Deck 37: Bronchodilator,antiasthmatic,and Mucolytic Drugs

Question 1

The nurse would teach the client to report which of the following adverse drug effects while taking albuterol (Proventil)?

A) Anxiety and rapid heart rate
B) Slow respiratory rate and snoring while asleep
C) Urinary frequency and altered sense of smell
D) Insomnia and inability to sweat

Answer 1

Anxiety and rapid heart rate

Question 2

The nurse would select which of the following if choosing the most commonly used agent to dilute respiratory secretions?

A) Water
B) Saline solution
C) Epinephrine
D) Corticosteroids

Answer 2

Water

Question 3

The nurse anticipates which of the following is an expected adverse effect of intravenous aminophylline?

A) Mild diuresis
B) Restlessness
C) Vasoconstriction
D) Lethargy

Answer 3

Restlessness

Question 4

When administering intravenous aminophylline,the nurse assesses the client carefully for which of the following signs of too-rapid infusion?

A) Dyspnea
B) Circulatory failure
C) Renal shutdown
D) Hepatomegaly

Question 5

Client teaching would include which of the following as adverse effects of albuterol (Proventil)?

A) Listlessness
B) Increased appetite
C) Tachycardia
D) Dyspnea

Question 6

The nurse would question an order for ipratropium (Atrovent)for a client with which of the following conditions?

A) Controlled asthma
B) Acute asthma attack
C) Emphysema
D) Chronic bronchitis

Question 7

Which of the following statements would the nurse use when teaching a client about the in-line method of administering albuterol (Proventil)?

A) "After you inhale the medication once,repeat until you obtain relief."
B) "Make sure that you puff out air repeatedly after you inhale the medication."
C) "Hold your breath as long as you can after you inhale the medication."
D) "After the drug escapes the machine,exhale for as long as possible."

Question 8

The nurse would question an order for albuterol (Proventil)for a client with which of the following conditions?

A) Mild asthma
B) Severe asthma
C) Bronchospasm
D) Viral bronchiolitis in a child

Question 9

The nurse explains to a client beginning drug therapy with inhaled ipratropium (Atrovent)that which of the following is a common adverse drug effect?

A) Dry mouth or throat
B) Blurred vision
C) Rapid heart rate
D) Skin rash

Question 10

Which of the following is an appropriate goal for a client using a bronchodilator who has a nursing diagnosis of Activity Intolerance?

A) Coughs effectively
B) Has normal breath sounds
C) Vital signs remain stable with ambulation
D) Takes in 3 L of fluid in 24 hours

Question 11

After the first few treatments of cromolyn sodium (Intal),a client reports mouth discomfort.The nurse should instruct this client to

A) stop taking the medication as soon as possible.
B) use full-strength peroxide and Cepacol oral rinses.
C) avoid any activity that leads to diaphoresis.
D) rinse the mouth after each treatment.

Question 12

The nurse explains to a client that the reason cromolyn sodium (Intal)is administered by aerosol treatments is that it

A) inhibits histamine release.
B) stimulates the release of bronchospastic agents.
C) provides an antiinflammatory response.
D) stimulates the release of acetylcholine.

Question 13

The nurse explains to a client that which of the following types of drugs that the client is already taking is also considered a mucolytic?

A) Bronchodilator
B) Expectorant
C) Antihistamine
D) Decongestant

Question 14

The nurse has just completed a client teaching session about the newly ordered drug ipratropium (Atrovent).The nurse evaluates that the client understands how the drug works when the client states that the peak effect of the dose will be felt how long after self-administration?

A) 3 to 4 hours
B) 1 to 2 hours
C) 30 to 45 minutes
D) 15 to 20 minutes

Question 15

For which of the following clients in the pulmonary clinic would the nurse not expect to see an order for salmeterol (Serevent)?

A) A 26-year-old with moderate persistent asthma
B) A 35-year-old with severe persistent asthma
C) A 17-year-old with an acute asthma attack
D) A 14-year-old with bronchospasm from reversible airway disease

Question 16

The nurse explains to a client beginning drug therapy with ipratropium (Atrovent)that urinary retention may result if which of the following drugs is taken concurrently?

A) Benztropine (Cogentin)
B) Furosemide (Lasix)
C) Acetaminophen (Tylenol)
D) Digoxin (Lanoxin)

Question 17

A client is taking albuterol (Proventil).The nurse would question a concurrent order for which of the following types of drugs,which would exert an antagonist action?

A) A sympathomimetic
B) A $\beta$ -adrenergic blocker
C) A monoamine oxidase inhibitor
D) A tricyclic antidepressant

Question 18

What instructions must the nurse give to the client who is receiving acetylcysteine (Mucomyst)therapy by aerosol?

A) Use hand nebulizers
B) Clear the airway by coughing before treatment
C) Clear the airway by gagging after treatment
D) Clearing the airway is not necessary

Question 19

A client beginning inhalation drug therapy with salmeterol (Serevent)asks the nurse about how frequently the inhaler will be used.The nurse responds that most clients have an order to take this drug

A) once a day upon rising.
B) once a day before bedtime.
C) twice a day,timed in the morning and late afternoon.
D) twice a day,approximately 12 hours apart.

Question 20

The nurse explains to a client who will begin taking albuterol (Proventil)that it will most likely be ordered by which of the following most common routes?

A) Capsule
B) Extended-release tablet
C) Subcutaneous injection
D) Inhalation

Question 21

The client who is using a nebulizer asks the nurse why the physician said to rinse the mouth after completing a treatment.The appropriate response by the nurse is that rinsing the mouth will do which of the following?

A) Aid systemic drug absorption
B) Prevent dry mouth
C) Reduce the risk of developing cold sores
D) Eliminate the risk of adverse drug effects

Question 22

The allergist has told a client that drug therapy will be needed with omalizumab (Xolair)as treatment for severe persistent asthma of an allergic nature.The nurse plans to teach the client that the drug is administered routinely by which of the following routes?

A) Oral
B) Inhalation
C) Subcutaneous
D) Intradermal

Question 23

The emergency department nurse obtains acetylcysteine (Mucomyst)from the medication storage area after hearing that a client with overdose of which of the following substances is in transport to the hospital?

A) Acetylsalicylic acid (aspirin)
B) Acetaminophen (Tylenol)
C) Acetazolamide (Diamox)
D) Acetohexamide (Dymelor)

Question 24

The nurse explains to a client with asthma that which of the following substances is the most effective mucokinetic agent for clearing the respiratory passages of mucus?

A) Normal saline
B) Water
C) Humidified oxygen
D) Guaifenesin (Robitussin)

Question 25

The nurse anticipates that a client with which of the following conditions would be a candidate for drug therapy with cromolyn (Intal)?

A) Bronchial asthma
B) Emphysema
C) Pneumonia
D) Nasal congestion

Question 26

The nurse teaches a client beginning drug therapy with theophylline (Slo-Phyllin)that which of the following items is likely to decrease drug effectiveness with excessive use?

A) Charcoal-broiled foods
B) Dark chocolate
C) Nonherbal tea
D) Hazelnut coffee

Question 27

The nurse explains to a client beginning drug therapy with nedocromil (Tilade)that which of the following may occur as an adverse drug effect?

A) Excessive salivation
B) Constipation
C) Excessive sleepiness
D) Bad taste in mouth after the dose

Question 28

A client beginning drug therapy with nedocromil (Tilade)indicates an understanding of drug information by stating that the full drug effects may not be noted for how many weeks?

A) One
B) Two
C) Three
D) Four

Question 29

The nurse notes a new medication order for montelukast (Singulair).The nurse understands that this medication would not be helpful for which of the following purposes?

A) To manage an acute asthma attack
B) To reduce bronchial inflammation
C) To interfere with mucus secretion
D) To prevent an asthma attack

Question 30

The nurse would assess the client receiving montelukast (Singulair)for which of the following adverse drug effects?

A) Headache and gastrointestinal distress
B) Hypothermia and dry skin
C) Muscle twitching and joint pain
D) Irregular heart rhythm and rapid pulse

Question 31

The nurse monitoring the serum theophylline level for a client taking theophylline (SLO Phyllin)notes that the client is having the expected result of therapy after noting which of the following results?

A) 5 mg/L
B) 9 mg/L
C) 14 mg/L
D) 24 mg/L

Question 32

The mother of a pediatric client tells the clinic nurse that she saw an advertisement on television for montelukast (Singulair)as treatment for allergic rhinitis.The nurse would explain that the child is not a candidate for treatment with this drug if the child were younger than

A) 6 months.
B) 1 year.
C) 2 years.
D) 5 years.

Question 33

The nurse explains to a client taking an inhaled corticosteroid that rinsing the mouth after each dose is necessary to reduce the risk of which most important problem?

A) Dry mouth
B) Oral candidiasis
C) Sore throat
D) Nasal congestion

Question 34

The nurse evaluates that drug therapy with acetylcysteine (Airbron)has been most effective after noting which of the following items of assessment data?

A) Slight improvement in right-sided breath sounds
B) Expectoration of increased amounts of mucus
C) Lack of adverse drug effects
D) Client compliance with dosing schedule

Question 35

A client newly diagnosed with asthma will begin drug therapy with albuterol (Proventil)and triamcinolone (Azmacort),two puffs each by inhalation.The nurse explains that which of the following directions is the proper method for self-administration?

A) Alternate puffs of each drug,beginning with albuterol
B) Alternate puffs of each drug,beginning with triamcinolone
C) Take the albuterol before the triamcinolone
D) Take the triamcinolone before the albuterol

Question 36

A client has an order to take two drugs by inhalation: albuterol (Proventil)and fluticasone (Flonase).The nurse instructs the client to wait how many minutes between inhalations between these two drugs?

A) 1 minute
B) 3 minutes
C) 5 minutes
D) 15 minutes

Question 37

The nurse would include which of the following directions when teaching a client about how to clean the spacer and mouthpiece of a metered-dose inhaler?

A) Rinse the mouthpiece three times per day
B) Use hot water when rinsing the mouthpiece
C) Shake the mouthpiece to remove large water drops before use after cleaning
D) Wash the mouthpiece and spacer with mild dishwashing soap twice per week

Question 38

The client is learning to use a metered-dose inhaler for bronchodilator medications.If the client will be using a spacer device,the nurse teaches the client to do which of the following as part of proper use?

A) Open the mouth widely
B) Place the device two fingerbreadths in front of the mouth
C) Inhale while pressing the canister down on the mouthpiece
D) Wait 10 minutes between inhalations

Question 39

A client taking theophylline telephones the clinic on the weekend to say that she used the last dose of the drug and the prescription has no refills.The client indicates her sister also takes theophylline but as a different brand name.She asks if she can use her sister's medication until her office visit in 2 days.Which response by the nurse is best?

A) "Yes,you can use your sister's medication as long as she does not run out also."
B) "Yes,you can use it but only for a few days until you come in for your appointment."
C) "No,you should not use it because of insurance reimbursement issues."
D) "No,you should not use it because it may not have the same effect as the brand you were using."

Question 40

The nurse interprets that a client taking theophylline (Slo-Phyllin)could be experiencing drug toxicity if which of the following items of assessment data was noted?

A) Insomnia
B) Cardiac dysrhythmias
C) Vomiting
D) Nervousness

Question 41

A pediatric client newly diagnosed with cystic fibrosis will need to receive dornase alfa (Pulmozyme).The nurse teaches the caregivers that this medication will be administered by which of the following routes?

A) Mouth
B) Subcutaneous injection
C) Rectal
D) Inhalation with nebulizer

Question 42

The nurse interprets that a caregiver of a client with cystic fibrosis understands how to properly administer dornase alfa (Pulmozyme)after the caregiver states to do which of the following?

A) Use the drug only if it is cloudy
B) Administer the dose every day at the same time
C) Use a mask to administer the drug
D) Mix the dose of the drug with a bronchodilator before administering