A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this clients airflow obstruction?

Correct Answer: C

Rationale: During an asthma attack, the preferred intervention is an inhaled beta-adrenergic agonist (e.g., albuterol), which rapidly relaxes bronchial smooth muscle, reversing airflow obstruction from bronchospasm, mucus, and inflammation. This short-acting bronchodilator acts within minutes, opening airways and relieving acute dyspnea, aligning with asthma guidelines (e.g., GINA) for exacerbations. Corticosteroids reduce inflammation but take hours, unsuitable for immediate relief. Anticholinergics (e.g., ipratropium) complement beta-agonists in severe cases but aren't first-line alone. Peak flow monitoring assesses obstruction severity, not treating it. The nurse's swift administration via inhaler ensuring proper technique (e.g., spacer use) restores ventilation, critical for this child's acute respiratory crisis, preventing escalation to status asthmaticus.

Correct Answer: D

Rationale: Prednisone, an oral corticosteroid, is prescribed for asthma to gain prompt control of inadequately controlled, persistent symptoms, typically as a short-term burst (3-10 days). It rapidly reduces severe inflammation driving exacerbations swelling, mucus, and bronchospasm when inhaled therapies fail, restoring airway patency fast. Long-term prevention relies on inhaled corticosteroids, not oral prednisone, due to systemic side effects (e.g., osteoporosis). Asthma isn't infection-driven; prednisone doesn't cure systemic infections, nor is it for pulmonary infection prevention antibiotics serve that role if needed. The nurse's explanation clarifies prednisone's acute role highlighting duration and monitoring (e.g., glucose spikes) ensuring the patient understands its temporary, potent purpose in asthma crisis management, per clinical guidelines.

Correct Answer: B

Rationale: Warfarin, an anticoagulant, delays clotting, posing a bleeding risk in surgery, so the nurse should consult the physician about the INR to assess clotting status. INR measures prothrombin time, indicating warfarin's effect typically held 5-7 days pre-op to normalize (INR 1.0-1.5). Chest X-rays assess lungs, not clotting. BUN evaluates kidney function, unrelated to warfarin's impact. CBC provides general blood data, but INR specifically tracks anticoagulation reversal needs. This action ensures the surgical team adjusts warfarin safely, preventing intraoperative hemorrhage while balancing thromboembolism risks, aligning with preoperative protocols for anticoagulant management.

Correct Answer: C

Rationale: Recommending family inclusion in preoperative education eases anxiety for both patient and relatives by clarifying procedures and postoperative roles, like coaching exercises. Family understanding reduces patient stress, enhancing compliance with instructions. Excluding family or limiting them to the waiting room misses this support opportunity education benefits from their involvement. Requiring attendance overstates policy; it's ideal, not mandatory. The nurse's response fosters a collaborative environment, aligning with holistic care to prepare the patient and family for the surgical experience, reducing misunderstandings and improving outcomes.

Correct Answer: B

Rationale: Anesthesia lowers metabolism, reducing heat production and causing postoperative hypothermia (97°F) and shivering, as the body's thermoregulation is depressed. A gown alone or laminar flow contributes minimally in a short procedure like carpal tunnel repair. No open body cavity exists here unlike major surgeries so heat loss is limited. The nurse's recognition guides warming measures (e.g., blankets), aligning with recovery care to restore normothermia safely.