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Questions 158

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Question 1 of 5

Which of the following medications requires close observation for bronchospasm in the client with chronic obstructive pulmonary disease or asthma?

Correct Answer: D

Rationale: Verapamil has the respiratory side effect of nasal or chest congestion, dyspnea, shortness of breath (SO
B), and wheezing. Amrinone has the effect of increased contractility and dilation of the vascular smooth muscle. It has no noted respiratory side effects. Epinephrine has the effect of bronchodilation through stimulation. Propranolol, esmolol, and labetalol are -blocking agents, which can increase airway resistance and cause bronchospasms.

Question 2 of 5

A child with cystic fibrosis is being treated with inhalation therapy with Pulmozyme (dornase alfa). A side effect of the medication is:

Correct Answer: C

Rationale: Pulmozyme, used to thin mucus in cystic fibrosis, can cause sore throat as a side effect due to inhalation irritation. Weight gain, hair loss, and brittle nails are not associated.

Question 3 of 5

A 17-year-old client has a T-4 spinal cord injury. At present, he is learning to catheterize himself. When he says, 'This is too much trouble. I would rather just have a Foley.' An appropriate response for the RN teaching him would be:

Correct Answer: A

Rationale: This response validates the client's feelings, provides education on reduced infection risk with intermittent catheterization, and encourages autonomy.

Question 4 of 5

Which of the following would differentiate acute from chronic respiratory acidosis in the assessment of the trauma client?

Correct Answer: C

Rationale: Increased PaCO2 is present in both acute and chronic respiratory acidosis due to hypoventilation. Decreased PaO2 may occur in respiratory acidosis but does not differentiate acute from chronic. Increased HCO3 indicates renal compensation, which occurs in chronic respiratory acidosis as the body attempts to buffer the excess CO2, but not in acute cases where compensation has not yet occurred. Decreased base excess is not specific to differentiating acute from chronic respiratory acidosis.

Question 5 of 5

A baby is circumcised. Immediate postoperative care should include:

Correct Answer: D

Rationale: A pressure diaper should be applied to discourage hemorrhage. The baby can be fed by his mother soon after the procedure, once it is assessed that he is not in any distress and is stable. Dressing changes should not be dry. Dry dressing will stick. Cuddling after the procedure will hopefully quiet the baby. Feeding is also important if his feeding was withheld prior to the procedure or it is time for a feeding.

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