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?

Accepted Answer

D

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?

Accepted Answer

Inhaled corticosteroids are the preferred drugs for long-term control of asthma as they have anti-inflammatory effects and reduce airway hyperresponsiveness. Inhaled beta 2 agonists are used as a rescue medication for quick relief of asthma symptoms but are not preferred for long-term control. Anticholinergics may be used in combination with inhaled corticosteroids but are not the preferred drug for long-term control. Systemic corticosteroids may be used for short-term control of exacerbations but are not recommended for long-term use due to their potential for systemic side effects.

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?

Accepted Answer

A short-acting selective beta-agonist inhaler is the drug of choice for treating an acute asthma attack. Subcutaneous epinephrine is not indicated for asthma and is reserved for severe anaphylaxis. An oral corticosteroid and methylxanthines may be used in the treatment of asthma, but they have a slower onset of action and are not appropriate for relieving acute symptoms during an attack.

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?

Accepted Answer

Oral beta-adrenergic agonists may increase blood pressure and worsen hypertension. Therefore, the nurse should question their use in a patient with a history of hypertension. The other options, inhaled corticosteroids, inhaled anticholinergic medications, and mast cell stabilizers, do not worsen hypertension and may be used safely in patients with this condition.

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?

Accepted Answer

The client's increased use of Salmeterol and the occurrence of asthma attacks suggest that he may have developed a tolerance to the medication. It is important for the nurse to assess the client's medication history and compliance to ensure he is taking the medication as directed. Adjusting the dosage or switching to a different medication may also be necessary. However, the information given does not indicate that the client needs to have his dose reduced and work back up to the full dose, nor does it suggest that he is not taking the medication correctly.

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?

Accepted Answer

The use of a spacer compensates for decreased dexterity in patients with degenerative arthritis. The spacer helps the client to inhale the medication correctly and may improve the effectiveness of the treatment.

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? ?

Accepted Answer

The highest priority goal for the inpatient management of new-onset asthma in a child is for the client to report improved ease of breathing by discharge. This is because improving the client's respiratory status is the most important aspect of asthma management, as it can be life-threatening in severe cases. Sleeping uninterrupted and parental education are also important goals, but respiratory status is the top priority. Demonstrating correct inhaler use is important, but it is not as urgent as ensuring the client's ease of breathing.

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?

Accepted Answer

The client has been newly diagnosed with asthma and needs education on the proper use of the salbutamol (Ventolin) rescue inhaler. Therefore, the most appropriate nursing diagnosis would be Knowledge, Deficient, related to the proper use of the albuterol inhaler.

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?

Accepted Answer

Ipratropium (Atrovent) is an anticholinergic medication that can increase intraocular pressure, which is not suitable for a client with a history of glaucoma.

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?

Accepted Answer

Inhaled steroids are commonly used for managing asthma, and they have a good safety profile. It is important to educate the client that the steroids used for treating airway problems are different from those abused by athletes, which can have harmful effects. It is also important to clarify that although the risks associated with inhaled steroids do exist, the benefits of controlling asthma symptoms outweigh them. It is not accurate to suggest that inhaled steroid use is short-term, as it can be a long-term treatment option for individuals with asthma.

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?

Accepted Answer

Avoiding stimuli such as secondhand smoke, pollutants, and cold air is an effective nonpharmacologic measure to manage moderate persistent asthma. Limiting protein intake and food with red and yellow dyes may help in managing attention deficit hyperactivity disorder (ADHD) symptoms but is not effective for asthma management. Keeping the child's immunizations up-to-date and wearing a face mask in public and limiting the child's contact with other children may help in reducing the risk of infection but do not directly address asthma symptoms.

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?

Accepted Answer

The answer of A nurse is caring for several clients...

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.

Accepted Answer

Inhaling an asthma medication offers a rapid and efficient way to get the medication directly into the lungs, resulting in an almost instantaneous onset of action which will relieve symptoms much more quickly. Inhaling the medication also allows for smaller doses to be used, reducing the risk of systemic effects.

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?

Accepted Answer

Theophylline (Uniphyl) is a medication that is used for bronchodilation in asthma and chronic obstructive pulmonary disease. It can cause increased heart rate and nervousness, and caffeine can exacerbate these side effects. Therefore, clients taking theophylline should be cautioned against ingesting caffeine-containing products. Cromolyn, beclomethasone, and salmeterol do not have caffeine intake restrictions.

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?

Accepted Answer

The desired outcome of mucolytic drugs is to increase the clearance of sputum by decreasing its viscosity, making it easier to cough up and clear from the airways. Mucolytics do not suppress cough, resolve atrial tachycardia, or decrease 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:

Accepted Answer

The client's symptoms indicate that their COPD is causing impaired gas exchange, which can lead to hypoxemia and other serious complications. This is the highest-priority nursing diagnosis and should be addressed immediately. Falls risk, deficient knowledge, and anxiety are important concerns for this client as well, but they are not as immediately life-threatening as impaired gas exchange.

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:

Accepted Answer

The answer of A client with limited strength in the...

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:

Accepted Answer

Using an inhaler provides direct delivery of medication to the lungs, which reduces the risk of systemic side effects that can occur with oral medication. This is especially important for medications that are used to treat respiratory conditions like asthma or COPD.

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?

Accepted Answer

The answer of A client in acute respiratory distress on...

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?

Accepted Answer

The answer of The nurse is teaching an asthmatic client...

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

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?