Question 1

The nurse in a pulmonary clinic is evaluating several clients' theophylline levels.Which levels would take the highest priority? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse in a pulmonary clinic is...

Question 2

The nurse is providing discharge instruction to a client newly diagnosed with asthma.The client has been prescribed albuterol (Proventil)for bronchospasm.Which side effects should the nurse explain to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Restlessness, tremor, and nervousness are common side effects of albuterol. Abnormal EKG and hypertensive crisis are less common and would require immediate medical attention.

Question 3

The nurse is planning strategies for managing a new asthma client's symptoms.Which strategies will decrease the risk for bronchospasms? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

A) Educating the client regarding the use of asthma medications can help the client understand how to manage their symptoms and prevent bronchospasms.
B) Educating the client regarding environmental control measures can help the client avoid triggers that can cause bronchospasms.
C) Successfully managing comorbidities, such as allergies or acid reflux, can help prevent exacerbations of asthma and bronchospasms. 
D) Not making changes once asthma control has been achieved can prevent adjustments that may be needed to maintain control and prevent bronchospasms. 
E) Using the maximum amount of medication allowed to achieve asthma control can increase the risk of side effects and exacerbations of asthma, which can lead to bronchospasms.

Question 4

The nurse is reviewing the admission history of a client taking zileuton (Zyflo CR)in the emergency department.Which patient reports would take highest priority during the physical assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse is reviewing the admission history...

Question 5

A client is prescribed zafirlukast (Accolate)for persistent,chronic asthma.Which nursing interventions take priority? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

- Zafirlukast can interact with aspirin, potentially causing adverse effects, so patients should be advised not to take aspirin while on this medication.- Zafirlukast should be taken on an empty stomach to enhance its absorption.- Headache is a common side effect of zafirlukast, and patients should be informed about this possibility.

Question 6

The admitting nurse suspects a client has moderate persistent asthma because: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Symptoms occurring every day, more than one night a week, and affecting daily activity are all indicative of moderate persistent asthma according to the National Asthma Education and Prevention Program (NAEPP) classification system. Occasional symptoms affecting daily activity (choice D) would classify as mild persistent asthma. Symptoms occurring only two times a month (choice E) would be classified as mild intermittent asthma.

Question 7

A client asks the nurse why the health care provider has ordered the asthma medication in inhalant rather than oral form.What is the nurse's best response? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Inhaling an asthma medication allows for a rapid and efficient delivery directly into the lungs, resulting in a faster onset of action and relief of symptoms. Inhalation also allows for smaller doses to be used, reducing the risk of systemic side effects.

Question 8

The nurse instructs a client with asthma that quick-relief medications that should be used for acute symptoms include: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Albuterol and ipratropium are both short-acting bronchodilators that provide quick relief of acute asthma symptoms. Beclomethasone, cromolyn, and montelukast are all long-term control medications that are used to prevent asthma symptoms and should not be used for acute symptoms.

Question 9

The nurse has taught a group of clients with asthma the importance of knowing when to use quick-relief medications and when to use long-acting medications.The nurse knows the clients have understood the teaching when they identify which medications as long acting? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

Budesonide, nedocromil, and zafirlukast are all long-acting medications used as controller medications in the management of asthma, while albuterol and ipratropium are short-acting medications used for quick relief of symptoms.

Question 10

The nurse helps a client establish goals to control asthma with medications.The nurse emphasizes that the preferred drugs for long-term control of asthma are:

Accepted Answer

Inhaled corticosteroids are the preferred long-term control medication for asthma as they reduce airway inflammation and improve symptoms without significant side effects. Inhaled beta 2 agonists are used for quick relief of symptoms but not for long-term control. Anticholinergics are sometimes used in combination with inhaled corticosteroids but not as a first-line therapy. Systemic corticosteroids are only used for short-term treatment of severe asthma exacerbations due to their potential for significant side effects.

Question 11

An asthmatic client has been taking Accolate (zafirlukast)for a number of years.Coumadin is being added to the client's medications because of atrial fibrillation.What concern does the nurse have related to this addition?

Accepted Answer

Zafirlukast (Accolate) can increase the levels of warfarin (Coumadin) in the body, leading to a potentiated effect of the anticoagulant. This means less warfarin may be needed to achieve the desired prothrombin time (PT), increasing the risk of bleeding if not monitored and adjusted appropriately.

Question 12

The nurse in a pulmonary clinic knows that theophylline (Theo-Dur)should not be prescribed for: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse in a pulmonary clinic knows...

Question 13

The nurse explains to a client that inhaled corticosteroid medications are used in the long-term management of asthma to decrease: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of The nurse explains to a client that...

Question 14

The nurse is discharging an asthma client with a new prescription for nedocromil (Tilade).What should the nurse instruct the client about this drug? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The nurse should instruct the client that nedocromil may cause a bitter taste and may take up to a week of therapy before benefits are obtained. Option B is incorrect because nedocromil is not used to terminate an acute asthma attack. Option D is incorrect because nedocromil should be used regularly as a preventative medication, not just as needed. Option E is incorrect because headache is not a common side effect of nedocromil.

Question 15

A pediatric nurse is educating a 6-year-old and the mother on the use of a metered-dose inhaler (MDI)with a spacer.The mother asks what the spacer is for.The nurse responds: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

A is correct because the spacer helps prevent the larger particles from falling out in the throat and instead allows them to reach the lungs. B is correct because using an MDI without a spacer can be difficult and result in the medication being sprayed into the mouth instead of the lungs. C is correct because the spacer helps hold the medication during inhalation, making it easier for the child to receive the full dose of medication without needing to worry about coordination. D is incorrect as the spacer does not automatically activate, but rather holds the medication in place for the child to inhale. E is incorrect as the spacer does not vaporize the medication.

Question 16

A client has been prescribed beclomethasone (Beconase)for long-term management of persistent asthma.Prior to discharge,the nurse teaches the client about possible side effects,including: Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

Accepted Answer

The answer of A client has been prescribed beclomethasone (Beconase)for...

Question 17

A client with persistent asthma has a history of multiple allergies,including peanuts and soy.The nurse knows that,given this history,which prophylactic medication should be avoided?

Accepted Answer

The answer of A client with persistent asthma has a...

Question 18

The nurse is caring for a client with chronic bronchitis and a history of glaucoma.The nurse recognizes that which drug would not be an appropriate choice for the control of the client's bronchospasm?

Accepted Answer

Ipratropium (Atrovent) is not an appropriate choice for a client with a history of glaucoma because it is an anticholinergic medication that can increase intraocular pressure, potentially worsening glaucoma.

Question 19

When planning care for a client newly diagnosed with asthma,the nurse is aware that heavy caffeine intake could make the client intolerant of certain respiratory medications,including:

Accepted Answer

Heavy caffeine intake can decrease the effectiveness of bronchodilators such as albuterol. It does not affect the efficacy of cromolyn, budesonide, or montelukast.

Question 20

A client admitted with persistent asthma has a history of hypertension.Which class of asthma drugs must be used cautiously with clients who have hypertension?

Accepted Answer

Oral short-acting beta-adrenergic agonists can cause vasoconstriction and elevation of blood pressure, so caution must be taken when administering them to clients with hypertension. Inhaled corticosteroids, inhaled anticholinergic medications, and mast cell stabilizers do not have significant effects on blood pressure.

Quiz 44: Pharmacotherapy of Asthma and Other Pulmonary Disorders