A patient is experiencing an acute asthma attack. Which medication should the nurse administer first?

Correct Answer: C

Rationale: The correct answer is C: Albuterol. During an acute asthma attack, a short-acting bronchodilator like albuterol is the first-line treatment to quickly open up the airways, relieve bronchospasm, and improve breathing. Albuterol acts rapidly to provide immediate relief of symptoms. Montelukast (A) is a leukotriene receptor antagonist used for long-term asthma control. Salmeterol (B) is a long-acting bronchodilator used for maintenance therapy, not for acute attacks. Ipratropium (D) is an anticholinergic bronchodilator that is used as an adjunctive therapy but not typically first-line for acute exacerbations.

Correct Answer: C

Rationale: The correct answer is C because a patient with asthma using accessory muscles to breathe indicates severe respiratory distress and imminent respiratory failure. Immediate intervention is needed to prevent further complications. Choice A is incorrect because mild dyspnea in a patient with chronic bronchitis may not warrant immediate attention. Choice B is incorrect because although an oxygen saturation of 88% is concerning, it may not always require immediate attention compared to a patient in severe distress like in Choice C. Choice D is incorrect as mild discomfort at the chest tube site may not be as urgent as a patient in respiratory distress.

Correct Answer: A

Rationale: The correct answer is A: Administer oxygen therapy immediately. In severe respiratory distress with a PaO2 of 48 mm Hg, the priority is to improve oxygenation. Administering oxygen therapy will help increase the PaO2 levels quickly, improving oxygen delivery to vital organs. Positioning the patient in high Fowler's (B) can help with breathing but does not address the immediate need for oxygen. Intubation (C) may be necessary but is not the first step. Notifying the healthcare provider (D) can cause delays in providing essential oxygen therapy.

Correct Answer: B

Rationale: The correct answer is B: Oxygen saturation of 88% on room air. This finding indicates severe hypoxemia, which is a medical emergency requiring immediate intervention to prevent hypoxia-related complications. Hypoxemia can lead to tissue damage and organ dysfunction. Immediate follow-up may involve providing supplemental oxygen and assessing the patient's respiratory status. Choice A: Temperature of 101°F is slightly elevated but not an immediate concern in the context of pneumonia treatment. Choice C: Productive cough with yellow sputum is a common symptom of pneumonia and does not require immediate follow-up unless accompanied by other concerning symptoms. Choice D: Crackles in both lung bases are expected in pneumonia and do not necessitate immediate action unless associated with respiratory distress.

Correct Answer: B

Rationale: The correct interpretation is uncompensated respiratory acidosis (Choice B). Step-by-step rationale: 1. pH is low (acidosis): Indicates an acid-base imbalance. 2. PaCO2 is high (55 mm Hg): Indicates respiratory acidosis. 3. HCO3- is within normal range (24 mEq/L): Indicates no compensation by the kidneys. Therefore, the patient is experiencing respiratory acidosis without compensatory metabolic changes. Other choices are incorrect: A: Metabolic acidosis: HCO3- is within normal range. C: Partially compensated metabolic acidosis: PaCO2 is high, not low. D: Compensated respiratory alkalosis: pH is low, indicating acidosis.