Question 1

The nurse is reviewing medications for the treatment of asthma.Which drugs are used for acute asthma attacks? (Select all that apply.)&#10;A) Salmeterol (Serevent)inhaler&#10;B) Albuterol (Proventil)nebulizer solution&#10;C) Epinephrine&#10;D) Montelukast (Singulair)&#10;E) Fluticasone (Flovent)Rotadisk inhaler

Accepted Answer

Albuterol (Proventil) and epinephrine are both bronchodilators used for the acute treatment of asthma attacks. Salmeterol (Serevent) and fluticasone (Flovent) are used for long-term management of asthma, while Montelukast (Singulair) is a leukotriene receptor antagonist used for both long-term management and prevention of exercise-induced asthma.

Question 2

After receiving a nebulizer treatment with a beta agonist,the patient complains of feeling slightly nervous and wonders if her asthma is getting worse.What is the nurse's best response?&#10;A) &#34;This is an expected adverse effect.Let me take your pulse.&#34;&#10;B) &#34;The next scheduled nebulizer treatment will be skipped.&#34;&#10;C) &#34;I will notify the physician about this adverse effect.&#34;&#10;D) &#34;We will hold the treatment for 24 hours.&#34;

Accepted Answer

Feeling slightly nervous is a common adverse effect of beta agonist medications used in nebulizer treatments. The nurse should reassure the patient that this is an expected reaction and assess the patient's vital signs, including pulse, to ensure they are within a normal range. Skipping the next scheduled treatment or holding treatment for 24 hours is not necessary or appropriate based on this symptom alone. The nurse should only notify the physician if the patient experiences more severe or persistent adverse effects.

Question 3

When educating a patient recently placed on inhaled corticosteroids,the nurse will discuss which potential adverse effects?&#10;A) Fatigue and depression&#10;B) Anxiety and palpitations&#10;C) Headache and rapid heart rate&#10;D) Oral candidiasis and dry mouth

Accepted Answer

The use of inhaled corticosteroids can lead to two potential adverse effects: oral candidiasis (thrush) and dry mouth. It is important for patients to rinse their mouths with water after each use to help prevent these complications. While some patients may experience systemic side effects such as fatigue or headache, these are less common and not typically discussed during patient education specifically related to inhaled corticosteroids. Anxiety and palpitations are also not common adverse effects.

Question 4

A patient has prescriptions for two inhalers.One inhaler is a bronchodilator,and the other is a corticosteroid.Which instruction regarding these inhalers will the nurse give to the patient?&#10;A) &#34;Take the corticosteroid inhaler first.&#34;&#10;B) &#34;Take the bronchodilator inhaler first.&#34;&#10;C) &#34;Take these two drugs at least 2 hours apart.&#34;&#10;D) &#34;It does not matter which inhaler you use first.&#34;

Accepted Answer

The patient should take the bronchodilator inhaler first as it will help to open up the airways and make it easier for the corticosteroid to penetrate and work effectively. The order of inhalers is important in this case.

Question 5

A patient will be receiving oral theophylline (Theo-Dur),600 mg/day,in three divided doses.Identify how many milligrams will the patient receive per dose._______

Accepted Answer

The answer of A patient will be receiving oral theophylline...

Question 6

The nurse is monitoring drug levels for a patient who is receiving theophylline.The most recent theophylline level was 22 mcg/mL,and the nurse evaluates this level to be:&#10;A) below the therapeutic level.&#10;B) at a therapeutic level.&#10;C) above the therapeutic level.&#10;D) at a toxic level.

Accepted Answer

The therapeutic level of theophylline is typically between 10-20 mcg/mL. A level of 22 mcg/mL is above this range and could increase the risk for toxicity. The nurse should monitor the patient closely and notify the healthcare provider.

Question 7

A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive pulmonary disease.The nurse will assess for which therapeutic response?&#10;A) Increased sputum production&#10;B) Increased heart rate&#10;C) Increased respiratory rate&#10;D) Increased ease of breathing

Accepted Answer

Aminophylline is a bronchodilator and smooth muscle relaxant used in the management of severe exacerbations of COPD. Therefore, the therapeutic response the nurse should assess for is increased ease of breathing. Options A, B, and C represent adverse effects of aminophylline, and should be monitored for as potential complications.

Question 8

A patient has a metered-dose inhaler that contains 200 actuations ('puffs'),and it does not have a dose counter.He is to take two puffs two times a day.If he does not take any extra doses,identify how many days will this inhaler last at the prescribed dose._______

Accepted Answer

The answer of A patient has a metered-dose inhaler that...

Question 9

A patient is in an urgent care center with an acute asthma attack.The nurse expects that which medication will be used for initial treatment? A) An anticholinergic such as ipratropium (Atrovent) B) A short-acting beta₂ agonist such as albuterol (Proventil) C) A long-acting beta₂ agonist such as salmeterol (Serevent) D) A corticosteroid such as fluticasone (Flovent)

Accepted Answer

A short-acting beta-agonist such as albuterol is the initial medication of choice for treating acute asthma attacks as it quickly relaxes the smooth muscles of the airways, allowing for easier breathing. Anticholinergics such as ipratropium may also be used in combination with a beta-agonist for more severe cases, and corticosteroids such as fluticasone are used for long-term control and prevention of asthma symptoms. Long-acting beta-agonists such as salmeterol are not appropriate for initial treatment of acute asthma attacks.

Question 10

The prescriber has changed the patient's medication regimen to include the leukotriene receptor antagonist (LTRA)montelukast (Singulair)to treat asthma.The nurse will emphasize which point about this medication?

A) The proper technique for inhalation must be followed.
B) The patient needs to keep it close by at all times to treat acute asthma attacks.
C) It needs to be taken every day on a continuous schedule,even if symptoms improve.
D) When the asthma symptoms improve,the dosage schedule can be tapered and eventually discontinued.

Accepted Answer

Montelukast is a maintenance medication for asthma and needs to be taken every day on a continuous schedule, even if symptoms improve. It is not a rescue medication and should not be kept close by for acute asthma attacks. It is taken orally and does not require inhalation technique. The dosage schedule should be determined by the prescriber and should not be tapered or discontinued without their input.

Question 11

A patient is taking a xanthine derivative as part of treatment for chronic obstructive pulmonary disease.The nurse will monitor for which adverse effects associated with the use of xanthine derivatives?

A) Diarrhea
B) Palpitations
C) Bradycardia
D) Drowsiness

Accepted Answer

The answer of A patient is taking a xanthine derivative...

Question 12

The nurse is providing instructions about the Advair inhaler (fluticasone propionate and salmeterol).Which statement about this inhaler is accurate?&#10;A) It is indicated for the treatment of acute bronchospasms.&#10;B) It needs to be used with a spacer for best results.&#10;C) Patients need to avoid drinking water for 1 hour after taking this drug.&#10;D) It is used for the prevention of bronchospasms.

Accepted Answer

The answer of The nurse is providing instructions about the...

Question 13

When evaluating a patient's use of a metered-dose inhaler (MDI),the nurse notes that the patient is unable to coordinate the activation of the inhaler with her breathing.What intervention is most appropriate at this time?

A) Notify the doctor that the patient is unable to use the MDI.
B) Obtain an order for a peak flow meter.
C) Obtain an order for a spacer device.
D) Ask the prescriber if the medication can be given orally.

Accepted Answer

The answer of When evaluating a patient's use of a...

Deck 37: Respiratory Drugs