Unit 3 Review

Asthma is a disease characterized by hypersensitivity of the airway smooth muscle to stimuli that elicit contractions of the muscle. Which of the following correctly pairs a drug with its mechanism of action in asthmatics?

Theophylline: phosphodiesterase inhibition Strategies to treat asthma target the physiological changes that compromise the etiology of the disease, including the sensitivity of smooth muscles to stimulation, alterations in inner action and nervous control, airway structure changes, and inflammation with the involvement of mast cells. Phosphodiesterase breaks down cAMP, which operates in the smooth muscles of the airway to allow them to relax, resulting in bronchodilatation. Theophylline also suppresses airway reactivity

A nurse is developing a teaching plan for a client about preventing acute asthma attacks. Which of the following points should the nurse plan to discuss first?

Addressing the client's perception of the disease process and what might have triggered past attacks Apply the nursing process priority-setting framework to plan client care and prioritize nursing actions. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, the nurse must first collect adequate data from the client.

A nurse in the emergency department is caring for a client who has a fruity breath odor, a dry mouth, and extreme thirst. Which of the following assessments should the nurse make?

Blood glucose level These findings are indications of hyperglycemia and diabetic ketoacidosis. Check client's blood glucose level as well as assess the client's respiratory status, vital signs, level of consciousness, and hydration status, including a laboratory assessment of his electrolyte levels.

A nurse is preparing a client for discharge following a bronchoscopy. Which of the following assessment sis the nurse's monitoring priority?

Confirming the gag reflex The greatest risk to client's safety is aspiration resulting from a depressed gag reflex. the nurse's priority is to make sure the client's gag reflex has returned before discharge so that the client can maintain hydration and nutrition without risk.

A nurse is caring for a client with pneumonia who is experiencing thick oral secretions. Which of the following actions should the nurse take first?

Encourage deep-breathing and coughing First action, airway, breathing, circulation approach

A nurse is preparing for a client for a bronchoscopy. Which of the following actions should the nurse take? (Select all that apply)

Explain that the client will receive sedation and will not remember the procedure Verify that the client understand the purpose and nature of procedure

A nurse is assessing a client who has heart failure and is taking daily furosemide. The client's apical pulse is weak and irregular. The nurse should identify these findings as manifestations of which of the following electrolyte imbalances?

Hypokalemia Furosemide can cause the loss of potassium, sodium, calcium, and magnesium. Manifestations of hypokalemia can include shallow respiration's, muscle weakness, lethargy, and ectopic heartbeats

Today, the patient feels that her asthma is much better with prednisone and would like to take prednisone on a chronic basis. Her physician counsels against chronic oral steroid therapy due to concern about resultant adrenal insufficiency. How does glucocorticoid therapy induce adrenal insufficiency?

Inhibition of both CRH and ACTH Cortisol is secreted by the zona Farsi Ulta a of the adrenal cortex in response to stimulation by adrenocorticotropic hormone (ACTH), which is secreted by the anterior pituitary in response to stimulation by corticotropin-releasing hormone (CRH), which is secreted by the hypothalamus. Negative feedback inhibition of both CRH and ACTH release by cortisol is essential to the regulation of serum cortisol levels. Mnemonic for adrenal cortex: Adrenal cortex: "GFR: The deeper you go, the sweeter it gets." "Salt" : zona Glomerulosa: aldosterone "Sugar": zona Fasciculata: cortisol "Sex": zona Reticularis: androgens

A nurse is assessing a client who has pharyngitis. Which of the following findings it the nurse's priority to report to the provider?

Inspiratory stridor Airway, breathiing, circulation. Always the priority. Stridor is a manifestation of airway obstruction. Nurse should notify the rapid response team and administer humidified oxygen.

A nurse is auscultations the lungs of a client who is having an acute asthma attack. Which of the following sounds should the nurse expect to hear?

Noisy wheezing Asthma causes bronchioles of lungs to constrict, creating a wheezing sound.

A nurse is preparing to assist a provider with an arterial blood withdrawal from a client's radial artery for ABG measurement. Which of the following actions should the nurse plan to take?

Perform an Allen's test prior to obtaining the specimen Ensure circulation to hand is adequate from ulnar artery in case the radial artery is injured from the blood draw. Most common site for withdrawal or arterial blood gases is the radial artery.

A nurse is caring for an older adult client who has aspiration pneumonia. Which of the following age-related changes contributes to the development of aspiration pneumonia?

Physiological changes of aging include a diminished cough reflex leading to a possible aspiration, which can then lead to pneumonia.

A nurse is caring for a client with heart failure whose telemetry reading displays a flattening of the T wave. Which of the following laboratory results should the nurse anticipate as the cause of this ECG change?

Potassium 2.8 mEq/L A flattened T wave of the development of U waves is indicative of a low potassium level.

A nurse is caring for a client who is extremely anxious and is hyperventilating. The client's ABG results are pH 7.50, PaCO2 27 mmHg, and HCO3- 25 mEq/L. The nurse should identify that the client has which of the following acid-base imbalances?

Respiratory alkalosis B/c of rapid breathing, client is exhaling excessive amounts of carbon dioxide. This loss of carbon dioxide of decreases the hydrogen ion level of the blood, which causes the pH to increase and results in respiratory alkalosis.