Deck 9: Mucus-Controlling Drug Therapy

Question 1

An expectorant whose action is thought to be mediated by stimulation of the gastrointestinal tract is

A)guaifenesin.
B)sodium bicarbonate.
C)SSKI.
D)mannitol.

Answer 1

guaifenesin.

Question 2

Which of the following are functions of mucus in the body?
1)Lubrication
2)Improvement of gas exchange
3)Waterproofing
4)Protection from inflammation

A)1 and 3 only
B)1 and 4 only
C)1,3,and 4 only
D)1,2,3,and 4

Answer 2

1,3,and 4 only

Question 3

Diseases with hypersecretion or poor clearance of secretions include which of the following?
1)Cystic fibrosis
2)Pneumonia
3)Congestive heart failure
4)Primary ciliary dyskinesia

A)1 only
B)1 and 2 only
C)2 and 3 only
D)1,2,and 4 only

Answer 3

1,2,and 4 only

Question 4

_________ is the most serious potential hazard associated with the use of acetylcysteine.

A)Nausea
B)Rhinorrhea
C)Tachycardia
D)Bronchospasm

Question 5

Which structures are responsible for providing most mucus secretions?

A)Surface epithelial cells
B)Goblet cells
C)Cilia
D)Submucosal glands

Question 6

The physical properties of mucus include which of the following?
1)Adhesion
2)Cohesion
3)Elasticity
4)Viscosity

A)1 only
B)1 and 2 only
C)1,2,and 3 only
D)1,2,3,and 4

Question 7

_____________ has not been tested and approved for use with dornase alfa.

A)PARI LC PLUS
B)Misty-Neb
C)Hudson RCI UP-DRAFT II OPTI-NEB
D)Acorn II

Question 8

The rate of mucociliary transport in the normal peripheral airway is approximately

A)0.5 mm/min.
B)1.5 mm/min.
C)5.0 mm/min.
D)21.5 mm/min.

Question 9

The standard dose of dornase alfa for aerosolization is

A)1.0 mg in 2.5 mL of diluent.
B)2.5 mg in 2.5 mL of diluent.
C)5.0 mg in 2.5 mL of diluent.
D)10.0 mg in 2.5 mL of diluent.

Question 10

A resident orders 4 mL of 20% Mucomyst aerosolized for an asthma patient.You are called by the unit secretary about the order.Which of the following should you do?

A)Verify the order in the chart and administer as written
B)Find a student and have him or her give the treatment
C)Not administer the treatment at all
D)Call the resident,suggest 10% Mucomyst,and obtain a verbal order to give a $\beta$ ₂ agonist with the Mucomyst

Question 11

The number of goblet cells per square millimeter of normal airway mucosa is

A)60
B)600
C)6000
D)60000

Question 12

You have a patient with cystic fibrosis (CF)who needs an aerosol medication to reduce the viscosity and adhesivity of infected respiratory secretions.What agent would you recommend?

A)Atropine
B)Dornase alfa
C)Cromolyn sodium
D)Albuterol

Question 13

Acetylcysteine is incompatible in solution with which of the following?

A)Certain antibiotics
B)Sympathomimetic bronchodilators
C)Anticholinergic bronchodilators
D)Saline

Question 14

Pulmozyme is the trade name for which mucoactive agent?

A)Dornase alfa
B)Acetylcysteine
C)Mucosil-20
D)Iodopropylidene glycerol

Question 15

Which of the following agents are currently approved for administration as aerosolized mucoactive agents?
1)Dry powder mannitol
2)N-acetylcysteine (NAC)
3)Dornase alfa
4)Ipratropium bromide
5)7% hyperosmolar saline

A)1 and 2 only
B)2,3,and 5 only
C)2 and 3 only
D)5 only

Question 16

The cholinergic response in terms of mucociliary clearance is
1)increased ciliary beat.
2)decreased ciliary beat.
3)increased mucus production.
4)decreased mucus production.

A)1 only
B)2 only
C)1 and 3 only
D)2 and 4 only

Question 17

Agents that increase volume or hydration of airway secretions are called

A)mucoregulatory.
B)mucolytics.
C)bronchodilators.
D)expectorants.

Question 18

Medications that increase mucociliary or cough efficiency are

A)mucokinetics.
B)mucolytics.
C)mucoregulatory agents.
D)expectorants.

Question 19

What mucus color typically indicates retained secretions and neutrophil activation?

A)White
B)Yellow
C)Brown
D)Green

Question 20

Which of the following provide antibacterial defense in the airway?
1)IgA
2)IgG
3)Phospholipids
4)Serine proteases

A)1 and 2 only
B)3 and 4 only
C)1,2,and 3 only
D)1,2,and 4 only

Question 21

Which of the following conditions or substances slow down the mucociliary transport and are associated with airway damage?
1)Chronic obstructive pulmonary disease (COPD)and cystic fibrosis (CF)
2)Mechanical ventilation
3)Narcotics
4)Cigarette smoke
5)Hyperoxia

A)1,2,and 5 only
B)2,3,and 5 only
C)1,3,4,and 5 only
D)1,2,3,4,and 5

Question 22

____________ is the term used for any medication or drug that has an effect on mucus secretion.

A)Mucoregulatory agent
B)Mucospissic agent
C)Mucoactive agent
D)Mucokinetic agent
E) Mucolytic agent

Question 23

Medication that increases the viscosity of secretions and may be effective in the therapy of bronchorrhea.

A)Mucoregulatory agent
B)Mucospissic agent
C)Mucoactive agent
D)Mucokinetic agent
E) Mucolytic agent

Question 24

__________ is the most common hazard associated with the use of dornase alfa.

A)Voice alteration
B)Rash
C)Tachycardia
D)Chest pain

Question 25

While working in the surgical intensive care unit (ICU),you read in your patient's chart that the patient had received atropine before endotracheal intubation.A respiratory therapy student asks you why.You explain it was given for the following reason:

A)It can add water content to respiratory secretions.
B)It prevents laryngospasm and decreases mucus secretions.
C)It breaks down DNA content in sputum.
D)It increases mucociliary beat frequency.

Question 26

Purulent material in the airways is called

A)gel.
B)mucus.
C)phlegm.
D)sol.
E) sputum.

Question 27

Expectorated phlegm that contains respiratory tract,oropharyngeal,and nasopharyngeal secretions and bacteria and products of inflammation including polymeric DNA and actin is called

A)gel.
B)mucus.
C)phlegm.
D)sol.
E) sputum.

Question 28

A drug that reduces the volume of airway mucus secretions and seems to be especially effective in hypersecretory states is called a

A)mucoregulatory agent.
B)mucospissic agent.
C)mucoactive agent.
D)mucokinetic agent.
E) mucolytic agent.

Question 29

How does N-acetyl cysteine (NAC)work?

A)Adds water content to respiratory secretions
B)Substitutes sulfhydryl radicals for disulfide bonds in mucus
C)Breaks down DNA content in sputum
D)Increases mucociliary beat frequency

Question 30

Secretion from surface goblet cells and submucosal glands composed of water,proteins,and glycosylated mucins.

A)Gel
B)Mucus
C)Phlegm
D)Sol
E) Sputum

Question 31

The mucoactive agent used as an irritant to induce a cough and hydrate airway surface fluid is

A)guaifenesin.
B)sodium bicarbonate.
C)albuterol.
D)hypertonic saline (7%).

Question 32

The weak gel containing attached mucins that bathes the beating cilia and usually separates that mucus layer from the epithelial surface is called

A)gel.
B)mucus.
C)phlegm.
D)sol.
E) sputum.

Question 33

How does dornase alfa work?

A)Adds water to secretions
B)Substitutes sulfhydryl radicals for disulfide bonds in mucus
C)Breaks down DNA content in sputum
D)Increases mucociliary beat frequency

Question 34

A physician asks you to suggest an airway clearance technique or device to use for a patient with neuromuscular weakness who is unable to cough effectively.Which of the following should you suggest?

A)Postural drainage
B)Chest physical therapy (CPT)
C)An insufflation-exsufflation device
D)Active cycle of breathing (ACB)

Question 35

General contraindications for mucoactive therapy include which of the following?
1)Forced expiratory volume in 1 second (FEV₁)greater than 25% of predicted
2)Gastroesophageal reflux
3)End-stage pulmonary disease
4)Acute exacerbation of chronic obstructive pulmonary disease (COPD)

A)1,2,and 4 only
B)2,3,and 4 only
C)1,2,and 3 only
D)1 only

Question 36

The term ________________ is used to describe the macromolecular pseudoplastic material that has both viscosity and elasticity.

A)gel
B)mucus
C)phlegm
D)sol
E) sputum

Question 37

Which of the following are essential secretory structures of the mucociliary system?
1)Surface epithelial cells
2)Pseudostratified,columnar,ciliated epithelial cells
3)Surface goblet cells
4)Clara cells in the distal airway
5)Submucosal glands

A)1 ,2,and 5 only
B)2,3,and 5 only
C)1,2,and 3 only
D)1,2,3,4,and 5

Question 38

Medications that degrade polymers in secretions are

A)mucokinetics.
B)mucolytics.
C)mucoregulatory agents.
D)expectorants.

Question 39

A medication that increases ciliary clearance of respiratory mucus secretions is called a

A)mucoregulatory agent.
B)mucospissic agent.
C)mucoactive agent.
D)mucokinetic agent.
E) mucolytic agent.

Question 40

When should mucoactive therapy be considered?

A)Before inhaled corticosteroids are administered
B)When an active upper respiratory infection is causing bronchospasm
C)After therapy to decrease infection and inflammation
D)Only during mechanical ventilation of a patient with COPD

Question 41

How much mucus does a healthy person produce per 24 hours?

A)25 mL
B)50 mL
C)75 mL
D)100 mL

Question 42

Medication that degrades polymers in secretions.

A)Mucoregulatory agent
B)Mucospissic agent
C)Mucoactive agent
D)Mucokinetic agent
E) Mucolytic agent