When reviewing the provider's orders, a nurse recognizes that clarification is needed for which of the following medications in a client experiencing an exacerbation of asthma?

Correct Answer: A

Rationale: The correct answer is A: Propranolol. Propranolol is a beta-blocker that can exacerbate asthma symptoms by causing bronchoconstriction. This medication is contraindicated in patients with asthma. The other choices (B: Theophylline, C: Montelukast, D: Prednisone) are commonly used in the management of asthma exacerbations and do not typically require clarification in this context. Theophylline is a bronchodilator, Montelukast is a leukotriene receptor antagonist, and Prednisone is a corticosteroid used for its anti-inflammatory effects in asthma.

Correct Answer: B

Rationale: The correct answer is B: Administer oxygen via face mask. Given the client's symptoms and ABG results showing respiratory alkalosis and hypoxemia, the priority is to improve oxygenation. Administering oxygen via face mask will help increase the oxygenation levels and alleviate the hypoxemia. Mechanical ventilation (A) is not indicated as the client is able to maintain their own ventilation. Administering a sedative (C) is not appropriate without addressing the underlying respiratory issue. Assessing for pulmonary embolism (D) may be important but not the immediate priority in this case.

Correct Answer: D

Rationale: The correct answer is D: A hyperextended position. During bronchoscopy with a rigid scope, the client's neck needs to be hyperextended to facilitate optimal insertion of the scope into the trachea. Hyperextension straightens and opens up the airway, providing better visualization and access to the bronchial tree. Choice A (flexed position) would obstruct the airway and make insertion difficult. Choice B (extended position) would not provide the necessary alignment for scope insertion. Choice C (neutral position) may not offer sufficient airway visibility and access. In summary, a hyperextended position is crucial for successful bronchoscopy with a rigid scope, as it ensures proper alignment, airway visibility, and scope insertion.

Correct Answer: A

Rationale: The correct answer is A: Withhold food and liquids until the client's gag reflex returns. After a flexible bronchoscopy, the client may have a decreased gag reflex due to topical anesthesia used during the procedure, which increases the risk of aspiration. Withholding food and liquids helps prevent aspiration until the gag reflex returns, usually within 1-2 hours. B: Irrigating the client's throat every 4 hours is unnecessary and may not be indicated post-bronchoscopy. C: Having the client refrain from talking for 24 hours is not necessary after a flexible bronchoscopy unless specifically instructed by the healthcare provider. D: Suctioning the client's oropharynx frequently is not indicated unless there is a clinical indication for it, such as excessive secretions or respiratory distress. Frequent suctioning can increase the risk of trauma to the airway.

Correct Answer: C

Rationale: The correct answer is C, increased heart rate, as it indicates a potential complication such as hemorrhage or pneumothorax post-thoracentesis. An increased heart rate can signify hypovolemia or respiratory distress, requiring immediate provider notification. Serosanguineous drainage (A) is expected initially, discomfort (B) is common, and decreased temperature (D) is not typically a complication post-thoracentesis.