Question 1

What is the reason for administering sodium chloride to a patient with emphysema?

Accepted Answer

Sodium chloride acts by hydrating mucus.This will decrease the viscosity of mucous plugs,which makes it easier for patients to cough up the dry hardened plugs blocking the bronchial tubes.Sodium chloride is not given to increase serum sodium iodide levels.Sodium does not reduce metabolic needs of the body or bronchial irritation.

Question 2

Premedication assessments before the use of anticholinergic bronchodilating agents should verify that the patient has no history of which condition?

Accepted Answer

Anticholinergic bronchodilating agents cause mydriasis (dilation of the pupils)and cycloplegia (loss of power in the ciliary muscle); therefore,they should not be used in patients with a history of closed-angle glaucoma.Diabetes,hypertension,and liver disease are not affected by the use of anticholinergic bronchodilating agents.

Question 3

The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease.What is the rationale for limiting caffeine?

Accepted Answer

Avoid caffeine-containing beverages because caffeine is a weak diuretic.Diuresis promotes thickening of lung secretions,making it more difficult to expectorate them.

Question 4

Within minutes of the initiation of a nebulizer treatment with a sympathomimetic bronchodilator,the patient turns on his call light and states that he feels "panicky" and his heart is racing.Which action will the nurse take?

Accepted Answer

Sympathomimetic drugs increase sympathetic nervous stimulation.Symptoms such as nervousness,palpitations,tremors,tachycardia,and anxiety typically are dose related.These symptoms should be reported to the health care provider immediately because the patient may require a decreased dosage.These symptoms could lead to further complications if allowed to persist and are not common adverse effects.Although this may be a common result,it is not an expected outcome.Diluting the medication would not decrease the dose.Although a sedative might be appropriate for the patient,this is not the intervention of choice.

Question 5

The nurse is obtaining a history of respiratory symptoms on a patient with the diagnosis of COPD.The patient reports smoking one pack of cigarettes per day for the past 20 years.The nurse calculates the pack years as

Accepted Answer

Pack years is defined as number of packs of cigarettes smoked per day times the number of years of smoking; 1 × 20 = 20.

Question 6

What structures in the respiratory tract assist in removing foreign bodies such as smoke and bacteria?

Accepted Answer

Normally,respiratory tract fluid forms a protective layer over the trachea,bronchi,and bronchioles.Foreign bodies,such as smoke particles and bacteria,are caught in the respiratory tract fluid and are swept upward by ciliary hairs that line the bronchi and trachea to the larynx,where they are removed by the cough reflex.The villi are hair-like protrusions into the intestine emanating from the wall of the intestine.The purpose of the villi is to slow the passage of food and allow food particles to be captured among these finger-like villi so that the blood inside the villi can absorb the nutrients in the food.The primary function of the Golgi apparatus,an organelle found in most eukaryotic cells,is to process proteins targeted to the plasma membrane,lysosomes,or endosomes and those that will be formed from the cell and to sort them within vesicles.Thus,it functions as a central delivery system for the cell.Erector pili are small muscles that cause hairs on the skin to rise when contracted.

Question 7

From where do the fluids of the respiratory tract originate?

Accepted Answer

The fluids of the respiratory tract originate from specialized mucous glands (goblet cells)and serous glands that line the respiratory tract.The goblet cells produce gelatinous mucus that forms a thin layer over the interior surfaces of the trachea,bronchi,and bronchioles.Lymph does not make up fluid in the respiratory tract.The beta cells in the islets of Langerhans are located in the pancreas.Cells that produce aqueous humor are located in the interior of the eye.

Question 8

A patient has questions regarding a recently prescribed antitussive agent.Which response by the nurse is the best?

Accepted Answer

Antitussive agents act by suppressing the cough center in the brain.The expected therapeutic outcome is reduced frequency of nonproductive cough to promote rest.Antitussive agents should be taken as prescribed by the health care provider.Antitussives are not likely to eliminate a cough.Antitussives should be taken throughout the day.

Question 9

A child has been diagnosed with asthma and the nurse is providing education to the family.Which statement by the mother indicates a need for further teaching?

Accepted Answer

Pets should be removed from the home or kept outside if at all possible.

Question 10

What is true about arterial blood gases (ABGs)?(Select all that apply.)

Accepted Answer

ABGs are taken from samples from arterial blood,which must be drawn and analyzed immediately.ABGs measure partial pressures of carbon dioxide and bicarbonate,pH,and partial pressures of oxygen.ABGs do not measure partial pressures of sodium.

Question 11

The health care provider in an outpatient clinic has prescribed omalizumab (Xolair)to a patient.Which primary outcome will the nurse teach the patient to expect?

Accepted Answer

The primary therapeutic outcome associated with omalizumab therapy is reduced frequency of acute asthmatic exacerbations.Easier expectoration of phlegm,increased moisture of the mucous membranes,and liquefaction of thick secretions are not outcomes of omalizumab.

Question 12

What is albuterol (Proventil)used to treat?

Accepted Answer

The short-acting beta agonists have a rapid onset (few minutes)and are used to treat acute bronchospasm.Beta agonists are not used to treat allergies.Decongestants are used for nasal congestion.Long-acting beta agonists are used for exertional dyspnea.

Question 13

What is the action of zafirlukast (Accolate),a leukotriene receptor antagonist?

Accepted Answer

Leukotrienes are a class of anti-inflammatory agents that block leukotriene formation,and they are part of the inflammatory pathway that causes bronchoconstriction.Leukotrienes work to reduce bronchoconstriction,and they do not inhibit histamine release or affect viscosity of secretions.

Question 14

A patient is seen in the emergency department.The patient had been maintained on theophylline (Theo Dur),and a blood sample reveals the serum theophylline level is subtherapeutic.Which may cause a subtherapeutic serum level?

Accepted Answer

The patient is not tolerant to the drug if the serum theophylline levels are too low.Cimetidine would enhance the effects of theophylline,not decrease the effects.Smoking reduces the therapeutic effects of xanthine derivatives,including theophylline.Overuse of the inhaler would cause a high level of serum theophylline.

Question 15

The nurse is teaching a patient with a history of COPD to self-administer tiotropium (Spiriva)by dry powder inhalation.Which information provided by the nurse is accurate?

Accepted Answer

The patient should not breathe into the mouthpiece at any time.Capsules are meant to be used as a single dose and should be disposed of after taking the daily dose.The HandiHaler uses capsules of medication that should be pierced before the patient inhales.The inhaler should be washed with hot water.

Question 16

Which is a common expectorant in over-the-counter medications?

Accepted Answer

Guaifenesin is used for symptomatic relief of conditions characterized by a dry,nonproductive cough such as the common cold,bronchitis,laryngitis,pharyngitis,and sinusitis.Guaifenesin is also used to remove mucous plugs from the respiratory tract.Dextromethorphan is an antitussive.Diphenhydramine is an anticholinergic agent with antihistaminic and antitussive properties.Codeine is an antitussive.

Question 17

The nurse is providing instruction about ipratropium (Atrovent)to a patient with chronic obstructive pulmonary disease (COPD).Which is a common adverse effect that tends to resolve with therapy?

Accepted Answer

Dry mouth is usually mild and tends to resolve with continued therapy.Anxiety,tachycardia,and urine retention are not common adverse effects.

Question 18

An adult patient is admitted for an asthma attack.Which assessment obtained by the nurse would support that albuterol (Proventil)was effective?

Accepted Answer

A bronchodilator would open the airways and result in a reduction of wheezing.Less dyspnea while positioned in a high Fowler's position,clear and watery sputum,and a respiratory rate decreased to 38 breaths/min would not indicate that the medication was effective.

Question 19

Which statement(s)is/are true regarding the nursing assessment of a patient with a respiratory disorder?(Select all that apply.)

Accepted Answer

Fingernail clubbing is a sign of hypoxia.Mental status will deteriorate as the oxygen level in the body diminishes.Apnea is present in Cheyne-Stokes respirations.Central cyanosis is not observed on the fingers and earlobes.The normal respiratory rate in an adult is more than 10 breaths/min.

Question 20

A resident in a long-term care facility diagnosed with COPD has a new medication order for indacaterol.When the nurse is providing education to the resident regarding this medication,information will include that

Accepted Answer

Onset of action is within 5 minutes.Indacaterol is an ultra-long-acting beta 2 agonist.
Patients using inhaled bronchodilators should wait approximately 10 minutes.Duration of action is about 24 hours.

Quiz 30: Drugs Used to Treat Lower Respiratory Disease

What is the reason for administering sodium chloride to a patient with emphysema?

Premedication assessments before the use of anticholinergic bronchodilating agents should verify that the patient has no history of which condition?

The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease.What is the rationale for limiting caffeine?

Within minutes of the initiation of a nebulizer treatment with a sympathomimetic bronchodilator,the patient turns on his call light and states that he feels "panicky" and his heart is racing.Which action will the nurse take?

The nurse is obtaining a history of respiratory symptoms on a patient with the diagnosis of COPD.The patient reports smoking one pack of cigarettes per day for the past 20 years.The nurse calculates the pack years as

What structures in the respiratory tract assist in removing foreign bodies such as smoke and bacteria?

From where do the fluids of the respiratory tract originate?

A patient has questions regarding a recently prescribed antitussive agent.Which response by the nurse is the best?

A child has been diagnosed with asthma and the nurse is providing education to the family.Which statement by the mother indicates a need for further teaching?

What is true about arterial blood gases (ABGs) ?(Select all that apply.)

The health care provider in an outpatient clinic has prescribed omalizumab (Xolair) to a patient.Which primary outcome will the nurse teach the patient to expect?

What is albuterol (Proventil) used to treat?

What is the action of zafirlukast (Accolate) ,a leukotriene receptor antagonist?

A patient is seen in the emergency department.The patient had been maintained on theophylline (Theo Dur) ,and a blood sample reveals the serum theophylline level is subtherapeutic.Which may cause a subtherapeutic serum level?

The nurse is teaching a patient with a history of COPD to self-administer tiotropium (Spiriva) by dry powder inhalation.Which information provided by the nurse is accurate?

Which is a common expectorant in over-the-counter medications?

The nurse is providing instruction about ipratropium (Atrovent) to a patient with chronic obstructive pulmonary disease (COPD) .Which is a common adverse effect that tends to resolve with therapy?

An adult patient is admitted for an asthma attack.Which assessment obtained by the nurse would support that albuterol (Proventil) was effective?

Which statement(s) is/are true regarding the nursing assessment of a patient with a respiratory disorder?(Select all that apply.)

A resident in a long-term care facility diagnosed with COPD has a new medication order for indacaterol.When the nurse is providing education to the resident regarding this medication,information will include that