Which of the following would indicate the effectiveness of a bronchodilator?
Retractions on assessment
Chest tightness
Use of accessory muscles
SpO2 increased from 87% to 94%.
The Correct Answer is D
A. Retractions on assessment: Retractions suggest increased respiratory effort and are a sign of respiratory distress. Their presence indicates that the airway is still obstructed or the patient is struggling to breathe, suggesting the bronchodilator has not been effective.
B. Chest tightness: Chest tightness is a subjective symptom often associated with bronchospasm or airway constriction. If it persists after bronchodilator use, it signals continued respiratory compromise and inadequate relief from the medication.
C. Use of accessory muscles: Use of accessory muscles indicates labored breathing and ongoing difficulty with ventilation. Effective bronchodilation should reduce the work of breathing and minimize reliance on these muscles.
D. SpO₂ increased from 87% to 94%: An increase in oxygen saturation indicates improved gas exchange and oxygenation, reflecting that the bronchodilator has successfully opened the airways. This is a measurable and objective sign of medication effectiveness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Fat-soluble vitamins:Children with cystic fibrosis often require supplementation with fat-soluble vitamins (A, D, E, and K) due to impaired fat absorption. However, these alone do not facilitate digestion; they are supplemental and secondary to enzyme therapy.
B. Pancreatic enzymes:Pancreatic enzymes are essential for children with cystic fibrosis because thick mucus blocks pancreatic ducts, preventing digestive enzymes from reaching the intestines. Administering these enzymes with meals promotes the digestion and absorption of fats, proteins, and carbohydrates.
C. Water-soluble minerals:Water-soluble minerals like magnesium or zinc may be needed in some cases, but they do not directly improve digestion or address malabsorption in cystic fibrosis. They are not the primary intervention.
D. Salt supplements:Salt supplements are often needed due to excessive sodium loss in sweat, especially in hot climates or during exercise. However, they help with electrolyte balance, not digestion or nutrient absorption.
Correct Answer is A
Explanation
A. Productive cough and crackles:These are hallmark signs of pneumonia. A productive cough indicates mucus in the airways, while crackles on auscultation suggest fluid and inflammation in the alveoli, consistent with lower respiratory tract infection.
B. Bradycardia and hypotension:Bradycardia is not typically associated with pneumonia. Hypotension can occur in severe or septic cases, but it is not specific or diagnostic. Neither finding is present in this case, nor do they support the pneumonia diagnosis.
C. Elevated WBC and hypertension:An elevated WBC count does support infection, but hypertension is not characteristic of pneumonia. Blood pressure changes are not diagnostic and may vary based on the individual’s baseline or stress response.
D. Decreased WBC & clear lung sounds:A low WBC count and clear lung sounds argue against an infectious process like pneumonia. These findings would more likely suggest that infection is absent or resolving, not active.
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