Respiratory pharmacology practice questions ATI

A nurse is reinforcing teaching about use of a metered dose inhaler (MD) with a client who has a new diagnosis of asthma. idetify the sequence the client should follow.

1. Shake the canister prior to using it in order to mid the medication evenly. 2. Place lips firmly around the mouthpiece with the opening pointing toward the back of the throat. 3.Inhale slowly over 3 to 5 seconds while pushing down on the canister. 4. Hold breath for 10 seconds 5. Instruct the client o exhale slowly through pursed lips as a way to keep the smaller airways open during exhalation.

Diphenhydrammine Antihistamine

A first generation antihistamine, dry mucous membranes and decreased secretion.

Budesonide via jet nebulizer

A glucocorticoid medication, is an asthma maintenance medication.

Montelukast

A leukotriene receptor blocker, is used to prevent exercise-induced asthma and as an asthma maintenance medication.

A nurse is caring for a school age child who has seasonal allergies and has been taking diphenhydramine. The provider recommends fexofenadine for the child. the child's parent's asks the nurse about the advantage of taking fexofenadine. Which of the following responses should the nurse make?

A. Fexofenadine is less sedating. Fexofenadine is a second generation antihistamine that causes much less sedation than diphenhydramine. Decongesting properties.

A nurse is reinforcing teaching to a school age child who has asthma. Which of the following medications should the nurse instruct the child to use to abort an ongoing attack?

Albuterol is a short acting beta2 agonist that relieves bronchospasm rapidly for clients to use during an acute attack.

Cromolyn

An anti-inflammatory agent that prevents bronchial inflammation. The client should use cromolyn prophylactically to manage asthma, not as a rescue medication.

The nurse has a prescription to give a client albuterol two puffs and beclomethasone dipropionate two puffs by metered dose inhaler. How much time should the nurse place between administering the albuterol and then the beclomethasone dipropionate?

B. 5 minutes since albuterol works within 5 minutes that is the soonest the beclomethasone dipropionate can be administered.

A nurse is reinforcing discharge teaching with a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions schould the nurse include.

B. Eat foods that contain plenty of potassium. furosemide, a high ceiling loop diuretic, can cause potassium loss. to prevent this the client should add potassium rich foods to his diet such as bananas or avocados.

A client has a prescription to take guaifenesin every 4 hours, as needed. The nurse determines that the client understands the most effective use of this medication if the client makes which statement?

B. I will take the tablet with a full glass of water. Guaifenesin is an expectorant. it should be taken with a full glass of water to decrease the viscosity of secretions.

A nurse is reinforcing discharge teach with a client who has asthma and a new prescription for salmeterol. Which of the following instructions should the nurse include?

B. This medication will provide long term control of asthma symptoms. Salmeterol is an inhaled, long acting beta2 adrenergic agonist used to treat severe persistent asthma. When used every day as prescribed, salmeterol deceases the number and severity of asthma attacks. Salmeterol is prescribed along with glucocorticoid medication, which adds an anti-inflammatory effects to the clients asthma treatment.

A nurse at a provider's office is collecting data from a client who report taking pseudoephedrine for the sinus problems. The nurse should recognize that which of the following conditions from the client's history places the client at risk for harm while taking pseudoephedrine?

C. Hypertension Sympathomimetic medications, like pseudoephedrine, can cause systemic vasoconstriction, which could be harmful for clients who have cardiovascular disorders. The risk is higher for oral medications than topical formulations. Therefore, the nurse should notify the provider and warn the client of the potential hazard.

A nurse is reinforcing discharge teaching with a client following an episode of status asthmaticus. The client has a prescription for two inhalations from an albuterol metered-dose inhaler. Which of the following statements by the client indicates an understanding of the teaching.

C. I will hold my breath at least 10 seconds after inhaling the medication. the client should hold his breath for a minimum of 10 seconds to allow for delivery of a maximum amount of the medication deep into the airway.

A nurse is reinforcing teaching with a client who is to start taking montelukast to treat asthma. Which of the following statements by the client indicates an understanding of the teaching?

C. I'll take this medication once a day in the evening. The client should take montelukast, a leukotriene modifier, on a regular schedule to manage chronic asthma and prevent exacerbations. the client should take it on a daily basis once a day in the evening for best results.

A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using beclomethasone MDI. For which of the following findings should the nurse instruct the client to monitor and report the provider as an adverse effect of the medication

C. White coating in the mouth Beclomethasone, an inhaled glucocorticoid, might cause oropharyngeal candidiasis. The client should gargle after each use, use a spacer to reduce the amount of the medication in the mouth and throat, and report any white patches inside the mouth or on the tongue.

A nurse is caring for a client who has a prescription for diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse make?

C. take the daily dose at bedtime. Taking the dose at bedtime will allow the client to obtain the benefit of maximum relief of symptoms and rest without itching.

Pseudoephedrine

Can dry the tissue of the nasal passages. Can cause headache. Can cause anorexia.

A nurse is reinforcing discharge instruction for a client who has asthma and is about to start taking zileuton. For which of the following findings should the nurse instruct the client to monitor and report to the provider as an adverse effect of the medication?

D. Abdominal pain Zileuton can cause liver damage and hepatitis. The client should report any signs of hepatic toxicity such as abdominal pain or jaundice.

A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following prescription should the nurse anticipate?

D. Albuterol via jet nebulizer. The nurse should anticipate administering albuterol, which is a bronchodilator that can stop the bronchospasm caused by an acute asthma attack.

A nurse is reinforcing teaching with the parents of a preschool age child who has asthma and a prescription for montelukast chewable tablets. Which of the following statements by a parent indicates understanding of the teaching?

D. I will have my child chew the tablet every evening. Montelukast provides better outcomes for clients who have asthma when taken once daily in the evening.

A nurse is caring for a client who has asthma and is taking fluticasone. For which of the following adverse effects should the nurse monitor?

D. Oral candidiasis Flucasone can cause oral candidiasis, or thrush.

A nurse is reinforcing teaching with a client who is going to take an expectorant to manage a cough. The nurse should explain that this type of medication treats coughs by which of the following mechanisms.

D. Stimulates secretions. Expectorants act by increasing secretions to improve a cough's productivity.

A nurse is reinforcing discharge ruction for a client who has asthma and is about to start taking theophylline. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of the medication?

D. Tachycardia Theophylline can increase cardiac stimulation and cause tachycardia.

Fluticasone glucocorticoid

Decreases bronchial inflammation and airway mucus production. The client should use this medication prophylactically to mange asthma, not a rescue medication.

Albuterol metered dose inhaler directions

Hold the inhaler with his dominants hand for better control of the device. Tilt head back slightly to assist with medication distribution to the airway. Instruct the client to wait 20-30 seconds between inhalations for maximum benefit.

Leukotriene (montelukast)

Monitor hepatic function ALT, AST, Bilirubin.

Glucocorticoid Fluticasone

Reduce inflammation

Codeine Antitussive

Suppresses the urge to cough.

Pseudoepherine

Sympathomimetic decongestant it's going to mimic reduction in the inflammation of the nasal membrane.

Theophylline

The client is more likely to develop nausea when taking theophylline.

Albuterol

The client is more likely to develop tremors when taking oral beta2 adrenergic agonist.

Ipratropoium

The client is more likely to developed dry mouth when taking an anticholinergic medication such as ipratropium.

A nurse is caring for a client who has asthma. The client asks the nurse how albuterol helps his breathing. Which of the following intonation should the nurse include in the response

This medication will prevent wheezing. This medication will open the airways.