37 and 38 respiratory

Which of the following drugs is most immediately helpful in treating a severe acute asthma attack? a) Beclomethasone (Qvar) b) Zileuton (Zyflo CR) c) Albuterol (Proventil, Ventolin) d) Salmeterol (Serevent)

c) Albuterol (Proventil, Ventolin)

The nurse teaches a 33-year-old male patient with asthma how to administer fluticasone (Flovent HFA) by metered-dose inhaler (MDI). Which statement by the patient to the nurse indicates correct understanding of the instructions? "I should not use a spacer device with this inhaler." "I will rinse my mouth each time after I use this inhaler." "I will feel my breathing improve over the next 2 to 3 hours." "I should use this inhaler immediately if I have trouble breathing."

"I will rinse my mouth each time after I use this inhaler."

The nurse performs discharge teaching with a patient who is prescribed the anticholinergic inhaler ipratropium bromide. Which statement by the patient indicates to the nurse that teaching has been successful? "Nausea and vomiting are common adverse effects of this medication." "I will not drink grapefruit juice while taking this drug." "This inhaler is not to be used alone to treat an acute asthma attack." "I may gain weight as a result of taking this medication."

"This inhaler is not to be used alone to treat an acute asthma attack."

The nurse is teaching a patient about the use of leukotriene receptor antagonists (LTRAs) drugs such as zafirlukast. Which statement would be appropriate by the nurse? "Take the medication when you are short of breath and begin wheezing." "It will take about 3 or 4 weeks before you notice a therapeutic effect." "This medication works by preventing the inflammation that causes your asthma attack." "Increase fiber and fluid in your diet to prevent the common adverse effect of constipation."

"This medication works by preventing the inflammation that causes your asthma attack."

A client has been prescribed fluticasone (flonase) to use with oxymetazoline (afrin). How should the client be taught to use these drugs? 1. use the fluticasone first, then the oxymetazoline after waiting 5 min 2. use the oxymetazoline first then the fluticasone after waiting 5 min 3. the drugs can be used in either order 4. the fluticasone should be used only if the oxymetazoline fails to relieve the nasal congestion

2. use the oxymetazoline first then the fluticasone after waiting 5 min

The nurse is teaching the client how to use a metered-dose inhaler (MDI) to administer a corticosteroid. Which of the following indicates that the client is using the MDI correctly? Select all that apply. A The inhaler is held upright B The head is tilted down while inhaling the medicine C The client waits 5 minutes between puffs D The client rinses the mouth with water following administration E The client lies supine for 15 minutes following administration

A The inhaler is held upright D The client rinses the mouth with water following administration

The nurse will monitor the patient taking albuterol (Proventil) for what conditions? (select all that apply) A) Palpitations B) Hypertension C) Hypoglycemia D) Bronchospasm E) Uterine Contractions

A) Palpitations B) Hypertension

The description states delivers medication without using chemical propellants, but requires strong and fast inhalation. A. DPI (dry powdered inhaler) B. spacer C. MDI (metered dose inhaler) D. nebulizer

A. DPI (dry powdered inhaler)

A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications? A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone. B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol. C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone. D. The patient inhales the Fluticasone and immediately inhales the Salmeterol.

A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone.

A woman begins using an albuterol inhaler and a beclomethasone inhaler for her asthma. Which statement by the client indicates further teaching is necessary? A) I use the albuterol inhaler first. After 5-10 minutes I use my beclomethasone inhaler. B) I should rinse my mouth with warm tap water after using my inhalers. C) I use my albuterol inhaler first then immediately use my beclomethasone inhaler. D) I can only use my albuterol inhaler when I am having an acute asthma attack.

C) I use my albuterol inhaler first then immediately use my beclomethasone inhaler.

The nurse is teaching the client the appropriate way to use a metered dose inhaler. Which action indicates the client needs additional teaching? A. The client takes a deep breath while depressing the inhaler. B. The client places the inhaler two fingers from the mouth. C. The client waits 15 seconds before using the inhaler a second time. D. The client exhales slowly using purse lipped breathing.

C. The client waits 15 seconds before using the inhaler a second time.

When discussing glucocorticoids to a patient, what statement by the nurse is accurate regarding the action of these medications? A. They decrease serum sodium and glucose levels. B. They regulate carbohydrate, fat, and protein metabolism. C. They stimulate defense mechanisms to produce immunity. D. They are produced in lower amounts during times of stress.

B. They regulate carbohydrate, fat, and protein metabolism.

Nurse if providing teaching about the asthma medication that has been prescribed. What statement by the patient indicates the need for more teaching? A "I'll take montelukast (singulair) pill before I work out so I can worry less about an asthma attack while working out B "Since I'm quitting smoking, I'm glad I'll have my coffee to look forward to every morning" C "I'll keep my albuterol with me at all time, and only use it if I have an asthma attack" D "I'm glad I changed from a beta-blocker to an arb!"

B "Since I'm quitting smoking, I'm glad I'll have my coffee to look forward to every morning"

A patient with asthma asks the nurse how his albuterol inhaler will work to help him breathe better. What is the best response for the nurse to explain the action of the medication? A) "Albuterol will increase your heart rate so you will feel like you are able to breathe better." B) "Albuterol causes bronchodilation in the lungs, improving function." C) "Albuterol will cause an increase in urinary output to remove extra fluid from the lungs." D) Albuterol causes bronchial smooth muscle contraction that forces air into the lungs."

B) "Albuterol causes bronchodilation in the lungs, improving function."

Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray (Flonase)? A. "I'll gradually stop taking this so I don't have any problems with withdrawal." B. "This drug will help prevent the inflammation and irritation from my allergies." C. "I'll have to be more careful about not falling, because my bones may break more easily." D. "I realize that I only need to take this when my symptoms are really bad."

B. "This drug will help prevent the inflammation and irritation from my allergies."

Discharge teaching for a patient receiving glucocorticoids would include the use of which medication for pain management?A. Aspirin (Acetylsalicylic acid) B. Acetaminophen (Tylenol) C. Ibuprofen D. Naprosyn (Naproxen)

B. Acetaminophen (Tylenol)

The nurse instructs a patient to avoid caffeine and stimulants when the individual is self-administering which medication? A. iotropium (Spiriva) B. Albuterol (Ventolin) C. Flunisolide (AeroBid) D. Montelukast (Singulair)

B. Albuterol (Ventolin)

After an acute asthma attack, which medication is used to prevent airway reactivity and increased secretions? A. Albuterol (Ventolin) B. Theophylline (Elixophyllin) C. Salmeterol (Serevent Diskus) D. Fluticasone propionate (Flonase)

D. Fluticasone propionate (Flonase)

The nurse has a prescription for a patient to receive prednisone (Deltasone) to treat contact dermatitis. The nurse would question this prescription for this patient with what condition? A. Asthma B. Multiple sclerosis C. Acquired immune deficiency syndrome (AIDS) D. Chronic obstructive pulmonary disease

C. Acquired immune deficiency syndrome (AIDS)

The nurse would question a prescription for steroids in a patient with which condition? A. Asthma B. Spinal cord injury C. Diabetes mellitus D. Rheumatoid arthritis

C. Diabetes mellitus

When reading this description, uses a chemical propellent to push the medication out of the inhaler, the nurse knows that this is what device? A. DPI (dry powdered inhaler) B. spacer C. MDI (metered dose inhaler) D. nebulizer

C. MDI (metered dose inhaler)

Which medication disrupts the inflammatory response and is indicated in the treatment of asthma? A. Salmeterol (Serevent) B. Ipratropium (Atrovent) C. Montelukast (Singulair) D. Theophylline (Theo-Dur

C. Montelukast (Singulair)

The nurse is providing care to a patient prescribed a nonselective adrenergic agonist bronchodilator. Which condition documented in the patient's medical history would alert the nurse to question this medication order? Thrombocytopenia Chronic obstructive pulmonary disease Coronary artery disease Mycobacterium tuberculosis

Coronary artery disease

A patient calls the home health agency to tell the nurse she is having a reaction to her albuterol (Proventil) inhaler. She tells the nurse she is shaking and trembling. What is the first question the nurse should ask the patient? A) "Are you having any other symptoms?" B) "How long ago did this start?" C) "When was the last time you took your inhaler?" D) "How many puffs on the inhaler did you take?"

D) "How many puffs on the inhaler did you take?"

A nurse is providing education to a patient taking two different bronchodilator medications. The nurse identifies which characteristic as the advantage of salmeterol over other beta2 agonists such as albuterol? Longer duration of action Extended time of action Quicker peak action Shorter onset of action

Longer duration of action

Before administering an LTRA medication, the nurse would assess the patient for allergies to which substance? (Select all that apply.) Select all that apply. Povidone Chlorhexidine Lactose Latex Cellulose

Povidone Lactose Cellulose

After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is an a. expected adverse effect of the medication. b. allergic reaction to the medication. c. indication that he has received an overdose of the medication. d. idiosyncratic reaction to the medication.

a. expected adverse effect of the medication.

Which drug acts by blocking leukotrienes, thus reducing inflammation in the lungs? a. Cromolyn b. Montelukast c. Theophylline d. Albuterol

b. Montelukast

After the patient takes a dose of an inhaled corticosteroid, such as fluticasone (Flovent), what is the most important action the patient needs to do next? a. Hold the breath for 60 seconds. b. Rinse out the mouth with water. c. Follow the corticosteroid with a bronchodilator inhaler, if ordered. d. Repeat the dose in 15 minutes if the patient feels short of breath.

b. Rinse out the mouth with water.

The nurse is providing discharge teaching to a patient receiving a beta-agonist bronchodilator. What side effect would the nurse emphasize the patient needs to report? Hypoglycemia Nonproductive cough Sedation Tachycardia

Tachycardia

What is the role of corticosteroids in the treatment of acute respiratory disorders? They stimulate the immune system. They increase gas exchange in the alveoli. They decrease inflammation. They directly dilate the bronchi.

They decrease inflammation.

A patient in severe respiratory distress is prescribed continuous albuterol nebulizers. Which of the following side effects should the nurse expect? Select all that apply. a) Dizziness b) Urticaria c) Hyperkalemia d) Tachycardia e) Tremors

a) Dizziness d) Tachycardia e) Tremors

A client is receiving treatment for asthma with albuterol (Proventil, VoSpire). The nurse teaches the client that while serious adverse effects are uncommon, the following may occur. (Select all that apply.) a) Tachycardia b) Sedation c) Temporary dyspnea d) Nervousness e) Headache

a) Tachycardia ) Nervousness e) Headache

The nurse is teaching a patient about the inhaler Advair (salmeterol/fluticasone). Which statements by the patient indicate a correct understanding of this medication? (Select all that apply.) a. "I will rinse my mouth with water after each dose." b. "I need to use this inhaler whenever I feel short of breath, but not less than 4 hours between doses." c. "This medication is taken twice a day, every 12 hours." d. "I can take this inhaler if I get short of breath while exercising." e. "I will call my doctor if I notice white patches inside my mouth."

a. "I will rinse my mouth with water after each dose." c. "This medication is taken twice a day, every 12 hours." e. "I will call my doctor if I notice white patches inside my mouth."

A patient who has been newly diagnosed with asthma is learning about self-management of the disease. Which statement made by the patient indicates the need for additional teaching by the healthcare provider? a. " after I use my corticosteroid inhaler I will make sure I rinse my mouth out well" b. " I will avoid holding my breath after I have inhaled the medication" c. I should wait about 1 to 2 mins between the first and second puff of the medication" d. " I will make sure I shake the metered dose inhaler well before I use it"

b. " I will avoid holding my breath after I have inhaled the medication"

A client is prescribed ipratropium and cromolyn sodium. What will the nurse teach the client? a. "Do not take these medications within 4 hours of each other." b. "Take the ipratropium at least 5 minutes before the cromolyn." c. "Administer both medications together in a metered-dose inhaler." d. "Take the ipratropium only in the mornings."

b. "Take the ipratropium at least 5 minutes before the cromolyn."

A client with asthma has a prescription for two inhalers, albuterol (Proventil, VoSpire) and beclomethasone (Qvar). How should the nurse instruct this client on the proper use of the inhalers?a) Use the albuterol inhaler, and use the beclomethasone only if symptoms are not relieved. b) Use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved. c) Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler. d) Use the beclomethasone inhaler, wait 5-10 minutes, then use the albuterol inhaler.

c) Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler.

What is the most important thing for the nurse to teach the client with a history of diabetes and asthma who has started on albuterol PRN? a. Take Tylenol for headaches when taking albuterol. b. Monitor for orthostatic hypotension every 2 hours when taking albuterol. c. Monitor blood glucose levels every 4 hours when taking albuterol. d. An antianxiety agent may be prescribed to help with nervousness.

c. Monitor blood glucose levels every 4 hours when taking albuterol.

A client newly diagnosed with moderate asthma asks whether he can just take salmeterol instead of salmeterol and albuterol, because he has read that they are both beta agonists. What is the nurses best advice? a. Yes, both of these drugs have the same action, and you only need one. b. Yes, because they both need to be used daily whether you are having symptoms or not, just take a little more of the salmeterol and don't take any of the albuterol. c. No, albuterol is used to relieve the symptoms during an actual asthma attack and salmeterol is used to prevent an attack. Both are needed. d. No, albuterol is taken through the use of an aerosol inhaler and salmeterol is an oral drug (tablet) that is activated in the stomach. Both are needed.

c. No, albuterol is used to relieve the symptoms during an actual asthma attack and salmeterol is used to prevent an attack. Both are needed.

During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast (Singulair), the nurse will tell the patient that the drug has which therapeutic effect? a. Improves the respiratory drive b. Loosens and removes thickened secretions c. Reduces inflammation in the airway d. Stimulates immediate bronchodilation

c. Reduces inflammation in the airway

A nurse has administered a dose of salmeterol (Serevent Diskus) to a client. The client develops a generalized rash and urticaria, and the eyelids begin to swell. Which action should the nurse take? a) Apply a lanolin-based cream to the rash. b) Encourage the client to drink fluids quickly .c) Assess the client's vision with a Snellen chart. d) Call the health care provider (HCP) immediately.

d) Call the health care provider (HCP) immediately.

For patients taking a leukotriene receptor antagonist, the nurse should include which information in thepatient teaching? a. If a dose is missed, the patient may take a double dose to maintain blood levels. b. The patient should gargle or rinse the mouth after using the inhaler. c. The medication should be taken at the first sign of bronchospasm. d. Improvement should be seen within a week of use.

d. Improvement should be seen within a week of use.

Which statement by the nurse would be included when teaching a patient about the proper use of metered-dose inhalers? "Wait 1 to 2 minutes before you take a second puff of the same drug." "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler." "After you inhale the medication once, repeat until you obtain relief." "Make sure that you puff out air several times after you inhale the medication."

"Wait 1 to 2 minutes before you take a second puff of the same drug."

Albuterol (Proventil HFA) two puffs and fluticasone propionate (Flovent Diskus) two puffs by metered-dose inhaler have been prescribed for a client with chronic obstructive pulmonary disease. The nurse caring for the client provides instructions regarding administration of the medication. Which statement by the client indicates an understanding of how to take these medications? 1. "I will take the two puffs of the fluticasone propionate first and then the two puffs of the albuterol." 2. "I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate." 3."I will alternate a single puff of each, beginning with the fluticasone propionate." 4. "I will alternate a single puff of each, beginning with the albuterol."

2. "I will take the two puffs of the albuterol first and then the two puffs of the fluticasone propionate."

A patient undergoing inhaled ipratropium (Atrovent) therapy visits the clinic for a follow-up. Which complaint does the nurse anticipate from the patient? 1CNS depression 2dry mouth 3increased appetite 4nasal congestion 5 headache

2dry mouth 4nasal congestion 5 headache

A client has a prescription for fluticasone (flonase). Place the instructions that follow in order in which the nurse will instruct the client to use this drug. 1. instill one spray directed high into the nasal cavity 2. clear the nose by blowing 3. prime the inhaler prior to first use 4. spit out any excess liquid that drains into the mouth

3,2,1,4

A client has been using a fluticasone (flovent) inhaler as a component of his asthma therapy. He returns to his health care providers office complaining of a sore mouth. On inspection, the nurse notices white patches in the clients mouth. What is a possible explanation for these findings? 1. the client has been consuming hot beverages after the use of the inhaler 2. the client has limited his fluid intake, resulting in dry mouth 3. the residue of the inhaler propellant is coating the inside of the mouth 4. the client has developed thrush as a result of the fluticasone

4. the client has developed thrush as a result of the fluticasone

To prevent the development of oral candidiasis when using corticosteroid inhalers, which instruction is MOST important for the nurse to teach the patient? A. Rinse the mouth after each use. B. Minimize use of an inhaler to every other day. C. Swish and swallow with Mycostatin after each use. D. Report any gingival irritation to the health care provider.

A. Rinse the mouth after each use.

A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation? a. A beta agonist, such as albuterol b. A leukotriene receptor antagonist, such as montelukast c. A corticosteroid, such as fluticasone d. An anticholinergic, such as ipratropium

a. A beta agonist, such as albuterol

A patient is to receive a new prescription for an ipratropium inhaler. The nurse will assess for which potential contraindications? (Select all that apply.) a. Allergy to soy lecithin b. Allergy to peanuts c. Allergy to iodine products d. Hypertension e. Seizure disorders

a. Allergy to soy lecithin b. Allergy to peanuts

A patient who has asthma may be prescribed which type of inhaled drug for its antiinflammatory effects? a. Corticosteroid b. Anticholinergic c. Xanthine derivative d. Beta adrenergic

a. Corticosteroid

A patient is experiencing status asthmaticus. The nurse will prepare to administer which drug first? a. Epinephrine b. Methylprednisolone c. Cromolyn d. Montelukas

a. Epinephrine

A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? a. Maintenance treatment of asthma b. Treatment of an acute asthma attack c. Reversing bronchospasm associated with COPD d. Treatment of inflammation in chronic bronchitis

a. Maintenance treatment of asthma

A nurse is teaching a patient about montelukast (Singulair). Which of these statements, if made by the patient, would indicate the nurse's teaching was effective? a. "I'll take a dose as soon as I feel short of breath and start to cough." b. "While taking this medicine, I may be able to reduce my steroid medication." c. "It is a priority medication to prevent exercise-induced asthma symptoms." d. "If I have nosebleeds or excessive bruising, I'll stop the medication immediately."

b. "While taking this medicine, I may be able to reduce my steroid medication."

The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a client. What is the nurse's best action? a. Question the order; three inhalers should not be given at one time. b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later. c. Administer each inhaler at 30-minute intervals. d. Administer beclomethasone first, wait 2 minutes, and administer ipratropium bromide, followed by the albuterol several minutes later.

b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later.

The nurse is teaching a group of patients about the use ofbronchodilators. It is important to remind them that overuse of bronchodilators may cause which adverse effects? (Select all that apply.) a. Blurred vision b. Increased heart rate c. Decreased heart rate d. Nausea e. Nervousness f. Tremor

b. Increased heart rate d. Nausea e. Nervousness f. Tremor

A 24 year old man with asthma has just been prescribed an albuterol inhaler as needed. The nurse reviewing the chart is concerned about this prescription noting the patient has a diagnosis of what condition? a. Cushing's b. Hypotension c. cardiac dysrhythmia d. sleep apnea

c. cardiac dysrhythmia