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Questions 158

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Question 1 of 5

The nurse is caring for a client with a history of asthma who is receiving Albuterol (Proventil). The nurse should monitor the client for:

Correct Answer: A

Rationale: Albuterol, a beta-agonist, commonly causes tachycardia as a side effect due to sympathetic stimulation. Hypotension, hypokalemia, and hyperglycemia are less frequent.

Question 2 of 5

Home-care instructions for the child following a cardiac catheterization should include:

Correct Answer: B

Rationale: A small bruise may develop around the insertion site and is not a reason for alarm. It is best to keep the child out of the bathtub until the sutures are removed. Acetaminophen, not aspirin, is the drug of choice if there is pain at the insertion site. The insertion site should be kept clean and dry and open to air.

Question 3 of 5

Before administering Theo-Dur (theophylline), the nurse should check the patient's:

Correct Answer: C

Rationale: Theophylline, a bronchodilator, can cause tachycardia. Checking the pulse before administration ensures the patient is not at risk for adverse cardiac effects. Urinary output, blood pressure, and temperature are less directly affected.

Question 4 of 5

A 60-year-old woman exhibits forgetfulness, emotional lability, confusion, and decreased concentration. She has been unable to perform activities of daily living without assistance. After a thorough medical evaluation, a diagnosis of Alzheimer's disease was made. An appropriate nursing intervention to decrease the anxiety of this client would include:

Correct Answer: A

Rationale: This answer is correct. The more the client is able to control her daily routine, the less anxiety she will experience. This answer is incorrect. Confrontation tends to increase anxiety. This answer is incorrect. Reality testing is an assessment tool. It does not decrease anxiety. This answer is incorrect. A highly stimulating environment increases distractibility and anxiety.

Question 5 of 5

A 4-week-old infant is admitted to the emergency room in respiratory distress. Which of the following statements indicates the nurse's knowledge of the anatomy of the respiratory system in pediatric clients?

Correct Answer: A

Rationale: The airway in children is much smaller than it is in adults. The diameter of the trachea in the newborn is 4 mm and that of the adult is 20 mm. A small change in the diameter of the airway can make a major difference in the pediatric client. The tongue is proportionally larger in children and fills most of the oral cavity, thereby decreasing air space. The entire pediatric airway is elastic. Elasticity diminishes with age, however. The distances between respiratory structures are shorter than that of adults, and therefore organisms are able to move more rapidly down the throat, leading to more extensive respiratory involvement.

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