1 HESI RN COMPREHENSIVE EXIT EXAM 1. . The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy? a. The patient uses albuterol (Ventolin HFA) before aerobic exercise. b. The patient says that the asthma symptoms are worse every spring. c. The patient’s heart rate increases after using the albuterol (Ventolin HFA) inhaler. d. The patient’s only medications are alb uterol (Ventolin HFAl) and salmeterol (Serevent). ANS: D Long -acting b2 -agonists should be used only in patients who also are using an inhaled corticosteroid for long - term control. Salmeterol should not be used as the first -line therapy for long -term cont rol. Using a bronchodilator before exercise is appropriate. The other information given by the patient requires further assessment by the nurse but is not unusual for a patient with asthma. 2. The nurse takes an admission history on a patient with possible asthma who has new -
onset wheezing and shortness of breath. Which information may indicate a need for a change in therapy? a. The patient has chronic inflammatory bowel disease. b. The patient has a history of pneumonia 6 months ago. c. The patient takes propranolol (Inderal) for hypertension. d. The patient uses acetaminophen (Tylenol) for headaches. ANS: C b-Blockers such as propranolol can cause bronchospasm in some patients with asthma. The other information will be documented in the hea lth history but does not indicate a need for a change in therapy. 3. A patient newly diagnosed with asthma is being discharged. The nurse anticipates including which topic in the discharge teaching? Use of long -acting b -adrenergic medications c. Self -admin istration of inhaled corticosteroids a. b. Side effects of sustained -release theophylline d. Complications associated with O2 therapy ANS: C Inhaled corticosteroids are more effective in improving asthma than any other drug and are indicated for all patien ts with persistent asthma. The other therapies would not typically be first -line treatments for newly diagnosed asthma. 4. A patient with cystic fibrosis (CF) has blood glucose levels that are consistently between 180 to 250 mg/ dL. Which nursing action wi ll the nurse plan to implement? a. Discuss the role of diet in blood glucose control. b. Evaluate the patient’s use of pancreatic enzymes. c. Teach the patient about administration of insulin.
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