Nursing Elites

1. A patient experiencing wheezing due to an allergic reaction needs immediate treatment. Which medication should be administered first?

• A. Albuterol via nebulizer
• B. Cromolyn via nebulizer
• C. Aminophylline IV
• D. Methylprednisolone IV

Correct answer: A

Rationale: The correct answer is A: Albuterol via nebulizer. Albuterol is a rapid-acting bronchodilator that helps relieve wheezing by opening up the airways. During an allergic reaction causing wheezing, prompt relief is crucial, making Albuterol the first-line treatment. Choice B, Cromolyn via nebulizer, is used more for preventing asthma symptoms rather than providing immediate relief. Choice C, Aminophylline IV, is a bronchodilator with a slower onset of action compared to Albuterol. Choice D, Methylprednisolone IV, is a corticosteroid used to reduce inflammation and is not the first-line treatment for acute wheezing in an allergic reaction.

2. A patient who received an enema reports abdominal cramping. What should the nurse do?

• A. Increase the flow of the enema solution
• B. Lower the height of the enema solution container
• C. Remove the enema tubing
• D. Stop the procedure

Correct answer: B

Rationale: When a patient who received an enema reports abdominal cramping, the nurse should lower the height of the enema solution container. This adjustment can help reduce the cramping by slowing down the flow of the solution into the colon, allowing the patient to tolerate the procedure better. Increasing the flow of the solution (Choice A) can exacerbate the cramping. Removing the enema tubing (Choice C) or stopping the procedure (Choice D) may not address the issue and could lead to incomplete treatment.

3. What is the priority action if a patient experiences hypoglycemia after an insulin dose?

• A. Check the patient's blood glucose level
• B. Administer IV dextrose
• C. Document the incident
• D. Continue monitoring the patient

Correct answer: A

Rationale: The priority action when a patient experiences hypoglycemia after an insulin dose is to check the patient's blood glucose level. This is crucial to confirm hypoglycemia before initiating any treatment. While administering IV dextrose may be necessary if the patient's blood glucose level is critically low, confirming hypoglycemia is essential to guide appropriate interventions. Documenting the incident is important for documentation purposes but is not the immediate priority when the patient's safety is at risk. Continuing to monitor the patient is essential, but it should follow the confirmation and initial management of hypoglycemia.

4. What is the priority lab value for monitoring a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. White blood cell count
• D. Hemoglobin levels

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring the CD4 T-cell count is crucial in patients with HIV as it serves as a key indicator of immune function. A count below 180 cells/mm3 indicates severe immunocompromise and an increased risk of opportunistic infections. Choice B, serum albumin levels, though important for assessing nutritional status, is not the priority lab value for HIV monitoring. Choice C, white blood cell count, is a nonspecific measure of immune function and may not accurately reflect the status of the immune system in HIV patients. Choice D, hemoglobin levels, are essential for evaluating anemia but are not the primary lab value for monitoring HIV.

5. What medication should be given first to a patient experiencing wheezing and coughing due to an allergic reaction?

• A. Albuterol 3 ml via nebulizer
• B. Cromolyn via nebulizer
• C. Aminophylline IV
• D. Methylprednisolone 100 mg IV

Correct answer: A

Rationale: The correct answer is Albuterol 3 ml via nebulizer. Albuterol is a bronchodilator that helps relieve wheezing and coughing by opening up the airways, making it the first-line treatment for allergic reactions presenting with these symptoms. Cromolyn and aminophylline are not typically used as first-line treatments for acute allergic reactions with wheezing and coughing. Methylprednisolone, a corticosteroid, may be beneficial for inflammation in the setting of an allergic reaction but is not the initial medication of choice to address wheezing and coughing.

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