Upper and Lower Respiratory Drug Questions NUR 311 Week 9
A person with HTN and known heart disease has frequent bronchospasms and asthma attacks that are most responsive to sympathomimetic drugs. This patient might be best treated with A. an inhaled sympathomimetic to decrease systemic effects B. a xanthine C. no sympathomimetics bc they would be contraindicated D. an anticholinergic
A
A pt receives diphenhydramine (first line antihistamine) orally. The nurse would expect this drug to begin acting within which time frame? A. 15 - 30 miin B. 30 - 45 min C. 45 - 60 min D. 60 - 75 min
A
Antihistimines should be used cautiously in pts with A. a hx of arrhythmias or prolonged QT intervals B. COPD or bronchitis C. asthma or season rhinitis D. angioedema or low BP
A
Treatment of obstructive pulmonary disorders is aimed at A. opening the conducting airways or decreasing the effects of inflammation B. blocking the autonomic reflexes that alter respirations C. blocking the effects of the immune and inflammation systems D. altering the respiratory membrane to increase the flow of oxygen and carbon dioxide
A
The nurse is preparing to administer an anticholinergic antiasthmatic med to a pt. Before administering it, what is the most important thing that the pt should do? A. void B. suck on a sugarless piece of candy C. take 5 deep breaths D. recline at a 15 degree angle
A to prevent urinary retention
Which statement by a pt who is prescribed triamcinolone, inhaled steroid, indicates the need for additional teaching? A. "I should see some results in about 3 to 4 days' B. "I cant use this drug if I have an acute attack"" C. "I might notice some hoarseness with the drug" D. "I should rinse my mouth after using the drug'
A can take 2-3 Weeks for the effect
What should the nurse include when teaching a pt about albuterol for possible side effects? Select All That Apply A. nervousness B. sweating C. chills D. bronchospasm E. hypotension
A, B, D
After teaching a group of students about zafiriukast, a leukotriene receptor antagonist, the student show correct understanding when they identify what as possible adverse effects? Select All That Apply A. vomiting B. constipation C. dizziness D. myalgia E. chills
A, C, D
The instructor is teaching her students about the reasons decongestants are prescribed for patients. The students who answer correctly are the ones that name which reasons? Select All That Apply A. common cold B. glaucoma C. hay fever D. middle ear infection E. benign prostatic hyperplasia
A, C, D
A patient calls the office to ask the nurse if she can take an OTC expectorant. The nurse is aware that an expectorant would be contraindicated or used carefully if the pt has what conditions? Select All That Apply A. emphysema B. urinary tract infection C. very productive cough D. hypothyroidism E. asthma
A, C, E
A pt is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the pt to use the inhaler at which time? A. immediately after beginning to exercise B. 15 min before engaging in exercise C. right before and after exercising D. midway during the exercise routine
B
A pt taking an OTC cold med and an OTC allergy med is found to be taking double doses of speudoephedrine. As a result the pt might exhibit A. ear pain and eye redness B. restlessness and palpitations C. sinus pressure and ear pain D. an irritating cough and nasal drainage
B
A pt with many adverse reactions to drugs is tried on an inhaled steroid for treatment of bronchospasm. For the first 3 days, the pt doesn't notice any improvement. You should A. switch the pt to a xanthine B. encourage the pt to continue the drug for 2-3 wks C. switch the pt to a sympathomimetic D. try the pt on a surfactant
B
After teaching a patient who is receiving an antitussive about the drug, which statement indicates the need for additional teaching? A. "ill get a humidifier for my bedroom" B. I'll keep the room warm and toasty" C. "I can use some lozenges for comfort" D. "I need to increase the amount of fluids I drink"
B
The HCP suggests a pt use guaifenesin, an expectorant, to help his cough. The nurse instructs the pt to call the HCP if he continues to have a productive cough after which amount of time? A. 5 days B. 1 week C. 2 weeks D. 3 weeks
B
The nurse administers an antitussive agent cautiously to a patient with asthma for which reason? A. The airway needs to be maintained B. The drug can lead to additction C. A loss of respiratory reserve can occur D. The patient may experience increased sedation
B
The nurse would expect to increase the dosage of theophylline if the patient has a current history of which of the following? A. hyperthyroidism B. cigarette smoking C. GI upset D. alcohol intake
B
Which of the following effects would result from the action of montelukast? A. increased neutrophil aggregation B. decreased eosinophil migration C; decreased capillary permeability D increased smooth muscle contraction
B
The clinical instructor is teaching her group of students about oral nasal decongestants. The students correctly identify which adverse effects as being sympathomimetic reactions? Select All That Apply A. cold, moist skin B. pallor C. arrhythmias D. feelings of sadness E. increased pulse
B, C, E
When teaching a patient who is receiving pseudoephedrine, an oral decongestant, about possible adverse effects, what would the nurse include? Select All That Apply A. dizziness B. sweating C. anxiety D. flushing E. sedation F. hypertension
B, C, F
When describing the action of xanthines, what would the nurse include? Select All That Apply A. block the action of acetylcholine at vagal mediated receptor sites B. direct effect on the mobilization of calcium within the cell C. selectively act at beta2 receptor sites as agonists D. stimulation of two prostaglandins, leading to smooth muscle relaxation E. inhibition of release of slow-reacting substance of anaphylaxis
B, D, E
The nurse is caring for a pt who is receiving acetylcysteine, a mucolytic, by aerosol. The nurse is aware that this pt is at risk for what adverse effects? Select All That Apply A. mucus plug B. stomatitis C. nasal congestion D. bronchospasm E. nausea
B, D, E the mucolytic is used to help thin secretions.
A patient has been prescribed salmeterol, a sympathomimetic. The nurse is aware that which ethnic group has a greater risk of asthma-related deaths when using this drug? A. native American B. Asian americans C. African americans D. hispanics
C
A pt is not getting a response to the antihistamine that was prescribed. Appropriate action might include A. switching to a decongestant B. stopping the drug and increase fluids C. trying a different antihistamine D. switching to a coritcosteroid
C
A pt is receiving dornase alfa, a mucolytic, at home. Which of the following would the nurse instruct the pt to do? A. store the drug at room temperature B. mix the drug with tap water C. protect the drug from light D. take the drug orally with meals
C
After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching? A. "we can use OTC products for our 5 yr od but not for our 18 month old' B. "we need to read the label carefully to see how often and how much to give" C. "we can use the adult brand, but we just have to decrease the amount" D. "we should use the cup that comes with the drug to measure it out"
C
After teaching a group of students about drugs as bronchodilators, the instructor determines that the teaching has been successful when the students identify which group of drugs as once being first-line agents? A. mast cell stabilizers B. leukotriene receptor antagonists C. xanthines D. sympathomimetics
C
Antitussives are useful in blocking the cough reflex and preserving the energy assoc with prolonged, non-productive coughing. Antitussives are best used with A. postop pts B. asthma pts C. pts with a dry irritating cough D. COPD pts who tire easily
C
The nurse instructs a pt who is prescribed a nasal steroid that it may take up to how long before effects may be noted? A. 2 days B. 4 days C. 7 days D. 21 days
C
The xanthines A. block the sympathetic nervous system B. stimulate the sympathetic nervous system C. directly affect the smooth muscles of the respiratory tract D. act in the central nervous system to cause bronchodilation
C
When describing the action of acetylcysteine, a mucolytic, in treating cystic fibrosis, which of the following would the nurse need to keep in mind about the drug? A. it binds with a heptatoxic metabolite B. It separates extracellular DNA from protein in the mucus C. It splits the disulfide bonds that hold mucus together D. It liquefies secretions to decrease viscosity
C
While reviewing a pt history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium, a anticholinergic. A. Eggs B. Dairy C. Peanuts D. Shellfish
C
Your patient has been maintained on theophylline for many years and has recently taken up smoking. The theophylline levels in this patient would be expected to: A. rise, bc nicotine prevents the breakdown of theophylline B. stay the same, bc smoking has no effect on theophylline C. fall, bc the nicotine stimulates liver metabolism of theophylline D. rapidly reach toxic levels
C
A patient is receiving ipratropium, an anticholinergic, as maintenance therapy for COPD. The nurse would caution the patient that up to how many inhalations may be used in 24 hours if needed? A. 4 B. 8 C. 12 D. 16
C 12 recommended dose is up to 4 x day, 2 inhalations ea time but can have up to 12 inhalations if needed in a 24 hr period
A patient took a dose of ipratropium, an anticholinergic, at 9:15am. The pt should notice the effects of the drug beginning at what time? A. 10:15am B. 10:00am C. 9:30am D. 9:45am
C 9:30am
The nurse caring for a patient who will be going home with a prescription for an antitussive. What discharge instructions are most important for the nurse to share with this patient? Select All That Apply A. this drug may cause you to have diarrhea B. while you are taking this medication, limit the fluids that you drink C. if cough continues for a week, contact your Dr D. use sugarless candy if the med causes you to experience a dry mouth E. don't drive or use heavy machinery b/c this med may cause sedation
C, D, E
A nurse knows that topical decongestants belong to which class? A. Adrenergic antagonists B. Anticholinergics C. Antihistamines D. Sympathomimetics
D
A pt is receiving theophylline intravenously. The nurse reviews the results of his serum drug levels and notifies the physician for which result? A. 10 mcg/mL B. 15 mcg/mL C. 20 mcg/mL D. 25 mcg/mL
D
A pt who is experiencing anaphylaxis with severe wheezing receives a dose of epinephrine IV. The nurse would expect the drug to exert its full effects within which time fram? A. 5 min B. 10 mn C. 15 min D. 20 min
D
A pt with a sinus pressure and pain related to seasonal rhinitis would benefit from taking A. an antitussive B. an expectorant C. a mucolytic D. a decongestant
D
After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state which of the following? A. the drugs are systemically absorbed when inhaled B. the drugs action leads to suppression of beta-adrenergic receptor activity C. the drugs are slowly absorbed from the respiratory tract D. the drugs are not for use during an acute attack
D
Leukotriene receptor antagonists act to block production of a component of slow reacting substance of anaphylaxis. They are most beneficial in treating A. seasonal rhinitis B. pneumonia C. COPD D. asthma
D
Pts with seasonal rhinitis experience irritation and inflammation of the nasal passages and passages of the upper airways. Treatment for these pts might include A. systemic corticosteroids B. mucolytic agents C. an expectorant D. topical nasal steroids
D
The patient is experiencing an acute asthmatic attack. Which agent would be most effective? A. inhaled steroid B. leukotriene receptor antagonist C. mast cell stabilizer D. beta-2 selective adrenergic agonist
D
When describing the effects of second-generation antihistamines, which of the following would the nurse address as being decreased from the first-generation? A. Hypersensitivity B. Dry mouth C. GI upset D. Sedation
D