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. What is the first medication to give for wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Cromolyn 20 mg via nebulizer
• C. Methylprednisolone 100 mg IV
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: Albuterol is the first-line medication for treating wheezing due to an allergic reaction. Albuterol is a short-acting beta-agonist that helps relieve bronchospasm quickly. Cromolyn is more commonly used for the prevention of asthma symptoms rather than for acute treatment. Methylprednisolone and aminophylline are not the first-line medications for acute wheezing due to an allergic reaction.

3. What is the first-line treatment for wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Cromolyn via nebulizer
• C. Methylprednisolone 100 mg IV
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction because it acts quickly to open the airways by relaxing the muscles in the air passages. Cromolyn (Choice B) is used for asthma prevention rather than acute wheezing. Methylprednisolone (Choice C) and Aminophylline (Choice D) are not the first-line treatments for acute wheezing in the setting of an allergic reaction.

4. A nurse is administering insulin to a patient after misreading their glucose as 210 mg/dL instead of 120 mg/dL. What should the nurse monitor for?

• A. Monitor for hypoglycemia
• B. Monitor for hyperkalemia
• C. Administer glucose IV
• D. Document the incident

Correct answer: A

Rationale: The correct answer is to monitor for hypoglycemia. Insulin administration based on a misread glucose level can lead to hypoglycemia due to the unnecessary lowering of blood sugar levels. Monitoring for hypoglycemia involves assessing the patient's blood glucose levels frequently, observing for signs and symptoms such as shakiness, confusion, sweating, and administering glucose if hypoglycemia occurs. Choice B, monitoring for hyperkalemia, is incorrect as insulin administration typically lowers potassium levels. Choice C, administering glucose IV, is not the immediate action needed as the patient could potentially develop hypoglycemia from the excess insulin. Choice D, documenting the incident, is important but not the immediate priority when dealing with a potential hypoglycemic event.

5. A patient is receiving discharge instructions for GERD. Which of the following statements by the patient demonstrates an understanding of the teaching?

• A. I should take my medication with orange juice.
• B. Having a bedtime snack will prevent heartburn.
• C. I will lie down after meals.
• D. I will limit activities that require bending at the waist.

Correct answer: D

Rationale: The correct answer is D. Patients with GERD should avoid activities that increase intra-abdominal pressure, such as bending at the waist, as this can lead to reflux. Choice A is incorrect because medications for GERD are usually taken with water, not citrus juices. Choice B is incorrect as having a bedtime snack can worsen GERD symptoms. Choice C is incorrect because lying down after meals can also exacerbate reflux due to the effects of gravity.

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