A client is experiencing an acute exacerbation of asthma. Which medication should the nurse administer first?

Correct Answer: A

Rationale: The correct answer is A: Albuterol (Proventil). Albuterol is a short-acting beta agonist bronchodilator that provides quick relief during an asthma exacerbation by relaxing the smooth muscles in the airways. This helps to rapidly open up the airways and improve breathing. Administering albuterol first is crucial in managing acute asthma symptoms. Summary of other choices: B: Ipratropium (Atrovent) is an anticholinergic bronchodilator that is often used in combination with albuterol for asthma exacerbations, but albuterol is preferred for initial rapid relief. C: Salmeterol (Serevent) is a long-acting beta agonist used for maintenance treatment of asthma, not for acute exacerbations. D: Fluticasone (Flovent) is an inhaled corticosteroid used for long-term control of asthma symptoms and prevention of exacerbations

Correct Answer: B

Rationale: The correct answer is B: Tracheal deviation. Tracheal deviation indicates a tension pneumothorax, a life-threatening emergency that requires immediate intervention to prevent further complications. The other choices are incorrect because: A: Production of pink sputum may indicate blood-tinged sputum, which could be a sign of minor bleeding but does not require immediate intervention. C: Pain at insertion site is common after chest tube insertion and can be managed with pain medication, not necessarily requiring immediate intervention. D: Sudden onset of shortness of breath could indicate various issues, including pneumothorax, but tracheal deviation is a more specific and urgent sign that requires immediate attention.

Correct Answer: D

Rationale: Correct Answer: D Rationale: 1. High-fiber foods promote gastric emptying, reducing the risk of bloating and discomfort in COPD patients. 2. COPD patients may experience difficulty breathing, leading to decreased physical activity and slower digestion. 3. Consuming high-fiber foods helps regulate bowel movements and prevents constipation, common in COPD patients. Summary of Incorrect Choices: A: Avoiding fluids just before and during meals is not specific to COPD patients and may not directly address their nutritional needs. B: Resting before meals if experiencing dyspnea may be helpful, but it does not address specific nutritional information. C: Having six small meals a day may be beneficial for some COPD patients, but it does not directly address the importance of high-fiber foods for promoting gastric emptying.

Correct Answer: B

Rationale: Pulmonary function tests (PFTs) are diagnostic procedures that evaluate lung function, requiring precise coordination between the nurse and respiratory therapist to ensure accurate results. The correct answer is **B: "The client is ready to go down to radiology for this examination,"** because PFTs are typically performed in a specialized pulmonary function lab or respiratory therapy department, not radiology. This miscommunication could lead to delays or confusion, as radiology is not the correct location for PFTs. The nurse should verify the correct testing location with the respiratory therapist to ensure the client is directed appropriately. **Why the other options are incorrect:** **A: "I held the client's morning bronchodilator medication."** Holding bronchodilators before PFTs is often necessary because these medications can artificially improve lung function, skewing test results. However, this statement is not directly relevant to pre-test communication with the respiratory therapist. The therapist does not need this information to perform the test—instead, it is part of the nurse's responsibility to follow pre-test protocols. The respiratory therapist focuses on administering the test, not medication management. **C: "Physical therapy states the client can run on a treadmill."** While some PFTs (such as cardiopulmonary exercise testing) may involve treadmill use, standard spirometry or diffusion capacity tests do not. This statement is irrelevant unless the specific PFT requires exercise, which is uncommon in basic assessments. Including unnecessary details may confuse the therapist or imply an incorrect test type. The nurse should clarify the exact PFT being performed before relaying unrelated physical therapy clearance. **D: "I advised the client not to smoke for 6 hours prior to the test."** Smoking before PFTs can affect results by irritating airways and altering lung function. However, this is another pre-test nursing responsibility, not a critical communication point for the respiratory therapist. The therapist expects the client to arrive prepared; their role is to conduct the test, not verify smoking cessation. The nurse should document this instruction in the client's chart rather than report it to the therapist. In summary, effective communication before PFTs should focus on logistical coordination (e.g., correct testing location) rather than reiterating pre-test instructions that are the nurse's duty. Misplaced statements (A, D) or irrelevant details (C) distract from ensuring the procedure is performed efficiently. The priority is confirming the client is in the right place at the right time with the necessary preparations already completed.

Correct Answer: A

Rationale: The correct answer is A because smoking while on nicotine replacement therapy can lead to nicotine overdose, increasing the risk of a stroke due to excessive nicotine intake. This statement emphasizes the importance of avoiding smoking during treatment. Choice B is incorrect as it does not address the specific risk associated with smoking while on the medication. Choice C is incorrect as stopping the medication suddenly does not directly increase the risk for a heart attack. Choice D is irrelevant to nicotine replacement therapy and does not provide information related to the medication's use.