Deck 8: Pharmacology of Asthma, Common Cold and other Pulmonary Disorders

Question 1

Over the course of treatment for chronic asthma, a client develops an allergy to the propellants in rapid-acting metered-dose inhalers (MDI). What option would the nurse expect to be used to address this problem after discharge?
1) Oral medication of the same class as the metered-dose inhaler
2) Nebulizer treatments
3) A concentrated-dose metered-dose inhaler
4) A dry powder inhaler (DPI)

Answer 1

4

Question 2

The nurse helps a client establish goals to control asthma with medications. what does the nurse teach are the preferred drugs for long-term control of asthma?
1) Inhaled corticosteroids.
2) Inhaled beta 2 agonists.
3) Anticholinergics.
4) Systemic corticosteroids.

Answer 2

1

Question 3

The nurse is caring for an orthopedic surgical client with mild intermittent asthma. During the second postoperative day, the client has an asthma attack while eating lunch. What classification of drug would the nurse expect an order for?
1) Subcutaneous epinephrine.
2) A short-acting selective beta-agonist inhaler.
3) An oral corticosteroid.
4) Methylxanthines

Answer 3

2

Question 4

A client admitted with persistent asthma has a history of hypertension. Which class of asthma drugs would the nurse question if ordered for this client?
1) Inhaled corticosteroids
2) Oral beta-adrenergic agonists
3) Inhaled anticholinergic medications
4) Mast cell stabilizers

Question 5

A client with moderate and persistent asthma has obtained control with Salmeterol (Serevent Diskhaler Disk) as a prophylactic bronchodilator before exercise. Recently he has been using it more frequently and has awoken with an asthma attack on a few occasions. What does the nurse suspect is the possible reason for the change in his asthma condition?
1) Is not taking the medication as directed.
2) Needs to have the dose reduced and work back up to the full dose.
3) Has developed a tolerance to the medication.
4) May not be taking the correct mix of medications.

Question 6

A client with degenerative arthritis is provided with a spacer along with a corticosteroid metered-dose inhaler. What dos the nurse recognize as the reason for the use of a spacer?
1) Compensates for decreased dexterity.
2) For giving a larger dose of the steroid.
3) Assists with weaning from the steroid drug.
4) Avoids thrush infections.

Question 7

The nurse is collaboratively setting goals for the inpatient management of new-onset asthma in a child. What does the nurse recognize as the highest priority goal for this client? ?
1) The client will report improved ease of breathing by discharge.
2) The client will sleep uninterrupted for four hours at a stretch every night during admission.
3) The client's parents will verbalize the importance of the medication regimen by discharge.
4) The client's mother will correctly demonstrate the use of an inhaler with a spacer by discharge.

Question 8

The nurse is teaching a client newly diagnosed with asthma about the use of a salbutamol (Ventolin) rescue inhaler. Which nursing diagnosis is most appropriate at this time?
1) Knowledge, Deficient related to proper use of albuterol inhaler
2) Gas Exchange, Impaired related to inadequate response to albuterol
3) Airway Clearance, Ineffective related to excess mucus formation
4) Activity Intolerance related to ineffective drug therapy

Question 9

The nurse is caring for a client with chronic bronchitis and a history of glaucoma. The nurse recognizes that which drug would not be an appropriate choice for the control of the client's bronchospasm?
1) Cromolyn
2) Zafirlukast (Accolate)
3) Dextromethorphan
4) Ipratropium (Atrovent)

Question 10

The nurse is assisting a client to master the use of a steroid inhaler. The client says, "I don't want to use steroids, aren't they bad for you? What information should be included in the nurse's response?
1) Steroids used to treat airway problems are very different from the steroids abused by individuals.
2) Steroids can be very risky, but the risk is necessary in this client's case.
3) Inhaled steroids are useful in managing asthma, with a fairly good safety profile.
4) Inhaled steroid use is usually short term, so any risk to the client is minimal.

Question 11

A mother is struggling to manage her child's moderate persistent asthma at home. The mother asks the nurse if there are any nonpharmacologic measures she can use. Which strategies are most likely to be effective?
1) Keeping the child's immunizations up-to-date and wearing a face mask in public
2) Limiting intake of protein and foods with red and yellow dyes
3) Avoiding stimuli such as secondhand smoke, pollutants, and cold air
4) Limiting the child's contact with other children.

Question 12

A nurse is caring for several clients receiving bronchodilator therapy for asthma. The nurse has noted that some clients develop hyperglycemia during therapy. Which bronchodilator would the nurse consider problematic?
1) Beclomethasone (QVAR)
2) Ipratropium (Atrovent)
3) Aminophylline
4) Theophylline (Theolair)

Question 13

A client asks the nurse why the health care provider has ordered the asthma medication in inhalant rather than oral form. What is the nurse's best response? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "Inhaling an asthma medication offers a rapid and efficient way to get the medication directly into your lungs."
2) "Inhaling an asthma medication results in an almost instantaneous onset of action, which will relieve your symptoms much more quickly."
3) "Inhaling an asthma medication will control your symptoms with smaller doses, reducing the risk of systemic effects."
4) "Inhaling an asthma medication is an effective way to get the medication right into your lungs and is also a lot less expensive than oral medications."
5) "Inhaling an asthma medication automatically increases the onset of the medication, resulting in quicker relief of your symptoms."

Question 14

When nurse is planning care for a client newly diagnosed with asthma. Which of the following medications ordered does the nurse teach the client to avoid caffeine intake with?
1) Cromolyn.
2) Theophylline (Uniphyl)
3) Beclomethasone.
4) Salmeterol (Serevent Diskhaler Disk)

Question 15

A client with chronic obstructive pulmonary disease (COPD) is experiencing difficulty with copious amounts of tenacious sputum. A mucolytic drug is prescribed. What is the desired outcome of this classification of medication?
1) Increase in clearance of sputum.
2) Cough Suppression
3) resolution of atrial tachycardia.
4) decrease in wheezing.

Question 16

The nurse is planning care for a client with chronic obstructive pulmonary disease (COPD). The client's symptoms are wheezing, tachycardia, increased respiratory rate, coughing up yellow mucus, and a low oxygen level. The highest-priority nursing diagnosis is:
1) Falls, Risk for
2) Knowledge, Deficient
3) Gas Exchange, Impaired
4) Anxiety.

Question 17

A client with limited strength in the hands is being prepared for discharge with a dry powder inhaler (DPI). The discharge nurse teaches the client that an advantage of this inhaler is that:
1) The client can activate the inhaler with less pressure than is needed for a metered-dose inhaler.
2) This inhaler has no dose limits.
3) The client can increase the effectiveness of the powder by instilling it into a small nebulizer.
4) The client can activate the inhaler simply by inhaling.

Question 18

A client is learning metered-dose inhaler technique. The client says, "I don't understand why I have to use this thing. Can't I just take pills?" The nurse responds that the inhalation route:
1) Is easier to master than is oral therapy.
2) Is less expensive than is oral therapy.
3) Is more likely to lead to termination of the disease process than are pills.
4) Delivers the medication directly, resulting in fewer systemic side effects.

Question 19

A client in acute respiratory distress on a medical unit is receiving a nebulizer albuterol treatment. The client asks why the medication is delivered by nebulizer instead of an MDI. What is the best response of the nurse?
1) "Nebulized therapy is more cost-effective in the inpatient setting."
2) "Suspension of the drug in liquid and delivery over a longer period increase the effectiveness."
3) "The nebulized form of the drug will have fewer negative effects on this distressed client."
4) "The anxious and dyspneic client is unlikely to be able to use a metered-dose albuterol inhaler effectively."

Question 20

The nurse is teaching an asthmatic client about the use of a corticosteroid inhaler prior to discharge. Whatdoes the nurse teach the client is the expected outcome of this therapy?
1) Less histamine formation, with less mucus in the upper airway.
2) Decreased hyper-responsiveness to allergens.
3) Resolution of all asthma symptoms.
4) Decreased inflammation of the mid-sized bronchial tubes.

Question 21

A client has been prescribed beclomethasone (QVAR) for long-term management of persistent asthma. Prior to discharge, the nurse teaches the client about possible side effects, including:
1) Hoarseness.
2) Vision changes.
3) Nervousness.
4) Insomnia.

Question 22

The nurse is providing discharge instruction to a client newly diagnosed with asthma. The client has been prescribed Salbutamol (Ventolin) for bronchospasm. Which side effects should the nurse explain to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Restlessness
2) Tremor
3) Nervousness
4) Abnormal EKG
5) Hypertensive crisis

Question 23

A pediatric nurse is educating a 6-year-old and the mother on the use of a metered-dose inhaler (MDI) with a spacer. The mother asks what the spacer is for. The nurse responds: Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) "Without the spacer, most of the medication does not get into the lungs because the heavier particles fall out into the throat."
2) "It can be difficult to properly coordinate pressing the canister and inhaling so the medication falls into the mouth instead of getting to the lungs."
3) "The spacer holds the medication during inhalation, so your child will not have to worry about coordination."
4) "The spacer is automatically activated when your child inhales, making it a lot easier to get the medication into the lungs."
5) "The spacer vaporizes the medication so your child can inhale it. More medication gets directly into the lungs."

Question 24

The priority assessment for a client receiving asthma medications to determine effectiveness of therapy should include: Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Increased ease of breathing.
2) Improved signs of peripheral oxygenation.
3) Absence of adventitious sounds.
4) Normal hepatic function.
5) Therapeutic levels of medications.

Question 25

The nurse instructs a client with asthma that quick-relief medications that should be used for acute symptoms include: Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Salbutamol (Ventolin)).
2) Ipratropium (Atrovent).
3) Beclomethasone (QVAR).
4) Cromolyn
5) Montelukast (Singulair).

Question 26

A nurse is teaching a class of clients newly diagnosed with asthma. What does the nurse teach the class on the effects an inhaled corticosteroid has in the long term management of asthma? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1) Decreases inflammation of the airways.
2) Promotes mucus production.
3) Decreases bronchial hyper-responsiveness.
4) Promotes bronchial constriction.
5) Manages edema.

Question 27

The nurse, discharging a client recently diagnosed with asthma, explains that symptoms that should be reported immediately to the health care provider include:
1) Difficulty breathing.
2) Feeling breathless when speaking.
3) Increased anxiety.
4) Increased activity level.
5) Increased appetite.

Question 28

The nurse explains to a client that drugs that activate beta 2-adrenergic receptors:
1) Relax bronchiolar smooth muscle.
2) Result in airway diameter narrowing.
3) Increase laboured breathing
4) Decrease production of viscous secretions.