Asthma Questions

A patient seen in the asthma clinic has recorded daily peak flow rates that are 75% of the baseline. Which action will the nurse plan to take next? a. Administer a bronchodilator and recheck the peak flow. b. Instruct the patient to keep the scheduled follow-up appointment. c. Increase the dose of the leukotriene inhibitor. d. Teach the patient about the use of oral corticosteroids.

a. Administer a bronchodilator and recheck the peak flow.

The nurse completes an admission assessment on a patient with asthma. Which information given by patient is indicates a need for a change in therapy? a. The patient's only medications are albuterol (Ventolin HFAl) and salmeterol (Serevent). b. The patient's heart rate increases after using the albuterol (Ventolin HFA) inhaler. c. The patient uses albuterol (Ventolin HFA) before aerobic exercise. d. The patient says that the asthma symptoms are worse every spring.

a. The patient's only medications are albuterol (Ventolin HFAl) and salmeterol (Serevent).

The nurse reviews the medication administration record (MAR) for a patient having an acute asthma attack. Which medication should the nurse administer first? a. Albuterol (Ventolin HFA) 2.5 mg per nebulizer b. Methylprednisolone (Solu-Medrol) 60 mg IV c. Salmeterol (Serevent) 50 mcg per dry-powder inhaler (DPI) d. Ipratropium (Atrovent) 2 puffs per metered-dose inhaler (MDI)

b. Methylprednisolone (Solu-Medrol) 60 mg IV ***key word: IV

The emergency department nurse is evaluating the effectiveness of therapy for a patient who has received treatment during an asthma attack. Which assessment finding is the best indicator that the therapy has been effective? a. Accessory muscle use has decreased. b. O2 saturation is >90%. c. Respiratory rate is 16 breaths/minute. d. No wheezes are audible.

b. O2 saturation is >90%. Want to keep this above 90%!

The nurse teaches a patient about pursed-lip breathing. Which action by the patient would indicate to the nurse that further teaching is needed? a. The patient practices by blowing through a straw. b. The patient puffs up the cheeks while exhaling. c. The patient's ratio of inhalation to exhalation is 1:3. d. The patient inhales slowly through the nose.

b. The patient puffs up the cheeks while exhaling.

The nurse teaches a patient who has asthma about peak flow meter use. Which action by the patient indicates that teaching was successful? a. The patient inhales rapidly through the peak flow meter mouthpiece. b. The patient uses an albuterol (Ventolin HFA) inhaler for peak flows in the yellow zone. c. The patient takes montelukast (Singulair) for peak flows in the red zone. d. The patient calls the health care provider when the peak flow is in the green zone.

b. The patient uses an albuterol (Ventolin HFA) inhaler for peak flows in the yellow zone.

A patient is scheduled for spirometry. Which action should the nurse take to prepare the patient for this procedure? a. Give the rescue medication immediately before testing. b. Withhold bronchodilators for 6 to 12 hours before the examination. c. Ensure that the patient has been NPO for several hours before the test. d. Administer oral corticosteroids 2 hours before the procedure.

b. Withhold bronchodilators for 6 to 12 hours before the examination.

The nurse assesses a patient with a history of asthma. Which assessment finding indicates that the nurse should take immediate action? a. RR of 26 b/m b. use of accessory muscles in breathing c. O2 of 91% (we want this here) d. PEFR of 240 l/min

b. use of accessory muscles in breathing

Which assessment finding in a patient who has received omalizumab (Xolair) is most important to report immediately to the health care provider? a. Respiratory rate 24 breaths/minute b. Pain at injection site c. Flushing and dizziness d. Peak flow reading 75% of normal

c. Flushing and dizziness

The clinic nurse makes a follow-up telephone call to a patient with asthma. The patient reports having a baseline peak flow reading of 600 L/min, and the current peak flow is 420 L/min. Which action should the nurse take first? a. Tell the patient to go to the hospital emergency department. b. Ask about recent exposure to any new allergens or asthma triggers. c. Instruct the patient to use the prescribed albuterol (Ventolin HFA). d. Question the patient about use of the prescribed inhaled corticosteroids.

c. Instruct the patient to use the prescribed albuterol (Ventolin HFA).

A patient who has been experiencing an asthma attack develops bradycardia and a decrease in wheezing. Which action should the nurse take first? a. Encourage the patient to cough and deep breathe. b. Administer IV methylprednisolone (Solu-Medrol). c. Notify the health care provider. d. Document changes in respiratory status.

c. Notify the health care provider.

A patient newly diagnosed with asthma is being discharged. The nurse anticipates including which topic in the discharge teaching? a. Side effects of sustained-release theophylline b. Complications associated with O2 therapy c. Self-administration of inhaled corticosteroids d. Use of long-acting β-adrenergic medications

c. Self-administration of inhaled corticosteroids

The nurse takes an admission history on a patient with possible asthma who has new-onset wheezing and shortness of breath. Which information may indicate a need for a change in therapy? a. The patient has a history of pneumonia 6 months ago. b. The patient has chronic inflammatory bowel disease. c. The patient takes propranolol (Inderal) for hypertension. d. The patient uses acetaminophen (Tylenol) for headaches.

c. The patient takes propranolol (Inderal) for hypertension.

Which information will the nurse include in the asthma teaching plan for a patient being discharged? a. Inhale slowly and deeply when using the dry powder inhaler (DPI). b. Hold your breath for 5 seconds after using the bronchodilator inhaler. c. Tremors are an expected side effect of rapidly acting bronchodilators. d. Use the inhaled corticosteroid when shortness of breath occurs.

c. Tremors are an expected side effect of rapidly acting bronchodilators.

A patient who is experiencing an acute asthma attack is admitted to the emergency department. Which assessment should the nurse complete first? a. Obtain the forced expiratory volume (FEV) flow rate. b. Ask about inhaled corticosteroid use. c. Determine when the dyspnea started. d. Listen to the patient's breath sounds.

d. Listen to the patient's breath sounds.