a direct indication of these conditions. Polyhydramnios refers specifically to the excessive accumulation of amniotic fluid. Congenital anomalies may lead to polyhydramnios if they affect the fetus's ability to swallow and process amniotic fluid normally, but the presence of polyhydramnios alone does not confirm these conditions.

Choice B reason:

Elevated levels of alpha-fetoprotein (AFP) in the amniotic fluid can be indicative of neural tube defects or other fetal abnormalities, but they are not a defining characteristic of polyhydramnios. Normal AFP levels in amniotic fluid at 15 to 21 weeks' gestation range from 10 to 150 ng/ml. Polyhydramnios is diagnosed based on the volume of amniotic fluid, not the AFP levels.

Choice C reason:

Carrying more than one fetus can lead to an increased amount of amniotic fluid, potentially resulting in polyhydramnios. However, the diagnosis of polyhydramnios itself does not imply a multiple gestation pregnancy. It simply indicates that there is more amniotic fluid than usual.

Choice D reason:

Polyhydramnios is defined as an excessive amount of amniotic fluid. It is typically diagnosed when the amniotic fluid index (AFI) exceeds 24 cm or the single deepest pocket (SDP) measures more than 8 cm. This condition can occur due to various reasons, including fetal anomalies, maternal diabetes, and other medical conditions.

A. Hyperreflexia. B. Defiance. C. Inattention. D. Impulsivity.

Correct Answer is D

Explanation

Choice A Reason
Hyperreflexia refers to an overactive or overresponsive reflexes, which is a neurological condition and not directly related to the behaviors described. It is typically seen in conditions affecting the central nervous system and is not characterized by the inability to wait turns or interrupting conversations.

Choice B Reason
Defiance implies a conscious choice to resist authority or rules, which may not necessarily be the case here. While children with behavioral issues may exhibit defiant behaviors, the symptoms described are more indicative of a lack of impulse control rather than a deliberate choice to defy.

Choice C Reason
Inattention is a component of several behavioral and cognitive disorders, including ADHD. However, the behaviors described—blurting out answers, inability to wait for turns, and interrupting others—are more specifically associated with impulsivity rather than inattention alone.

Choice D Reason
Impulsivity is the tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences. The behaviors described—such as blurting out answers and interrupting others—are classic signs of impulsivity, which is often seen in conditions like ADHD.

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Which medication should the nurse question for a client admitted with an exacerbation of chronic obstructive pulmonary disease (COPD)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should understand that this diagnosis means which of the following?

Correct Answer is D

Explanation

Assessment data for a 9-year-old reveals that she blurts out answers to questions before the question is completed, is unable to wait her turn, and persistently interrupts and intrudes in the conversations of others. The nurse would assess these behaviors as relating primarily to:

Correct Answer is D

Explanation

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