Deck 36: Lower Respiratory Disorders

Question 1

A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about disease and medication management, the nurse will instruct the patient to administer these medications in which order?

A) Albuterol, ipratropium bromide, steroid
B) Albuterol, steroid, ipratropium bromide
C) Ipratropium bromide, albuterol, steroid
D) Steroid, ipratropium bromide, albuterol

Answer 1

Albuterol, ipratropium bromide, steroid

Question 2

The nurse provides teaching for a patient who will begin taking montelukast sodium (Singulair). Which statement by the patient indicates a need for further teaching?

A) "I will need to have periodic laboratory tests while taking this medication."
B) "I will not take ibuprofen for pain or fever while taking this drug."
C) "I will take one tablet daily at bedtime."
D) "I will use this as needed for acute symptoms."

Answer 2

"I will use this as needed for acute symptoms."

Question 3

The nurse is teaching a patient who will begin taking oral theophylline (Theo-Dur) when discharged home from the hospital. What information will the nurse include when teaching the patient about this drug?

A) An extra dose should be taken when symptoms worsen.
B) Anorexia and gastrointestinal upset are unexpected side effects.
C) Avoid caffeine while taking this medication.
D) Food will decrease the amount of drug absorbed.

Answer 3

Avoid caffeine while taking this medication.

Question 4

The nurse is caring for a patient recently diagnosed with mild emphysema and provides teaching about the disease and medications for treatment. Which statement by the patient indicates understanding of the medication regimen?

A) "I should use albuterol when my symptoms worsen."
B) "I will need to take oral prednisone on a daily basis."
C) "My provider will frequently prescribe prophylactic antibiotics."
D) "My symptoms are reversible with proper medications."

Question 5

A patient who has been taking theophylline at home reports having palpitations and jitteriness. Which of the following could interact with theophylline to increase side effects such as these?

A) Ephedra.
B) Acetaminophen.
C) Ibuprofen.
D) Diphenhydramine.

Question 6

A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse notes white spots on the patient's tongue and oral mucous membranes. After notifying the provider, the nurse will remind the patient to perform which action?

A) Avoid using a spacer with the inhaled glucocorticoid medication.
B) Clean the inhaler with hot, soapy water after each use.
C) Consume yogurt daily while using this medication.
D) Rinse the mouth thoroughly with water after each use.

Question 7

The nurse is performing a medication history on a patient who reports long-term use of montelukast (Singulair) and an albuterol metered-dose inhaler (Proventil). The nurse will contact the provider to discuss an order for which laboratory tests?

A) Cardiac enzymes and serum calcium
B) Electrolytes and a complete blood count
C) Liver function tests and serum glucose
D) Urinalysis and serum magnesium

Question 8

The nurse is preparing to administer epinephrine to a patient who is experiencing an acute bronchospasm. The nurse understands that because epinephrine is a nonselective alpha- and beta-adrenergic agonist, the patient will experience which effects?

A) Decreased blood pressure
B) Anticholinergic effects
C) A shorter duration of therapeutic effects
D) Cardiac and pulmonary effects

Question 9

A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The nurse will explain that the inhaled form of albuterol:

A) has a more immediate onset than the oral form.
B) may cause more side effects than the oral preparation.
C) requires an increased dose in order to have therapeutic effects.
D) will not lead to tolerance with increased doses.

Question 10

A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication?

A) Failure to respond to the medication indicates a need for a higher dose.
B) Monitor for hypoglycemia symptoms when using this medication.
C) Palpitations are common with this drug even at normal, therapeutic doses.
D) Overuse of this medication can result in airway narrowing and bronchospasm.

Question 11

A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to report experiencing cough and a bad taste. The nurse will instruct the patient to perform which action?

A) Drink water before and after using the inhaler.
B) Schedule an appointment to discuss these effects with the provider.
C) Stop taking the medication immediately.
D) Use the inhaler only as needed for acute bronchospasms.

Question 12

The nurse is caring for a patient who is receiving intravenous theophylline. The patient complains of headache and nausea. The nurse will contact the provider to:

A) change the medication to an oral theophylline.
B) obtain an order for a serum theophylline level.
C) request an order for an analgesic medication.
D) suggest an alternative methylxanthine medication.

Question 13

The nurse is caring for a patient who will begin taking theophylline at home. During the assessment, the nurse learns that the patient smokes. The nurse expects that the patient will eventually require which of the following?

A) A smaller than typical dose of theophylline.
B) A larger than typical dose of theophylline.
C) A typical dose of theophylline.
D) A change in medication since theophylline is contraindicated in those who smoke.

Question 14

The nurse is caring for a patient diagnosed with COPD who has been prescribed tiotropium (Spiriva). Which statement will the nurse include in the education?

A) Remove the capsules from the packaging and place in your 7-day med box.
B) If you experience dry mouth, stop taking the medication immediately.
C) Use tiotropium as needed for sudden breathing problems.
D) Tiotropium works by relaxing and dilating the bronchioles.

Question 15

A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is prescribed primarily for which reason?

A) To be more convenient for patients who require both medications
B) To improve compliance in patients who may forget to take both drugs
C) To increase forced expiratory volume, an indicator of symptom improvement
D) To minimize the side effects that would occur if the drugs are given separately