Chapter 55: Drugs Acting on the Lower Respiratory Tract

The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic? a)15 mcg/mL b)5 mcg/mL c)30 mcg/mL d)25 mcg/mL

a)15 mcg/mL

The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time? a)15 minutes prior to exercising b)One hour before exercise c)Immediately on beginning to exercise d)In the morning of the day when exercise is planned

a)15 minutes prior to exercising

A 6-year-old child weighing 52 pounds has had a loading dose of aminophylline (Truphylline). The nurse is ready to administer the regular prescribed dose of 4 mg/kg every 4 hours for 3 doses. How many mg will the patient receive in 12 hours? a)284 mg b)344 mg c)94 mg d)44 mg

a)284 mg

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication? a)Albuterol causes relaxation of the bronchial smooth muscles. b)Albuterol causes stimulation of the bronchial tissue. c)Albuterol blocks the stimulation of the beta-2 receptors. d)Albuterol decreases vital capacity.

a)Albuterol causes relaxation of the bronchial smooth muscles.

The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order? a)Albuterol first, wait five minutes and then follow with flunisolide b)Flunisolide followed immediately by albuterol c)Flunisolide first, wait five minutes and then follow with albuterol d)Albuterol followed immediately by flunisolide

a)Albuterol first, wait five minutes and then follow with flunisolide

A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following? a)Coffee b)Alcohol c)Vitamin C d)Salt

a)Coffee

The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which? a)Coffee b)Cheese c)Carrots d)Tea

a)Coffee

The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take? a)Contact the care provider and inform him or her that the client has toxic theophylline levels. b)Inform the care provider that an increase in the client's dose of theophylline may be necessary. c)Administer the scheduled dose of theophylline with as needed (PRN) dose of a bronchodilator. d)Withhold the scheduled dose of theophylline pending the next day's blood work results.

a)Contact the care provider and inform him or her that the client has toxic theophylline levels.

A client was using a nicotine patch to stop smoking when he was started on theophylline for emphysema. He has successfully stopped smoking and has stopped using his nicotine patch. Which of following would the nurse anticipate about the prescribed theophylline? a)Dose should be decreased. b)Dose should be increased. c)The drug should be discontinued. d)The client will receive the same amount.

a)Dose should be decreased.

In children, high doses of nebulized albuterol have been associated with what conditions? (Select all that apply.) a)Hyperglycemia b)Hypokalemia c)Tachycardia d)Hyperkalemia e)Hypotension

a)Hyperglycemia b)Hypokalemia c)Tachycardia

A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following? a)Increased serum theophylline b)Increased prothrombin time c)Increased pulse rate d)Increased serum zileuton

a)Increased serum theophylline

The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler? a)Nervousness b)Fatigue c)Bradycardia d)Hypotension

a)Nervousness

A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation? a)Salmeterol is contraindicated based on his wife's condition. b)The health care provider will most likely order continuation of the salmeterol with increased dosage. c)The extra doses facilitated bronchodilation and probably saved her life. d)The husband made the correct decision in giving the extra doses. SUBMIT ANSWER

a)Salmeterol is contraindicated based on his wife's condition.

What is the most common first-line therapy for relief of an acute asthma attack? a)beta2-adrenergic agonist b)inhaled steroid c)leukotriene modifier d)xanthine

a)beta2-adrenergic agonist

An adult client with a diagnosis of asthma has been prescribed montelukast. The nurse should teach the client that this drug will help relieve symptoms by which mechanism? a)preventing the bronchoconstriction and inflammation that is caused by leukotrienes b)preventing mast cells from releasing histamine c)reducing the muscle tone in the alveoli and facilitating gas exchange d)relaxing smooth muscle in the bronchi and bronchioles

a)preventing the bronchoconstriction and inflammation that is caused by leukotrienes

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements? a)"I need to inhale my medication and hold my breath for 10 seconds." b)"When I am short of breath, I will increase the use of my fluticasone." c)"I will wash my sheets weekly." d)"When I can do some, but not all of my usual activities, I am in the yellow zone."

b)"When I am short of breath, I will increase the use of my fluticasone."

A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem? a)Renal insufficiency b)Adrenal insufficiency c)Pancreatic insufficiency d)Pituitary insufficiency

b)Adrenal insufficiency

After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)? a)Arformoterol b)Albuterol c)Salmeterol d)Formoterol

b)Albuterol

During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications? a)Omalizumab b)Albuterol c)Salmeterol d)Epinephrine

b)Albuterol

The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations? a)Theophylline b)Albuterol c)Acetylcysteine d)Beclomethasone

b)Albuterol

Which of the following would a nurse identify as a surfactant? a)Theophylline b)Beractant c)Cromolyn d)Zileuton

b)Beractant

A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer? a)Montelukast b)Cromolyn c)Triamcinolone d)Calfactant

b)Cromolyn

A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.) a)Bradycardia b)Damaged airway mucosa c)Elevated temperature d)Airway inflammation

b)Damaged airway mucosa d)Airway inflammation

A neonate is receiving beractant. The nurse understands that this agent is administered by which route? a)Intramuscular b)Intratracheal c)Intravenous d)Subcutaneous

b)Intratracheal

Which of the following would be most important to assess before administering calfactant? (Select all that apply.) a)Bowel sounds b)Oxygen saturation levels c)Lung sounds d)Endotracheal tube placement e)Abdominal girth

b)Oxygen saturation levels c)Lung sounds d)Endotracheal tube placement

A client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage? a)green tea b)coffee c)acai juice d)grapefruit juice

b)coffee

A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration? a)ipratropium bromide b)epinephrine c)pseudoephedrine d)cromolyn

b)epinephrine

A client prescribed albuterol should be educated on identifying and managing which adverse reaction? a)diarrhea b)tachycardia c)polydipsia d)hypotension

b)tachycardia

A client is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time? a)Midway during the exercise routine b)Immediately after beginning to exercise c)15 minutes before engaging in exercise d)Right before and after exercising

c)15 minutes before engaging in exercise

A patient who is prescribed ipratropium administers the drug at 9:15 AM. The patient should begin to notice the drug beginning to act at which time? a)10:00 AM b)10:15 AM c)9:30 AM d)9:45 AM

c)9:30 AM

A client is experiencing an acute asthmatic attack. Which agent would be most effective? a)Inhaled steroid b)Leukotriene receptor antagonist c)Beta-2 selective adrenergic agonist d)Mast cell stabilizer

c)Beta-2 selective adrenergic agonist

A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse? a)"I'll make sure I don't take my inhalers more often than they've been prescribed." b)"I'm a heavy coffee drinker, but I know that I now know I need to cut down on this." c)I'll keep taking my medications until I'm not experiencing any more symptoms." d)"I'll try to make sure that I drink plenty of fluids each day."

c)I'll keep taking my medications until I'm not experiencing any more symptoms."

A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective? a)Changing the newborn's position frequently to assure effective distribution of medication b)Supply supplemental oxygen as prescribed c)Monitoring respirations for bilateral chest movement d)Suctioning the infant every 30 minutes for 2 hours after the treatment has been initiated

c)Monitoring respirations for bilateral chest movement

A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient a)has a history of pneumonia. b)is a 56-year-old man. c)has a high coffee intake. d)prefers a high-calorie diet.

c)has a high coffee intake

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following? a)Hyperthyroidism b)Gastrointestinal upset c)Alcohol intake d)Cigarette smoking

d)Cigarette smoking

After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example? a)Montelukast b)Zileuton c)Zafirkulast d)Fluticasone

d)Fluticasone

A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing? a)Monitor closely b)Decrease c)Discontinue d)Increase

d)Increase

How do inhaled corticosteroid agents assist in the treatment of asthma? a)Inhaled corticosteroid agents will reduce respiratory rate. b)Inhaled corticosteroid agents will depress the central nervous system. c)Inhaled corticosteroid agents will reduce bronchodilation. d)Inhaled corticosteroid agents will reduce airway inflammation.

d)Inhaled corticosteroid agents will reduce airway inflammation.

An 8-year-old child with an acute asthmatic attack is receiving metaproterenol via nebulizer. Which of the following would be most appropriate? a)Have the child lie flat. b)Encourage rapid shallow breaths. c)Turn the device off when the mist slows. d)Mix the drug with saline.

d)Mix the drug with saline.

An elderly female client insists her asthma is exacerbated by her least favorite television show. While explaining that her dislike for the show's host may be a contributing factor, the nurse relates that an asthma attack is caused by substances released from mast cells, which cause: a)smooth muscle dilation. b)bronchodilation and capillary permeability. c)decreased capillary permeability and fluid leakage. d)bronchoconstriction and inflammation.

d)bronchoconstriction and inflammation.