A nurse is caring for a patient with a history of asthma who is complaining of chest tightness and wheezing. What is the priority intervention?

Correct Answer: B

Rationale: The correct answer is B: Notify the healthcare provider. The priority intervention is to inform the healthcare provider because the patient is experiencing worsening symptoms of asthma, which may require immediate medical attention or a change in treatment plan. Administering a bronchodilator (choice A) can help relieve symptoms, but it is not the priority when the patient's condition is deteriorating. Encouraging deep breathing exercises (choice C) may not be effective in managing acute asthma exacerbation. Administering a sedative (choice D) is not appropriate and can worsen respiratory distress. Overall, notifying the healthcare provider ensures timely assessment and appropriate intervention for the patient's worsening condition.

Correct Answer: A

Rationale: The correct answer is A: Administer nitroglycerin. Nitroglycerin is the first-line medication for chest pain related to myocardial infarction as it helps dilate blood vessels, improving blood flow to the heart. Administering nitroglycerin promptly can help relieve chest pain and prevent further damage to the heart. Summary of other choices: B: Administer beta-blockers - Beta-blockers may be used later to stabilize the heart rate and blood pressure but are not the priority in the acute phase of MI. C: Administer oxygen and monitor - Administering oxygen is important, but nitroglycerin takes precedence in relieving chest pain and improving blood flow. D: Administer analgesics - While analgesics may help with pain relief, nitroglycerin is specifically indicated for chest pain related to MI and should be given first.

Correct Answer: D

Rationale: The correct answer is D: Administer insulin. The priority nursing action is to manage the patient's blood glucose levels when experiencing nausea and vomiting, as it may lead to diabetic ketoacidosis. Administering insulin helps stabilize blood sugar. Administering antiemetics (A and B) may provide symptomatic relief but does not address the underlying issue. Administering pain medications (C) is not the priority in this scenario.

Correct Answer: D

Rationale: The correct answer is option D because an increase in albuterol inhaler use over the last 4 days indicates poor asthma control. This statement suggests that the patient's condition is worsening, leading to increased reliance on rescue medication rather than effective long-term asthma management. This situation necessitates immediate education on proper asthma management strategies, including the importance of using controller medications regularly to prevent exacerbations. Option A is incorrect as not having had any acute asthma attacks in the past year does not specifically indicate a need for teaching regarding medication use. Option B is also incorrect as becoming short of breath an hour before coming to the hospital is a symptom of the acute asthma attack rather than a clear indicator of medication misuse. Option C is incorrect because taking Tylenol for chest pain does not directly relate to asthma medication use. In an educational context, it is essential for nurses to recognize cues from patients that indicate a lack of understanding or adherence to their medication regimen. By identifying such cues, nurses can provide targeted education to improve patient outcomes and prevent further exacerbations of chronic conditions like asthma. Understanding these nuances in patient statements is crucial for effective nursing care and patient education.

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse to take first is to attempt to reinsert the tracheostomy tube with the obturator in place (Option C). This is the priority because it restores the patient's airway, which is crucial for oxygenation and ventilation. Without a secure airway, the patient is at risk for respiratory distress or failure. Option A (Arrange for arterial blood gases to be drawn immediately) is incorrect because assessing oxygenation status is important, but securing the airway takes precedence in this situation. Option B (Cover stoma with sterile gauze and ventilate through stoma) is incorrect because while covering the stoma and providing ventilation is important, reinserting the tracheostomy tube is the priority to ensure a patent airway. Option D (Assess the patient's oxygen saturation and notify the health care provider) is incorrect because while assessing oxygen saturation is essential, it is secondary to the immediate need to secure the airway. Educationally, it is crucial for nurses to understand the priority interventions in emergency situations like airway compromise. This scenario highlights the critical thinking and quick decision-making skills required in nursing practice to ensure patient safety and optimal outcomes. Nurses must be prepared to act swiftly and confidently to manage airway emergencies effectively.