The nurse prepares to administer a bronchodilator to a patient experiencing an acute asthma exacerbation. Which medication should the nurse administer first?

Correct Answer: D

Rationale: The correct answer is D, Albuterol (Ventolin), because it is a short-acting bronchodilator that provides immediate relief by dilating the airways during an acute asthma exacerbation. This helps improve airflow and relieve symptoms quickly. Ipratropium (A) is another bronchodilator but is not as fast-acting as albuterol. Salmeterol (B) is a long-acting bronchodilator used for maintenance therapy, not for immediate relief during an acute attack. Montelukast (C) is a leukotriene receptor antagonist and is not a bronchodilator; it is used for long-term asthma control, not for acute exacerbations.

Correct Answer: A

Rationale: Step 1: Oxygen saturation of 89% indicates hypoxemia, which can be life-threatening. Step 2: Administering oxygen therapy will help improve oxygenation levels. Step 3: Priority is to address hypoxemia to prevent complications. Step 4: Chest physiotherapy, deep breathing exercises, and sputum sample are not immediate priorities for hypoxemia. Administering oxygen is crucial to address the primary issue.

Correct Answer: B

Rationale: The correct answer is B because blowing into the peak flow meter hard and fast ensures an accurate measurement of peak expiratory flow rate. This technique helps assess the severity of asthma and monitor response to treatment. Choice A is incorrect because using the meter before medication may not reflect actual lung function. Choice C is incorrect as inhaling deeply does not measure lung capacity. Choice D is incorrect because peak flow meters are used for proactive monitoring, not just when feeling short of breath.

Correct Answer: B

Rationale: The correct answer is B: Apply oxygen via nasal cannula. This is the first action because in a suspected pulmonary embolism, the priority is to optimize oxygenation to prevent hypoxia. Oxygen therapy helps improve oxygen saturation and tissue perfusion. Administering a bronchodilator (Choice A) would not address the primary issue of oxygenation. Preparing for a chest x-ray (Choice C) may be necessary but not the initial action. Initiating IV fluids (Choice D) may be needed later but does not directly address the immediate concern of oxygenation in a suspected pulmonary embolism.

Correct Answer: C

Rationale: The correct action is to check the system for loose connections (Choice C). First, ensure that all connections are secure to prevent further air leakage. Clamping the chest tube (Choice A) can create tension leading to more air leaks. Repositioning the chest tube (Choice B) may not address the underlying issue of loose connections. Notifying the healthcare provider (Choice D) is important but addressing the immediate concern of loose connections should be the initial action to prevent complications.