Pharm Review 3
A man who is using a steroid inhaler complains of anorexia and discomfort when he eats. The nurse reports this to the care provider, and the patient receives a diagnosis of oropharyngeal candidiasis. It is possible to decrease this adverse effect by which of the following actions? (Check all that apply.) 1. reducing the dose 2. administering the drug more frequently 3. rinsing the mouth after use 4. using a spacer device
1 3 4
The nurse notes that a patient's serum theophylline level is 25 mcg/mL and that a scheduled dose of the medication is due. The nurse should 1. hold the scheduled dose, contact the health care provider, and assess the patient for signs of theophylline toxicity 2. administer the dose as scheduled 3. administer only half of the dose and repeat the theophylline level in 4 hours 4. hold the dose until the next meal and administer at that time
1.
What is the onset of bronchodilation when using ipratropium bromide?
15 minutes.
Montelukast is effective in relieving the inflammation and bronchoconstriction associated with acute asthmatic attacks through which principal action? 1. stabilizing mast cells 2. blocking leukotriene receptors 3. binding to immunoglobulin E (IgE) 4. decreasing prostaglandin synthesis
2
When teaching a patient about the proper use of metered-dose inhalers, which of the following statements should be included? 1. "Make sure that you puff out air repeatedly after you inhale the medication." 2. "After you inhale the medication, hold the breath for approximately 10 seconds, and exhale slowly." 3. "After you inhale the medication once, repeat until you obtain relief." 4. "Rinse out your mouth before using the inhaler to decrease the development of a mouth infection."
2.
A 68-year-old man who has been well controlled on theophylline for 2 years complains of insomnia, nervousness, nausea and vomiting, and tachycardia. He originally thought the nervousness was due to his recent smoking cessation. He had smoked one pack per day for 10 years. The nurse practitioner assesses the patient and tells him that he is likely experiencing theophylline toxicity. A serum theophylline level confirms the diagnosis. What is the best explanation for theophylline toxicity in this patient? 1. Because of his age, the patient is likely having renal insufficiency. 2. The patient is not taking the medication as prescribed. 3. A concurrent medication is altering the metabolism of theophylline. 4. The metabolism of theophylline has decreased with the recent smoking cessation.
4
What is the duration of ipratropium bromide?
4-6 hours.
A man asks the nurse when he should take his daily dose of levothyroxine. Which of the following instructions is the most appropriate to teach him? a. Take it before breakfast on an empty stomach b. Take it with meals every 8 hours in divided doses c. Take it every night at bedtime with a snack d. Take it everyday at the same time without regard to meals
A
A patient is prescribed Alendronate (Fosamax) at 0800 for the treatment of osteoporosis. As the nurse you know you must administer this medication:* A. on an empty stomach with a full glass of water and keep the patient upright for 30 minutes. B. right after breakfast and to lay the patient flat (as tolerated) for 30 minutes. C. with food but to avoid giving this medication with dairy products. D. on an empty stomach with a full glass of juice or milk.
A
A patient with a thyroid disorder is treated with a drug that directly results in activation of nuclear receptors and altered gene expression. Which of the following was most likely given? a. levothyroxine b. methimazole c. potassium iodide d. propylthiouracil
A
A woman receives a prescription of hydrocortisone for adrenal insufficiency. It is necessary to report which of the following conditions to the primary health care provider? a. fever b. headache c. insomnia d. neuropathic pain
A
Parathyroid hormone plays an important role in bone health. When the parathyroid gland secretes PTH (parathyroid hormone) it causes: A. the body to increase the calcium levels by stimulating the osteoclast activity. B. the body to decrease the calcium levels by inhibiting osteoclast activity. C. the body to increase the calcium levels by stimulating osteoblast activity. D. the body to decrease the calcium levels by inhibiting osteoblast activity.
A
The nurse administering a continuous IV infusion of calcium properly diluted in a compatible IV fluid. Which one of the following would it be most important for the nurse to monitor? a. cardiac rhythm b. urine output c. hearing changes d. musculoskeletal pain
A
When assessing for potential adverse effects of fludrocortisone (Florinef), the nurse monitors for signs and symptoms of which condition?A. Hypokalemia B. Hypovolemia C. Hyponatremia D. Hypercalcemia
A
Which statement by the patient demonstrates an understanding of discharge instructions on the use of levothyroxine (Synthroid)? a. "I will take this medication in the morning so as not to interfere with sleep." b. "I will double my dose if I gain more than 1 pound per day." c. "I will stop the medication immediately if I lose more than 2 pounds in a week." d. "I can expect to see relief of my symptoms within 1 week."
A
You prescribe a drug that selectively inhibits thyroid peroxidase, and requires several weeks of treatment to produce a euthyroid state in your patient with Grave's disease. Which drug did you prescribe? a. levothyroxine b. methimazole c. potassium iodide d. propranolol
A
An infant has diminished growth and development with a very slow pulse and below normal temperature. Based on the symptoms, what disorder is suspected? a. Cretinism b. Cushing's disease c. Addison's disease d. Thyroid storm
A A child with poor growth and development along with slow pulse and subnormal temperature should be assessed.
Mr. Bates is admitted to the surgical ICU following a left adrenalectomy. He is sleepy but easily aroused. An IV containing hydrocortisone is running. The nurse planning care for Mr. Bates knows it is essential to include which of the following nursing interventions at this time? a. monitor blood glucose levels every shift to detect development of hypo/hyper glycemia b. keep flat on back with minimal movement to reduce risk of hemorrhage following surgery c. administer hydrocortisone until vital signs stabilize, then continue IV d. teach Mr. bates how to care for his wound since he is at high risk for developing postoperative infection
A Hydrocortisone promotes gluconeogenesis and elevates blood glucose levels. Following adrenalectomy the normal supply of hydrocortisone is interrupted and must be replaced to maintain the blood glucose at normal levels. Care for the client following adrenalectomy is similar to that for any abdominal operation. The client is encouraged to change position, cough, and deep breathe to prevent postoperative complications such as pneumonia or thrombophlebitis. Maintenance doses of hydrocortisone will be administered IV until the client is able to take it by mouth and will be necessary for six months to two years or until the remaining gland recovers. The client undergoing an adrenalectomy is at increased risk for infection and delayed wound healing and will need to learn about wound care, but not at this time while he is in the ICU.
A patient who is in her first trimester of pregnancy is diagnosed with hyperthyroidism. Which medication do you suspect the patient will be started on?* a. Propylthiouracil (PTU) b. Radioactive Iodine c. Tapazole d. Synthroid
A Propylthiouracil (PTU) is the only antithyroid medication that can be used during the 1st trimester of pregnancy.
A client with influenza is prescribed with an antiviral drug. The nurse determines that the client indicates an understanding of the treatment if he or she state the following? a. i will take the medication exactly as prescribed b. i will not be able to infect others while I am on this treatment c. I will stop the medication once I feel okay d. I will resume my usual activities because these medications have minimal undesirable effects
A Antiviral drugs are taken exactly as prescribed Option B: Antiviral drugs do not prevent the spread of influenza and patients are still contagious for up to two days after the start of the therapy. Option C: The durations for the medications are followed until the last day of the treatment. Option D: Side effects such as dizziness and drowsiness will alert the client to be careful resuming their daily activities.
Before discharge, what should a client with Addison's disease be instructed to do when exposed to periods of stress? a) Administer hydrocortisone I.M. b) Drink 8 oz of fluids. c) Perform capillary blood glucose monitoring four times daily. d) Continue to take his usual dose of hydrocortisone.
A Clients with Addison's disease and their family members should know how to administer I.M. hydrocortisone during periods of stress. It's important to keep well hydrated during stress, but the critical component in this situation is to know how and when to use I.M. hydrocortisone. Capillary blood glucose monitoring isn't indicated in this situation because the client doesn't have diabetes mellitus. Hydrocortisone replacement doesn't cause insulin resistance.
Select the drugs below that are considered sympathomimetic drugs:* A. Albuterol B. Dopamine C. Epinephrine D. Propranolol
A B C
You're providing discharge teaching to a patient who was admitted with asthma. You discussed the early warning signs of an asthma attack and ask the patient to list some of them. Select all the correct early warning signs verbalized by the patient: A. Easily fatigued with physical activity B. Reduced peak flow meter reading C. Chest retractions D. Cyanosis E. Wheezing with activity F. Nighttime coughing G. No relief with short-acting bronchodilator inhaler
A B E F
During an outpatient visit you are assessing the patient's understanding about the signs and symptoms associated with osteoporosis. Select all of the signs and symptoms stated by the patient that are correct: A. Dowager's Hump B. Loss of 0.5 inches in height compared to young adult height C. Swelling and warmth at the bone site D. Some patients are asymptomatic E. Fractures most commonly in the hips, wrist, and spine
A D E
A Cromolyn sodium (Intal) inhaler is prescribed to a client with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the client that which undesirable effect is associated with this medication? a. wheezing b. insomnia c. hypotension d. constipation
A. Cromolyn Sodium (Intal) is used to prevent asthma attacks in people with bronchial asthma. Undesirable side effects associated with the use of inhaler is wheezing, cough, nasal congestion, bronchospasm and throat irritation. Options B, C, and D, are not related to the medication.
What should be avoided by patients using Ipratropium Bromide aerosols?
Allowing the aerosol to come into contact with their eyes
What are some parasympatholytic agents?
Atropine sulfate, ipratropium bromide (Atrovent), tiotropium (Spiriva) and duoneb/combivent (Ipratropium bromide/albuterol).
A patient who has recently suffered from weight gain, chronic fatigue, cold intolerance, and myxedema is diagnosed with hypothyroidism. Which of the following would be the best treatment choice for this patient? iodide salts a. levothyroxine (T4) b. L-triiodothyroxine (T3) c. methimazole d. propylthiouracil
B
The administration of fludrocortisone is necessary in which of the following conditions? a. hypoglycemia b. hypernatremia c. hypercalcemia d. hyperphosphatemia
B
What should the nurse assess prior to the administration of levothyroxine? a. Blood Glucose b. Heart rate c. Lung sounds d. Urine output
B
A patient receiving propylthiouracil (PTU) asks the nurse how this medication will help relieve his symptoms. What is the nurse's best response? a. "Propylthiouracil inactivates any circulating thyroid hormone, thus decreasing signs and symptoms of hyperthyroidism." b. "Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal." c. "Propylthiouracil helps your thyroid gland use iodine and synthesize hormones better. d. "Propylthiouracil stimulates the pituitary gland to secrete thyroid-stimulating hormone (TSH), which inhibits the production of hormones by the thyroid gland."
B "Propylthiouracil inhibits the formation of new thyroid hormone, thus gradually returning your metabolism to normal."\
A patient has been treated for ventricular dysrhythmias and amiodarone. What is the patient at risk for developing? Graves disease Thyroiditis Thyroid storm Cretinism
B A client treated with amiodarone has the potential of developing thyroiditis
common adverse effects of calcitonin include: a. headache b. flushing of the face and hands c. abdominal tenderness d. diarrhea
B Calcitonin is available in IM, subcutaneous, and nasal forms. Other adverse effects include skin rash, nausea and vomiting, urinary frequency, and local inflammation at the site of injection. Headache and diarrhea are common in bisphosphonates.
The antithyroid agent of choice for pregnant women. a. methimazole b. PTU c. levothyroxine d. iodine solution
B Other antithyroid agents can lead to development of cretinism
Thyroid hormones can: a. stimulate overproduction of TSH b. increase oxygen consumption c. increase the heart rate without affecting the respirations d. retard growth and maturation
B Thyroid hormones increase the metabolic rate of body tissues, increasing oxygen consumption, respiration, heart rate, growth and maturation, and the metabolism of fats, carbohydrates, and proteins
A patient is taking Calcitonin for osteoporosis. The patient should be monitored for? A. Hyperkalemia B. Hypokalemia C. Hypocalcemia D. Hypercalcemia
C
A patient suffering from thyroid storm is treated with propranolol, potassium iodide, and a thioamide that inhibits both thyroid gland peroxidase, and the peripheral deiodination of T4 to T3. Which thioamide was given? a. carbimazole b. methimazole c. propylthiouracil d. thiocyanate
C
The hcp has prescribed alendronate for the patient. Which one of the following should the nurse include in discharge teaching? a. "take alendronate first thing in the in the morning with orange juice" b. "take alendronate at bedtime wit ha glass of milk" c. "take alendronate first thing in the morning with water" d. "take alendronate on a full stomach after breakfast"
C
The nurse is caring for a patient who takes alendronate. Which adverse effects should the nurse observe for? a. numbness and tingling of the extremities b. irregular pulse rate and angina c. acid reflux and difficulty swallowing d. rash and skin lesions
C
Which patient below is NOT at risk for osteoporosis? A. A 50 year old female whose last menstrual period was 7 years ago. B. A 45 year old male patient who has been taking glucocorticoids for the last 6 months. C. A 30 year old male who drinks alcohol occasionally and has a BMI of 28. D. A 35 year old female who has a history of seizures and takes Dilantin regularly.
C
Your patient is having a sudden and severe anaphylactic reaction to a medication. You immediately stop the medication and call a rapid response. The patient's blood pressure is 80/52, heart rate 120, and oxygen saturation 87%. Audible wheezing is noted along with facial redness and swelling. As the nurse you know that the first initial treatment for this patient's condition is?* A. IV Diphenhydramine B. IV Normal Saline Bolus C. IM Epinephrine D. Nebulized Albuterol
C
All of the following should be included in the nursing interventions for patients taking thyroid hormones, except: a. consistent administration before breakfast each day b. monitor cardiac response c. advise patients to frequently exercise to develop the core d. provide for temperature control and safety precautions
C As much as possible, patients should be provided for rest periods when on this therapy
A commonly prescribed mast cell stabilizer used for asthma is: a. albuterol b. budesonide c. cromolyn sodium d. theophylline
C C: Cromolyn sodium is a mast stabilizer commonly prescribed for patients with asthma. A: Albuterol is not a mast cell stabilizer; it is a short-acting beta2 adrenergic agonist. B: Budesonide is an inhaled corticosteroid. D: Theophylline is classified as methylxanthine.
Nurse Lourdes is teaching a client recovering from Addisonian crisis about the need to take fludrocortisone acetate and hydrocortisone at home. Which statement by the client indicates an understanding of the instructions? a. "i'll take my hydrocortisone in the late afternoon before dinner." b. "i'll take all of my hydrocortisone in the morning right after I wake up." c. "i'll take two-thirds of the dose when I wake up and one-third in the late afternoon" d. "i'll take the entire dose at bedtime"
C Hydrocortisone, a glucocorticoid, should be administered according to a schedule that closely reflects the body's own secretion of this hormone; therefore, two-thirds of the dose of hydrocortisone should be taken in the morning and one-third in the late afternoon. This dosage schedule reduces adverse effects.
hyperparathyroidism a. leads to low serum level of calcium has a primary form which is more common in elderly men b. has a primary form which is more common in elderly men c. benefits from antihypercalcemic agents d. secondary form is common in patients with chronic liver failure
C Hyperparathyroidism is a condition characterized by excessive production of PTH leading to elevated calcium level (hypercalcemia). Therefore, it will benefit from antihypercalcemic agents. Primary hyperparathyroidism occurs more often in women between 60-70 years of age. Secondary hyperparathyroidism occurs most frequently in patients with chronic renal failure.
When administering the methylxanthine theophylline, the nurse can expect: a. decreased pulmonary function b. decreased tidal volume c. increased pulmonary function d. increased residual volume
C Option C: Theophylline will improve ventilation so there will be an overall improvement of pulmonary measurements. Options A, B, D: Other choices are the opposite of what will actually occur with theophylline administration.
A patient is being discharged home for treatment of hypothyroidism. Which medication is most commonly prescribed for this condition?* a. Tapazole b. PTU (Propylthiouracil) c. Synthroid d. Inderal
C Synthroid is the only medication listed that treats hypothyroidism. All the other medications are used for hyperthyroidism.
You assist your patient with using their inhaler. The inhaler contains the medication Budesonide. Before administering the inhaler, you will want to connect what device to the inhaler to help decrease the patient from developing ________? A. Peak flow meter; pneumonia B. Incentive spirometer; thrush C. Spacer; thrush D. Peak flow meter; mouth sores
C The answer is C. Budesonide is a corticosteroid. Inhaled corticosteroids can cause thrush. Therefore, it is important to connect a spacer to the inhaler before usage to help prevent the patient from developing thrush and for the patient to gargle and rinse the mouth with water.
You're assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and chest tightness. You auscultate the patient's lung fields and note expiratory wheezes. The patient's peak flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with the fastest relief from these signs and symptoms of an asthma attack?* A. Theophylline B. Tiotropium C. Albuterol D. Cromolyn
C The answer is C. During an asthma attack, the patient needs a medication that will quickly open the airways. Medications that are best for this include short-acting bronchodilators, such as Albuterol, short-acting beta agonists. Another type of short-acting bronchodilator is an anticholinergic bronchodilator called Ipratropium (this is given if a patient can't tolerated short-acting beta agonists like Albuterol). Theophylline is a bronchodilator but given orally and is NOT for quick relief. Tiotropium is a bronchodilator, as well, but is a LONG-ACTING anticholinergic bronchodilator. Cromolyn is an inhaled nonsteroidal anti-allergy medication that doesn't provide quick relief.
You're educating a patient how to use a peak flow meter to help monitor the status of their asthma. Which statement by the patient demonstrates they understand how to use the device? A. "This device will help keep my lungs strong so I don't have another asthma attack." B. "I will inhale as hard as I can while using the device." C. "I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading." D. "I will notify the doctor if my peak flow rating is 90% or more than my personal best peak flow."
C The answer is C. This option is correct. Option A is wrong because this device monitors how controlled a patient's asthma is and if it is getting worst. It doesn't make the lung stronger. Option B is wrong because the patient exhales as hard as they can onto the device. Option D is wrong because a flow rate of 90% of the personal best peak flow is a good reading.
Alendronate (Fosamax) is given to a client with osteoporosis. The nurse advises the client to? a. take the medication in the morning with meals b. take the medication 2 hours before bedtime c. take medication with a glass of water after rising in the morning d. take the medication during lunch
C lendronate needs to be taken with a glass of water after rising in the morning in order to prevent gastrointestinal effects.
A nurse teaches a client about the use of a respiratory inhaler. Which action by the client indicated a need for further teaching? a. removes the cap and shakes the inhaler well before use b. presses the canister down with fingers as he breathes in c. inhales the mist and quickly exhales d. waits 1-2 minutes between puffs if more than one puff has been prescribed
C Option C: The client should be instructed to hold his or her breath at least 10 to 15 seconds before exhaling the mist.
A 62- year old woman has a reduced thyroid stimulating hormone level of 0.07 micro unit/L and a normal T3 and T4. Which of the following symptoms is she at risk for developing? a. Sinus bradycardia b.Premature ventricular contractions c.Atrial fibrillation d. Prolong QT
C. Women older than 60 yrs old with a thyroid stimulating hormone level between 0.1 mcg/l and a normal t3 and t4 are at risk for developing atrial fibrillation.
A Cromolyn sodium (Intal) inhaler is prescribed to a client with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the client that which undesirable effect is associated with this medication? a. insomnia b. constipation c. wheezing d. hypotension
C. Option C: Cromolyn Sodium (Intal) is used to prevent asthma attacks in people with bronchial asthma. Undesirable side effects associated with the use of inhaler is wheezing, cough, nasal congestion, bronchospasm, and throat irritation.
Which if the following hormones opposes the actions of the parathyroid hormone?
Calcitonin
Which laboratory test value is elevated in clients who smoke and can't be used as a general indicator of cancer?
Calcitonin salmon products approved by the FDA to treat postmenopausal osteoporosis include Miacalcin (calcitonin salmon synthetic) injection and nasal spray (Novartis Pharmaceuticals Corporation); Fortical (calcitonin salmon recombinant) nasal spray (Upsher Smith Laboratories) and generic equivalents of Miacalcin.
What is the combination of Albuterol and Ipratropium Bromide?
Combivent
.What are examples of combination drugs?
Combivent or duoneb (ipratropium bromide/albuterol).
A 21- year old woman is taking levothyroxine for hypothyroidism. She has recently become sexually active and would like to take an oral contraceptive. Which of the following aspects of patient teaching is most acceptable? a. A low dose oral contraceptive agent is permissible with levothyroxine b. Oral contraceptive agents increase the amount of thyroid hormone c. For protection from pregnancy it is necessary to use an oral contraceptive and an alternative form of birth control d. Oral contraceptive agents result in diminished levothyroxine levels due to inactivation
D
A 48-year-old woman who has a history of hyperthyroidism arrives in your clinic exhibiting signs and symptoms of hypothyroidism. She is currently not taking any medications. Which form of therapy was most used in her treatment that could account for her present condition? a. methimazole b. potassium iodide c. propylthiouracil d. radioactive iodine
D
A man has a serum calcium level of 6.8 mg/dl. the health care provider orders a vitamin D supplement. Which one of the following laboratory values for serum calcium indicates that the vitamin D is effective? a. 5.5 mg/dl b. 6.8 mg/dl c. 7.5 mg/dl d. 8.5 mg/dl
D
A patient is taking fludrocortisone acetate for adrenal insufficiency. Which of the following symptoms indicates that the patient is hypokalemic? a. tetany b. irregular pulse rate c. decreased pulse rate d. muscle weakness
D
A patient with hyperthyroidism is taking propylthiouracil (PTU). The nurse will monitor the patient for: a. gingival hyperplasia and lycopenemia. b. dyspnea and a dry cough. c. blurred vision and nystagmus. d. fever and sore throat.
D
A woman taking propylthiouracil develops a sore throat and fever. What does the nurse suspect is wrong with this woman? She has developed a goiter She has an elevated liver function She has developed a hypersensitivity reaction She has agranulocytosis
D
The home care nurse is visiting with a patient who has a diagnosis of hypothyroidism. The patient is being treated with levothyroxine. The assessment of the patient reveals the following findings: an audible S3, crackles in the lower lobes, edema of the lower extremities, and a heart rate of 120 beats per minute. What does the nurse suspect the patient has developed? a. Myocardial infarction b. Thrombophlebitis c. Pulmonary embolism d. Heart failure
D
When considering an appropriate treatment for your hyperthyroid patient, you decide to prescribe a drug that can produce a relatively rapid inhibition of thyroid hormone release, but should not be given for more than a few weeks. Which drug has these characteristics? a. levothyroxine b. methimazole c. potassium iodide d. propylthiouracil
D
Which medication below blocks the function of Leukotriene for the treatment of asthma? A. Salmeterol B. Theophylline C. Tiotropim D. Montelukast
D
You're caring for a patient who has a health history of severe osteoporosis. On assessment you note the patient has severe kyphosis of the upper back. Which nursing diagnosis takes priority for this patient's care? A. Risk for skin breakdown B. Knowledge deficient regarding disease process C. Limited mobility D. Risk for falls
D
A patient taking calcitriol is also prescribed with a magnesium-containing antacid. Which of the following should be included in the nurse's monitoring? a. color of stool b. signs of bleeding c. liver function test d. serum electrolyte level
D Antihypocalcemic agents combined with magnesium-containing antacids increase the risk for hypermagnesemia. Therefore, it is important to monitor serum magnesium level.
The strongest predisposing factor for asthma is: a. chronic exposure to airway irritants b. exercise c. medications d. allergy
D D: Allergy is the strongest predisposing factor for asthma. A: One of the causes of chronic exposure to airway irritants. B: Exercise is one of the predisposing factors of asthma. C: Medications can also start the development of asthma.
A physician has prescribed propylthiouracil (PTU) for a client with hyperthyroidism and the nurse develops a plan of care for the client. A priority nursing assessment to be included in the plan regarding this medication is to assess for: a. relief of pain b. signs of renal toxicity c. signs and symptoms of hyperglycemia d. signs and symptoms of hypothyroidism
D Excessive dosing with propylthiouracil (PTU) may convert the client from a hyperthyroid state to a hypothyroid state. If this occurs, the dosage should be reduced. Temporary administration of thyroid hormone may be required. Propylthiouracil is not used for pain and does not cause hyperglycemia or renal toxicity
This is the most common type of thyroid dysfunction a. cretinism b. myxedema coma c. hyperthyroidism d. hypothyroidism
D Hypothyroidism is a lack of sufficient levels of thyroid hormones to maintain a normal metabolism. This is the most common type of thyroid dysfunction and is common among older women and men. Symptoms include obesity and fatigue, among others
A nurse is about to administer Albuterol (Ventolin HFA) 2 puff and Budesonide (Pulmicort Turbohaler) 2 puff by metered dose inhaler. The nurse plans to administer by? a. alternating with a single puff each, starting with albuterol b. alternating with single puff each, starting with budesonide c. budesonide inhaler first then albuterol d. albuterol inhaler first then the budesonide
D If two different inhaled medications are prescribed and one of the medications contains a corticosteroid, administer the bronchodilator (Albuterol) first and the corticosteroid (Budesonide) second. This will allow for the widening of the air passages by the bronchodilator, making the corticosteroids more effective.
The nurse is giving medication teachings to a client receiving theophylline. The nurse instructs the client to limit the intake of which of the following? a. strawberries and avocado b. butter and cheese c. salmon and tuna d. hot tea and cocoa
D Option D: Theophylline is a methylxanthine bronchodilator. The nurse instructs the client to limit the intake of xanthine-containing foods such as chocolate, cola, cocoa, tea, and coffee.
A patient with asthma is receiving a nebulizer of Cromolyn. The patient reports a burning sensation in the nose along with a horrible taste in their mouth. As the nurse you will? A. Immediately stop the nebulizer B. Re-adjust the nebulizer C. Call a rapid response because the patient is having a potential anaphylactic reaction to the medication. D. Reassure the patient this is a temporary side effect of this medication.
D The answer is D. Cromolyn can temporarily cause the following side effects during administration: sneezing, burning in nose, itchy/watery eyes, bad taste in mouth. Reassure the patient that these are temporary side effects of this medication.
A client is receiving theophylline intravenously. After several dosages, the client started to become restless and complains of palpitations. The nurse determines that the client is experiencing theophylline toxicity in which of the following? a. theophylline level of 10 mcg/ml b. theophylline level of 15 mcg/ml c. theophylline level of 20 mcg/ml d. theophylline level of 25 mcg/ml
D Theophylline toxicity is likely to occur when the serum level is higher than 20 mcg/ml. Early signs of toxicity include restlessness, nervousness, tachycardia, tremors and palpitations
Montelukast (Singulair) is prescribed to a client with asthma. During the medication therapy, which of the following laboratories should be monitored? a. complete blood count b. sodium and potassium c. calcium and platelet count d. ALT and AST
D Montelukast (Singulair) is a leukotriene receptor and is used with caution in clients with impaired renal function. Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) should be monitor while taking this medication. Options A, B, and C are not related to the use of this medication.
Beta-adrenergic agonists such as albuterol are given to Carlo, a child with asthma. Such drugs are administered primarily to do which of the following? a. reduce airway inflammation b. decrease postnasal drip c. reduce secondary infections d. dilate the bronchioles
D Option D: Beta-adrenergic agonists, such as albuterol, are highly effective bronchodilators and are used to dilate the narrow airways associated with asthma. Option A: Corticosteroids may be used for their anti-inflammatory effect. Option B: Decongestants may be given to decrease postnasal drip. Option C: Antibiotics are used to prevent secondary infection.
A client is receiving theophylline intravenously. After several dosages, the client started to become restless and complains of palpitations. The nurse determines that the client is experiencing theophylline toxicity in which of the following? a. theophylline level of 2.5 mcg/ml b. theophylline level of 5 mcg/ml c. theophylline level of 20 mcg/ml d. theophylline level of 25 mcg/ml
D Option D: Theophylline toxicity is likely to occur when the serum level is higher than 20 mcg/ml. Early signs of toxicity include restlessness, nervousness, tachycardia, tremors, and palpitations.
The nurse is giving medication teachings to a client receiving theophylline. The nurse instruct the client to limit the intake of which of the following? a. apple and banana b. yogurt and cheese c. tuna and oysters d. cola and chocolate
D. Theophylline is a methylxanthine bronchodilator. The nurse instructs the client to limit the intake of xanthine-containing foods such as chocolate, cola, and coffee.
Which of the following history data will possibly render strong iodine products contraindicated for the patient? a. 35 years old b. history of blood-tinged sputum for the past three weeks c. intake of oral anticoagulants d. both B and C
D. both B and C A blood-tinged sputum for the past three weeks may signify tuberculosis. If this is the case, strong iodine products are contraindicated. Also, strong iodine products can change the metabolism and level of anticoagulants and may place the patient at greater risk for bleeding. Lastly, I131 is only for patients over 30 years old because of adverse effects associated with radioactivity
You note in reviewing the chart of a COPD patient that his serum theophylline level is 25 mcg/mL. He is complaining of a headache and insomnia. What would you recommend?
Decrease the theophylline dosage.
An asthmatic patient who is prescribed MDI albuterol (Proventil) q6h complains that she develops wheezing an hour or two before scheduled treatments. What is the appropriate action?
Increase the treatment frequency.
Patients taking levothyroxine (Synthroid) and warfarin (Coumadin) concurrently would be monitored for which adverse effect?
Increased risk of bleeding
The nurse would suspect excessive thyroid replacement in a patient taking levothyroxine (Synthroid) when the patient is exhibiting which adverse effect?
Irritability
How is ipratropium bromide administered?
MDI HFA, nebulizer and soft mist: propellant-free (not available in US).
The repeated administration of beclomethasone (Vanceril) by inhalation is associated with what adverse effects?
Oral candidiasis.
A 45-year-old patient with asthma is prescribed 0.3 mL of albuterol (Proventil) in 3 mL normal saline via small volume nebulizer. Before initiating therapy, you note from chart review that the patient is severely hypertensive and has been experiencing episodes of super ventricular tachycardia. What you should do?
Postpone the treatment and consult the physician.
What would be best to prevent a bronchospasm in a patient who is ordered nebulized acetylcysteine?
Pretreat the patient with 2.5 mg of albuterol by nebulizer 20 min prior to the mucomyst.
The kidneys secrete
Renin, Erythropoietin, and Calcitriol
A HCP is caring for a patient who is to begin taking calcitonin-salmon (Miaclcin) intranasal spray to treat osteoprosis. Which of the following information should the health care professional include?
Report rash or itchingPrime the pumpReport nasal irrigation
Theophylline therapy would tend to increase the risk of exacerbating of what condition?
Sinus tachycardia.
You are administering an aerosolized albuterol (Proventil) treatment to a patient when you note he complains of dizziness, heart palpitations and feeling flushed. What would your next action?
Stop the therapy, monitor the patient and inform the patient's doctor.
During an aerosol treatment with 1.0 mL of albuterol (Proventil) and 3 mL of saline, you note that the patient's pulse has increased from 86 to 120/min. What is the most appropriate action for this?
Stop the treatment and recommend a lower dose of albuterol.
Your patient with asthma is taking Theophylline. Which product below should the patient avoid consuming? A. Caffeine B. Dairy C. Wheat D. Shellfish
The answer is A. Caffeine has the same properties as Theophylline and can increase the effects the drug.
PTH, calcitriol and calcitonin are?
The main regulators of calcium in the blood
A home care patient with COPD has persistent dyspnea and exhibits signs of increased work of breathing even at rest, but little or no wheezing. The patient currently is receiving no medication. What drug would you recommend for this patient?
Theophylline
Proper growth requires which of these hormones?
Thyroid hormone, Calcitriol, Insulin, and Growth hormone
a woman begins using an albuterol inhaler an a beclomethasone inhaler for her asthma. She asks if it matters which inhaler she uses first. The best response by the nurse is which of the following? a. "you should use the albuterol inhaler first followed in 5 to 10 minutes by the beclomethasone inhaler." b. "you should use the beclomethasone inhaler first followed in 5 to 10 minutes by the albuterol inhaler." c. "The order in which you use the inhalers does not matter" d. "you should not use the inhalers one right after the other"
a
Prior to administering calcitonin-salmon (Miacalcin) for the first time to patient who i diagnosed with postmenopausal osteoporosis, the health care professional should perform which of the following task?
check for allergies using skin testing
