Deck 40: Drugs for Asthma and Other Pulmonary Disorders

Question 1

The client receives beclomethasone (Beconase). What will the best assessment by the nurse include?

A) Assess the client's mouth for any sign of fungal infection.
B) Assess the client's blood glucose prior to administration of nasal spray.
C) Assess if the client has blown his nose prior to administration of nasal spray.
D) Assess if the client has had a change in taste.
E) Assess the client for any hoarseness or change in voice.

Answer 1

Assess the client's mouth for any sign of fungal infection.
Assess if the client has blown his nose prior to administration of nasal spray.
Assess if the client has had a change in taste.
Assess the client for any hoarseness or change in voice.

Question 2

The client receives albuterol (Proventil) via inhaler. He asks the nurse why he can't just take a pill. What is the best response by the nurse?

A) "When you inhale the drug the blood supply in your lungs picks it up rapidly, resulting in quicker effects."
B) "Because pills cannot help your illness; you must have inhaled medications for relief of symptoms."
C) "Because pills would produce too many side effects; you will have very few side effects with inhaled medications."
D) "Because this medication cannot be absorbed from your GI tract; the acid in your stomach would destroy it."

Answer 2

"When you inhale the drug the blood supply in your lungs picks it up rapidly, resulting in quicker effects."

Question 3

Leukotriene modifiers are primarily used for

A) status asthmaticus.
B) infection.
C) bronchodilation in asthma.
D) prophylaxis of asthma symptoms.

Answer 3

prophylaxis of asthma symptoms.

Question 4

The physician has ordered ipratropium (Atrovent) for the client. What is a priority assessment question for the nurse to ask prior to administering this medication?

A) "Are you allergic to soy?"
B) "Do you have diabetes mellitus?"
C) "Do you have seizures?"
D) "Do you have gout?"

Question 5

The nurse plans to teach an adolescent about inhalation therapy as part of the treatment plan for the client's asthma. What does the best plan by the nurse include?

A) Inhalation therapy is effective because it provides around-the-clock therapy, as opposed to oral medications.
B) Inhalation therapy is the preferred treatment for adolescents because it is easier for them to manage.
C) Inhalation therapy is effective because it provides systemic relief of symptoms as well as local relief.
D) Inhalation therapy is effective because it goes to the direct site of action in the respiratory tract.

Question 6

The nurse would observe for fungal infection of the throat with which class of medications?

A) Methylxanthines
B) Beta-adrenergic agonists
C) Mast cell inhibitors
D) Glucocorticoids

Question 7

The physician has prescribed cromolyn (Intal) for the client with asthma. The nurse plans to do medication education. What will the best plan by the nurse include?

A) This medication is indicated for acute asthma attacks.
B) This medication can affect blood glucose levels.
C) This medication will help prevent asthma attacks.
D) This medication can result in hypertension.

Question 8

The client asks the nurse why she must continue taking her asthma medication even though she has not had an asthma attack in several months. What is the best response by the nurse?

A) "The medication needs to be taken indefinitely according to your doctor, so you should discuss this with him."
B) "The medication is still needed to decrease inflammation in your airways and help prevent an attack."
C) "The medication needs to be taken or your lungs will be severely damaged, and we will not be able to stop an acute attack."
D) "The medication needs to be taken for at least a year; then, if you have not had an acute attack, you can stop it."

Question 9

The nurse teaches the client about the use of a metered-dose inhaler (MDI) and spacer. The nurse evaluates that additional teaching is required when the client makes which statement?

A) "I need to follow the instructions about using the metered-dose inhaler (MDI)."
B) "I need to rinse my mouth each time after using the metered-dose inhaler (MDI)."
C) "I need to drink a lot of fluids while I am using the metered-dose inhaler (MDI)."
D) "I should keep the spacer moist between uses by storing it in a plastic zip bag."

Question 10

The nurse is preparing to administer beclomethasone (Beconase) to several clients. For which client would the nurse hold the drug and contact the physician?

A) The client who has had a myocardial infarction (MI)
B) The client who has methicillin resistant Staphylococcus aureus (MRSA)
C) The client who has diabetes mellitus
D) The client who has terminal cancer

Question 11

The client receives ipratropium (Atrovent). She tells the nurse she is going to stop it because of the bitter taste in her mouth after using the medication. What is the best response by the nurse?

A) "That is a good idea; you are experiencing a serious side effect."
B) "That is a common side effect; it will go away in time."
C) "You can decrease that side effect by rinsing your mouth after use."
D) "Are you sure you are using the medication properly?"

Question 12

Which statement is true regarding asthma?

A) It has both inflammatory and bronchoconstriction components.
B) Asthma is caused by a virus.
C) Asthma cannot be treated.
D) Symptoms most often occur with rest.

Question 13

The client receives ipratropium (Atrovent) via inhalation for the treatment of chronic asthma. The nurse plans to do medication education with the client. What will the best plan by the nurse include?

A) Wait 15 minutes before using any other inhaled medications.
B) The medication may also be used for acute asthma attacks.
C) Report any increased dyspnea.
D) Report any changes in urinary pattern.
E) Use the medication consistently, not occasionally.

Question 14

Which statement is true regarding dry powder inhalers (DPI)?

A) The medication is delivered by tablet orally.
B) The medication is delivered by fine mist.
C) The device is activated by inhalation.
D) The medication is applied topically.

Question 15

A client receives theophylline (Theo-Dur) and calls the clinic to say he has had nausea and vomiting for 2 days. What is the best action by the nurse?

A) Tell the client to come to the clinic for an assessment.
B) Ask the client if he has eaten at any unclean restaurants.
C) Ask the client if he has been exposed to anyone with the flu.
D) Recommend that the client begin a clear liquid diet.

Question 16

The nurse understands that one advantage of inhaled pulmonary drugs over oral drugs is that inhaled drugs

A) increase adverse effects.
B) allow for convenience to the client.
C) are delivered to systemic locations.
D) allow for quick absorption.

Question 17

The client receives zafirlukast (Accolate) as treatment for asthma. The nurse has completed medication education and evaluates that learning has occurred when the client makes which statement?

A) "This medication activates my fight-or-flight response."
B) "This medication is good when I have an acute attack of asthma."
C) "This medication dilates my airways so I can breathe better."
D) "This medication decreases the inflammation in my lungs."

Question 18

The nurse teaches a medication class on bronchodilators for clients with asthma. The nurse evaluates that learning has occurred when the clients make which statement?

A) "The medication widens the airways because it decreases the production of mucus that narrows them."
B) "The medication widens the airways because it decreases the production of histamine that narrows them."
C) "The medication widens the airways because it acts on the parasympathetic nervous system."
D) "The medication widens the airways because it stimulates the fight-or-flight response of the nervous system."

Question 19

The nurse is providing disease management education for a patient who has just been diagnosed with asthma. The nurse provides which information? (Select all that apply.)

A) Drink additional fluids.
B) Eat small, frequent meals.
C) Sleep in a warm room.
D) Do all activity early in the morning and rest in the afternoon.
E) Avoid foods high in protein.

Question 20

Bronchoconstriction in the airways is stimulated by

A) perfusion.
B) ventilation.
C) the sympathetic nervous system.
D) parasympathetic nervous system.

Question 21

The nurse has provided medication education to a patient who was just diagnosed with asthma. The nurse would evaluate that additional teaching is necessary when the patient makes which statement? (Select all that apply.)

A) "My albuterol inhaler should be taken routinely to prevent asthma attacks."
B) "I should plan to take my corticosteroid for the rest of my life."
C) "My cromolyn inhaler (Intal) will help me prevent asthma attacks."
D) "I'll use my montelukast (Singulair) inhaler every day."
E) "My therapy will include both oral and inhaled drugs."

Question 22

A patient who takes albuterol (Proventil) reports to the emergency department with reports of fatigue and palpitations. The nurse would closely assess which laboratory test?

A) Amylase
B) Electrolytes
C) Hemoglobin
D) Arterial blood gases

Question 23

A nurse works in a clinic that sees both children and adults with asthma. Which assessments will the nurse routinely monitor on patients taking corticosteroids? (Select all that apply.)

A) Height measurement in children
B) Bone density test results in adults
C) IQ measurements in both adults and children
D) Weight measurements in children
E) EKGs on adults

Question 24

An 8-year-old child was just diagnosed with asthma. Which assessment questions should the nurse ask the child and parents?

A) "Have you eaten any new foods?"
B) "Are you exposed to anyone who smokes?"
C) "Have you had your carpet cleaned lately?"
D) "Have you grown taller since last year?"
E) "Has there been a change in laundry products recently?"

Question 25

A nurse is explaining the process of respiration to a client. Which information should be given?

A) "Moving air in and out of the lungs is really called ventilation."
B) "The smooth muscle in the alveoli helps to pull air into the lungs."
C) "Exchange of oxygen and carbon dioxide occurs across a thin capillary membrane."
D) "Respiration is not effective without perfusion."
E) "Your basic respiratory drive is determined by your brain."

Question 26

A client diagnosed with COPD says, "I don't see why I need to stop smoking. The damage to my lungs is already done." How should the nurse respond to this statement?

A) "If you stop smoking now, your COPD may not get worse as fast."
B) "If you stop smoking, your lungs will get better pretty quickly."
C) "Your symptoms might not be as bad if you aren't smoking."
D) "You are probably correct, but you should at least try."
E) "If I were you, I would enjoy what time I have left."

Question 27

Which condition is an adverse effect of a beta-adrenergic agonist?

A) Bradycardia
B) Constipation
C) Tachycardia
D) Runny nose

Question 28

A client has been prescribed a leukotriene modifier. Which assessment finding would cause the nurse to question this prescription?

A) The client is 54 years old.
B) The client reports frequent foot cramps.
C) The client reports drinking two or three mixed alcohol drinks each day.
D) The client has chronic hepatitis C.
E) The client has a history of a CVA 2 years ago.

Question 29

A patient presents to the emergency department with exacerbation of asthma that occurred while eating breakfast at a local buffet. The nurse would ask which assessment questions? (Select all that apply.)

A) "Did you eat bacon or sausage?"
B) "Did you have any dairy products?"
C) "Did you drink orange juice?"
D) "Did you have pastries with nuts?"
E) "Did you drink coffee?"

Question 30

A client says, "My doctor told me that I have COPD and might develop emphysema. I always thought I had chronic bronchitis." How should the nurse respond to this statement?

A) "Are you certain he didn't say you have asthma?"
B) "Chronic bronchitis doesn't have anything to do with COPD."
C) "COPD is either asthma, chronic bronchitis, or emphysema, or a combination of those disorders."
D) "As COPD progresses, it becomes emphysema."
E) "Both diagnoses are correct."