A 20-year-old woman who is 15 weeks pregnant is admitted feverish and dehydrated with acute severe asthma associated with a community-acquired pneumonia. She has a history of angioedema following a cephalosporin. Which of the following is not appropriate therapy?

Correct Answer: D

Rationale: Acute asthma and pneumonia in pregnancy require urgent care. IV crystalloids rehydrate, safe and necessary. High FiO2 (40%) supports oxygenation in asthma/pneumonia, appropriate. Nebulized salbutamol, a beta-agonist, relieves bronchospasm, standard and safe. IV hydrocortisone reduces inflammation, suitable. IV gentamicin, an aminoglycoside, treats pneumonia but is inappropriate due to cephalosporin cross-reactivity risk (angioedema history) and fetal ototoxicity concerns, making it unsafe here. Alternative antibiotics (e.g., macrolides) are preferred, prioritizing maternal and fetal safety.

Correct Answer: A

Rationale: Albuterol is an example of a bronchodilator medication commonly used to treat respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Bronchodilators work by relaxing the muscles in the airways, which helps to open up the air passages and improve airflow to the lungs. This action can help relieve symptoms like wheezing, shortness of breath, and chest tightness. Albuterol is typically administered via inhalation to provide quick relief during an asthma attack or COPD exacerbation.

Correct Answer: B

Rationale: Alprazolam is a medication commonly used in treating anxiety disorders, panic disorders, and anxiety associated with depression. It belongs to a class of drugs known as benzodiazepines, which act on the central nervous system to produce a calming effect. Alprazolam helps to reduce feelings of anxiety and promote relaxation by enhancing the activity of certain neurotransmitters in the brain. It is not used for relief of drowsiness, bronchospasms, or cardiac arrest.

Correct Answer: D

Rationale: A sudden increase in temperature in a client receiving Pentamidine IV for the treatment of Pneumocystis carinii is most likely an indication that the client has developed another infection. Pentamidine is an antiparasitic medication used to treat Pneumocystis carinii pneumonia in immunocompromised individuals such as those with HIV/AIDS. An increase in temperature could be a sign of a new or worsening infection, especially in patients who are already immunocompromised. It is important for the nurse to monitor the client closely for signs of infection and notify the healthcare provider if there are any concerning symptoms.

Correct Answer: C

Rationale: Alpha1-selective adrenergic blocking agents block smooth muscle receptors in the prostate, prostatic capsule, prostatic urethra, and urinary bladder neck, which leads to a relaxation of the bladder and prostate and improved flow of urine in male patients. Although they also block the postsynaptic alpha1-receptor sites, causing a decrease in vascular tone and vasodilation that leads to a fall in blood pressure without the reflex tachycardia that occurs when the presynaptic alpha2-receptor sites are blocked, this is not the purpose for administering the drug to a patient with BPH. They do not reduce the size of the prostate.