Practice question that doesn't seem right.

[dudette10, MSN, RN]

I'm doing a bunch of NCLEX practice questions, and the rationale on the answer for this one had me very puzzled. Or, maybe I'm just an idiot who shouldn't be in the ER.

The client admits to the ER with what appears to be an acute asthma attack. Which medication should the nurse administer first?

a. IV aminophylline

b. two puffs of a steroid inhaler

c. albuterol

d. oxygen via Venturi mask

Which one would you give first and why?

[FazzDazzle]

C.) Albuterol. Since this is fast acting.

Although, I'm sure the correct answer would be D. the O2 mask, Simply because I don't need a doctor's order to give a pt O2.

It doesn't say if these are MD approved meds.

Please share the answer!

[That Guy, BSN, RN, EMT-B]

^^^^^

Meds are ALWAYS pre-approved on tests. You have to go into tests thinking that you have an order for everything. Just a little test taking FYI right there

[dudette10, MSN, RN]

The answer given was oxygen, but I picked albuterol for the fast-acting bronchodilation. If the airways are closed, what good will giving oxygen do? Wouldn't you want to open them up first?

The rationale said that "O2 should be given for acute respiratory distress, such as in an acute asthma attack." Nothing was said about doctor's orders, so that wasn't part of the rationale.

[CuriousMe]

The answer given was oxygen, but I picked albuterol for the fast-acting bronchodilation. If the airways are closed, what good will giving oxygen do? Wouldn't you want to open them up first?

The rationale said that "O2 should be given for acute respiratory distress, such as in an acute asthma attack." Nothing was said about doctor's orders, so that wasn't part of the rationale.

Things don't happen at the same time in NCLEX World....they happen sequentially. So, maybe the idea is...you see a patient in respiratory distress, so you put them on oxygen....you don't know they're having an asthma attack, but you know they're in respiratory distress. As they're on the O2, you assess (Hx, listen to airways) and then have evidence to support giving the albuterol.

[MammaNurse2Be]

I have been in that situation before and I was given albuterol first then oxygen. Maybe I wasn't in enough distress :).

[CuriousMe]

I have been in that situation before and I was given albuterol first then oxygen. Maybe I wasn't in enough distress :).

Yes, but were you in that situation in NCLEX World?

[shortnorthstudent]

I chose O2.

My thought process:

you know you have a patient in respiratory distress. You believe it is asthma, but aren't sure. You have patient in a room/curtain and right there there is O2. The albuterol is great and I'll probably be running after it right away. But, patient is conscious. Therefore his airway isn't completely blocked and the O2 will help with oxygenation until we can get the albuterol in hand.

[myty23]

I chose albuterol too, but thinking about it and reading the rationale by shortnorthstudent it makes sense that you would give O2 first.

[Jjearkwein]

O2...

when it comes to "emergency" circumstances the most basic(may it be cardio/respiratory problem) is O2,... for some reason too(again for cardio/respiratory problems) when it comes to having to choose a "priority" intervention O2 is always the answer...

possibly because its easier/simplest to administer,fail proof,and everyone needs oxygen...

[NnSweets]

The key to this question are the words "appears to be." In the question this implies that at this point, you as the nurse are not certain that it is in fact an asthma attack. Therefore oxygen is the best and safest choice.

[Jonathank]

To play the devil's advocate:

Couldn't the O2 be dangerous if the pt. actually had COPD rather than asthma?