Nursing Central: Unbound Scenarios- Asthma/RSV Study Guide

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Sample questions from Nursing Central: Unbound Scenarios- Asthma/RSV Study Guide

This material has 18 questions with answers and rationales. Here are the first 5.

1. 1.An adult receiving treatment for a severe asthma exacerbation becomes drowsy. Wheezing is less audible, breath sounds are markedly diminished, and respirations are shallow. Which action should the nurse take first?

   • A.Provide discharge teaching about trigger avoidance.
   • B.Ask the client to complete three peak flow attempts.
   • C.Activate emergency assistance and prepare for advanced respiratory support.
   • D.Document that bronchospasm has resolved.

   Rationale: B is correct because drowsiness, shallow breathing, and poor air entry suggest impending respiratory failure. A incorrectly interprets reduced wheezing as improvement. C delays stabilization and may be impossible for an exhausted client. D is appropriate only after recovery and does not address the immediate threat.

2. 2.A 5-month-old with a first episode of RSV bronchiolitis has nasal congestion and reduced feeding but no apnea or severe distress. Which prescribed intervention is most consistent with usual supportive care?

   • A.Routine oral antibiotics for the duration of the cough.
   • B.Gentle nasal suction before feeding when secretions interfere.
   • C.Routine chest physiotherapy every 2 hours.
   • D.Scheduled systemic corticosteroids.

   Rationale: C is correct because gentle nasal suction may improve feeding when nasal secretions are obstructive. A is not indicated without evidence of bacterial infection. B is not routinely beneficial for typical bronchiolitis. D is also not routinely recommended and can increase distress without improving outcomes.

3. 3.A client with severe asthma continues to have marked respiratory distress. Initially, PaCO2 was 28 mm Hg. The repeat PaCO2 is 43 mm Hg. Which interpretation is most appropriate?

   • A.The value may indicate respiratory muscle fatigue despite falling within the reference range.
   • B.The exacerbation has resolved because PaCO2 is normal.
   • C.Supplemental oxygen should be discontinued immediately.
   • D.The client has developed metabolic alkalosis.

   Rationale: A is correct because a rise from a low PaCO2 toward normal during persistent severe distress can signal declining ventilation. B ignores the clinical context. C cannot be concluded from PaCO2 alone and does not explain the trend. D is unsafe; oxygen is adjusted to the prescribed target and clinical status, not discontinued solely because of this value.

4. 4.A client has a personal-best peak flow of 500 L/min. Today's highest acceptable reading is 225 L/min. Which instruction is appropriate?

   • A.Average the three readings before making any decision.
   • B.Wait until the next morning to repeat the measurement.
   • C.Continue the usual plan because the reading is in the green zone.
   • D.Follow the red-zone instructions and obtain urgent help as directed.

   Answer and rationale are in the full material.

5. 5.Which statement by a client using an inhaled corticosteroid indicates correct understanding?

   • A.Oral thrush means that I must avoid every asthma medication permanently.
   • B.I should discontinue it as soon as I have one symptom-free day.
   • C.I will rinse my mouth and spit after using this medication.
   • D.This inhaler always replaces my rapid-relief medication during an attack.

   Answer and rationale are in the full material.