A person with asthma arrives at the emergency department and is visibly distressed, coughing and with audible wheeze. Why are they prescribed salbutamol (beta-adrenergic agonist)?

Correct Answer: A

Rationale: The correct answer is A) To dilate the airways. Salbutamol is a beta-adrenergic agonist medication commonly used to treat asthma because it acts as a bronchodilator. In the context of asthma exacerbation where the patient is visibly distressed, coughing, and wheezing, the primary goal of treatment is to rapidly dilate the constricted airways to improve airflow and alleviate symptoms. Salbutamol works by binding to beta-2 adrenergic receptors in the airway smooth muscles, leading to relaxation and widening of the airways, which helps to relieve bronchospasm and improve breathing. Option B) To reduce secondary infections is incorrect because salbutamol does not have direct antibacterial or antiviral properties. Its primary mechanism of action is bronchodilation, not infection control. Option C) To decrease postnasal drip is incorrect as salbutamol is not indicated for this purpose. Postnasal drip is typically associated with conditions like allergic rhinitis or sinusitis, and salbutamol does not directly address this symptom. Option D) To reduce airway inflammation is incorrect because salbutamol is not a medication specifically designed to target inflammation. While inflammation plays a key role in asthma pathophysiology, salbutamol primarily focuses on bronchodilation rather than directly addressing the inflammatory component of asthma. In an educational context, understanding the rationale behind prescribing medications like salbutamol is crucial for nursing students to provide safe and effective care to patients with asthma. By comprehending how salbutamol works as a bronchodilator to alleviate symptoms of bronchospasm, students can make informed clinical decisions and monitor patient responses appropriately during medication administration. This knowledge enhances nursing practice and empowers students to deliver evidence-based care in emergency situations like asthma exacerbations.

Correct Answer: B

Rationale: In the scenario of a resident continually refusing medication, the correct action of reassessing the resident (Option B) is essential for several reasons. Firstly, it is crucial to uphold the resident's autonomy and rights in making decisions about their own healthcare. By reassessing the resident, the healthcare team can delve deeper into understanding the reasons behind the refusal. This can involve exploring potential side effects, discussing alternative treatment options, addressing fears or misconceptions, or identifying any underlying health issues that may be contributing to the refusal. Stopping trying to give the resident medication (Option A) is not a proactive approach as it does not address the root cause of the refusal and may compromise the resident's health. Using stronger measures (Option C) should only be considered as a last resort and must be done in collaboration with the resident, their family, and the healthcare team. Asking another resident to give the medication (Option D) is inappropriate as it can pose risks related to medication errors, confidentiality, and boundary violations. In an educational context, understanding how to handle situations where residents refuse medication is crucial for nursing students and healthcare professionals. It requires a holistic approach that considers the resident's physical, emotional, and psychological well-being. By choosing the correct answer of reassessing the resident, professionals can provide individualized care that respects the resident's autonomy while ensuring their safety and well-being.

Correct Answer: A

Rationale: The correct answer is A) allodynia. In the context of complex regional pain syndrome (CRPS), allodynia refers to the experience of pain in response to a normally non-painful stimulus, such as light touch. This phenomenon is a hallmark characteristic of CRPS and is indicative of the patient's hypersensitivity to stimuli in the affected area. Option B) hypoalgesia refers to decreased sensitivity to painful stimuli, which is the opposite of the intense pain experienced by the patient in this scenario. Option C) neuritis refers to inflammation of a nerve, which may cause pain but does not specifically describe the type of pain experienced in CRPS. Option D) paresthesia refers to abnormal sensations like tingling or numbness, which are different from the pain described by the patient. Understanding the different types of pain sensations is crucial for nurses involved in pain management, as it guides appropriate interventions and treatments for patients with conditions like CRPS. Recognizing allodynia in this scenario allows the nurse to provide targeted pain management strategies that address the specific nature of the patient's pain, ultimately improving their quality of life and treatment outcomes.

Correct Answer: C

Rationale: The correct answer is C) Guided imagery. Guided imagery involves asking patients to create and focus on mental images, which requires cognitive abilities such as imagination and concentration. This can be challenging for older adult patients who are cognitively impaired, as they may struggle with creating or maintaining these images due to their cognitive limitations. Option A) Aromatherapy is a nonpharmacologic intervention that involves the use of essential oils to promote relaxation and well-being. This intervention does not rely on cognitive abilities and can be easily implemented with cognitively impaired patients. Option B) Distraction involves redirecting a patient's attention away from unpleasant stimuli. While this technique may require some cognitive abilities, it is generally easier to implement compared to guided imagery for cognitively impaired patients. Option D) Heat application is a nonpharmacologic intervention that provides comfort and pain relief through the application of heat. This intervention does not rely on cognitive abilities and can be effectively used with older adult patients who are cognitively impaired. In an educational context, understanding the appropriateness of nonpharmacologic interventions for different patient populations is crucial for nursing practice. By recognizing the cognitive limitations of older adult patients with cognitive impairment, nurses can select interventions that are most suitable and effective for their care. This knowledge helps in providing patient-centered care and optimizing outcomes for this specific patient population.

Correct Answer: D

Rationale: In the context of a chronic pain management team, the main responsibilities of a pain management nurse primarily involve reviewing the patient's medical history, monitoring medications, and providing education to the patient and their family. This is the correct answer (Option D) because pain management nurses play a crucial role in ensuring that the patient's medications are effectively managed, potential drug interactions are identified, and that the patient and their family are educated on the safe and appropriate use of medications. Options A, B, and C are incorrect because they do not directly align with the specific responsibilities of a pain management nurse on an interprofessional chronic pain management team. Assessing function, designing exercise plans, implementing psychosocial evaluations, providing cognitive behavioral interventions, and offering ergonomic training are important aspects of chronic pain management, but these tasks typically fall under the purview of other team members such as physical therapists, psychologists, and occupational therapists. In an educational context, understanding the distinct roles and responsibilities of each team member in a chronic pain management team is essential for providing comprehensive and effective care to patients. By highlighting the specific duties of a pain management nurse, students and healthcare professionals can develop a clear understanding of how each team member contributes to the overall management of chronic pain and the importance of collaboration and communication within an interprofessional team.