What should the nurse do first when a patient's SpO2 drops to 85% during exercise?

Correct Answer: B

Rationale: The correct answer is to administer supplemental oxygen (B) first when a patient's SpO2 drops to 85% during exercise. This is crucial because a SpO2 reading of 85% indicates severe hypoxemia, which can lead to serious complications like tissue damage and organ dysfunction. Providing supplemental oxygen helps increase oxygen saturation levels rapidly, ensuring adequate oxygen delivery to tissues and organs, especially during increased metabolic demand like exercise. Encouraging rest (A) is not the first priority when a patient is hypoxemic as it does not address the underlying issue of inadequate oxygenation. Monitoring respiratory rate (C) and checking pulse oximetry again (D) are important steps in assessing the patient's response to interventions but should follow the immediate action of administering supplemental oxygen to correct the hypoxemia. In an educational context, understanding the significance of oxygen therapy in managing hypoxemia is essential for nurses, especially when caring for patients with respiratory conditions or compromised oxygenation. Recognizing the urgency of addressing low oxygen saturation levels promptly during activities like exercise is crucial to prevent further deterioration and ensure patient safety and well-being. Nurses should be adept at quickly identifying and responding to oxygenation issues to optimize patient outcomes.

Correct Answer: B

Rationale: The correct answer is B) Rifampin. Rifampin is known to cause orange-colored body secretions as a side effect, particularly urine, sweat, saliva, and tears. This discoloration is harmless and reversible, and typically not a cause for alarm or discontinuation of the medication. It is important for nurses and healthcare professionals to educate patients about this potential side effect to alleviate concerns. Option A) Isoniazid is incorrect because it does not typically cause orange-colored body secretions. Common side effects of isoniazid include peripheral neuropathy and hepatotoxicity. Option C) Ethambutol is incorrect because it is associated with alterations in red-green color discrimination, particularly affecting vision. It is important to monitor for changes in vision while on ethambutol. Option D) Pyrazinamide is incorrect as it is not typically associated with orange-colored body secretions. Common side effects of pyrazinamide include hepatotoxicity and hyperuricemia. Educationally, understanding the side effects of medications used in the treatment of tuberculosis is crucial for nurses and healthcare providers to ensure safe administration and monitoring of patients. By being knowledgeable about these side effects, healthcare professionals can educate patients effectively, monitor for adverse reactions, and intervene promptly if needed.

Correct Answer: A

Rationale: In this NCLEX question about drug interactions for a patient with HIV and TB, the correct answer is option A: Antiretroviral and TB medications. This is because antiretroviral drugs used to treat HIV and medications for TB can interact with each other, leading to potential complications and reduced effectiveness of treatment. Option B (Expected symptoms) is incorrect because drug interactions are not related to symptoms but rather to the way medications interact within the body. Option C (Normal progression) is incorrect as it does not address the specific concern of drug interactions in this scenario. Option D (Routine treatment) is incorrect because it does not acknowledge the potential for drug interactions that can occur when treating both HIV and TB simultaneously. Educationally, understanding drug interactions is crucial for healthcare providers to ensure safe and effective treatment for patients with multiple co-existing conditions. It highlights the importance of thorough medication reconciliation, close monitoring for adverse effects, and the need to adjust treatment plans accordingly to optimize patient outcomes. Healthcare professionals must be knowledgeable about potential drug interactions to prevent harm and provide quality care to patients with complex health needs.

Correct Answer: D

Rationale: Readings in the yellow zone indicate a decrease in peak flow. The patient should use short-acting β2-adrenergic (SABA) medications. Readings in the green zone indicate good asthma control. The patient should exhale quickly and forcefully through the peak flow meter mouthpiece to obtain the readings.

Correct Answer: B

Rationale: The correct answer is B) No, only with inhaled corticosteroids. Long-acting β2-agonists should not be used alone for asthma control because they do not address the underlying inflammation in asthma. Inhaled corticosteroids are the cornerstone for long-term control of asthma as they reduce airway inflammation and hyperresponsiveness. Combining long-acting β2-agonists with inhaled corticosteroids provides both bronchodilation and anti-inflammatory effects, resulting in better asthma control. Option A) Yes, as first-line therapy is incorrect because using long-acting β2-agonists alone without inhaled corticosteroids can lead to inadequate control of asthma symptoms and increased risk of exacerbations. Option C) Yes, before exercise is incorrect because long-acting β2-agonists are not recommended as sole therapy for asthma control, even before exercise. Inhaled corticosteroids should be included in the treatment regimen for long-term asthma control. Option D) No, only with SABA is incorrect because short-acting β2-agonists (SABA) are used for quick relief of acute asthma symptoms, while long-acting β2-agonists are used for long-term control when combined with inhaled corticosteroids. In an educational context, it is crucial for healthcare providers to understand the appropriate use of medications in asthma management to optimize patient outcomes. Emphasizing the importance of using inhaled corticosteroids as the foundation of long-term asthma control and the role of long-acting β2-agonists as adjunct therapy can help healthcare providers make informed decisions in managing asthma effectively.