ATI - The Respiratory System

You should instruct a patient using phenylephrine spray for nasal congestion to do which of the following to avoid rebound congestion?

Limit the drug's use to 3-5 days Add an intransal glucocorticoid Taper the dose prior to discontinuation Restrict the drug's use to one nostril at a time

You are instructing a patient about using cromolyn via inhalation to treat exercise-induced asthma. You should advise the patient to take the drug

15 minutes before exercise

A healthcare professional is caring for a patient who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the healthcare professional expect to administer?

Acetylcysteine (a mucolytic); Acetylcysteine is a mucolytic that loosens thick respiratory secretions.

What would you use for someone who is suffering from acute bronchospasm?

Albuterol

When talking to a patient who is prescribed albuterol via inhaler and fluticasone (Advair) via inhaler for asthma management, you should tell the patient to use the albuterol inhaler before the fluticasone inhaler for which of the following reasons?

Albuterol will increase the absorption of fluticasone.; Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid, when the patient uses it before the glucocorticoid.

You are advising a patient about using intranasal glucocorticoids. What instructions should you include?

Allow at least 2 weeks for the full therapeutic effect; It can take 2 or 3 weeks to see the full effect from intranasal glucocorticoids.

When advising a patient about taking prednisone for chronic asthma, a healthcare professional should include which of the following information?

Avoid taking NSAIDs; Gastric protective measures are essential for patients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so patients should not take them concurrently with prednisone.

You should recognize that using pseudoephedrine (Sudafed) to treat allergic rhinitis requires cautious use with patients who have which of the following?

Coronary artery disease; Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with patients who have severe hypertension or coronary artery disease.

You are advising the patient about the use of beclomethasone (Beconase AQ), an intranasal glucocorticoid, to treat asthma. You should explain that the drug treats asthma because it performs which of the following actions?

Decreases inflammation; Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

You should monitor a patient taking dextromethorphan due to the potential for:

Drug abuse

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks?

Drug abuse; Because it is possible to alter pseudoephedrine and epinephrine, the law restricts the drugs' purchase.

You should recognize that codeine is contraindicated for patients who have which of the following?

Emphysema

You are advising a patient about the use of cromolyn sodium. Which of the following instructions should you include?

Expect a bitter aftertaste; Cromolyn sodium, a mast cell stabilizer, leaves a bitter aftertaste. Taking sips of water or sucking on hard candy after use of the drug can minimize this effect.

When advising a patient about using zileuton (Zyflo), a healthcare professional should include which of the following instructions?

Have lab tests performed at regular intervals (liver fnx); Zileuton, a leukotriene modifier, can cause liver injury. The health care professional should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment.

When advising a patient who is beginning fluticasone propionate/salmeterol (Advair) therapy, which of the following instructions should a healthcare professional include?

Increase weight-bearing activity; Weight-bearing activity can help minimize bone loss, which is a side effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid.

You are caring for a patient who is taking ipatropium (Atrovent). You should explain which of the following adverse effects to the patient?

Muscle tremors is incorrect. Muscle tremors can occur with beta2 agonists, not with inhaled anticholinergics such as ipratropium. Urinary retention is correct. Urinary retention can occur with ipratropium, an inhaled anticholinergic. Dry mouth is correct. Ipratropium can dry the oral secretions. Insomnia is incorrect. Methylxanthines, not inhaled anticholinergics such as ipratropium, can cause insomnia. Tachycardia is incorrect. Tachycardia can occur with beta2 agonists, not with inhaled anticholinergics such as ipratropium.

A healthcare professional should tell a patient who is taking albuterol (Proventil) to report which of the following possible indications of a serious adverse effect?

Palpitations; Beta2 agonists can cause cardiac stimulation, resulting in chest pain, tachycardia, and hypertension. This is rare with short-acting beta2 agonists, but it is possible.

Which of the following information indicates to you that a patient who is taking theophylline needs further instruction?

Patient drinks two cups of coffee

A patient is starting ipretropium inhaler. What is a contraindication?

Peanut allergy Glaucoma

Before prescribing dextromethorphan (Robitussin) to a patient, the primary care provider should know that when given with an opioid, the drug can result in which of the following?

Potentiation of the analgesic effect of the opiod; Combining dextromethorphan with an opioid, such as morphine, increases the analgesic effect of the opioid.

A healthcare professional who is advising a patient about the use of antihistamines to treat allergic rhinitis should explain that these drugs are effective because they perform which of the following actions?

Prevents histamine from binding to receptors; Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

You are advising the patient on the use of cromolyn sodium to prevent bronchospasm. You should explain that the drug prevents bronchospasm because it performs which of the following actions?

Reduces inflammation (inhibits the inflammatory response); Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.

A healthcare professional who is advising a patient about the use of an expectorant to treat a cough should explain that this type of drug is effective because it performs which of the following actions?

Reduces surface tension; Expectorants act by reducing the surface tension of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

You are caring for a patient who is taking codeine. Which of the following is the most important assessment following the administration of the drug?

Respirations; The greatest risk to patients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the most important assessment is the respiratory rate.

You are advising a patient about the adverse effects of pseudoephedrine (Sudafed). Which of the following should you include?

Restlessness is correct. Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. Bradycardia is incorrect. Pseudoephedrine is more likely to cause tachycardia rather than bradycardia. Insomnia is correct. Insomnia is an adverse effect of pseudoephedrine. Muscle pain is incorrect. Muscle pain is not an adverse effect of pseudoephedrine. The drug is more likely to cause numbness of the extremities. Anxiety is correct. Anxiety is an adverse effect of pseudoephedrine.

You should explain to a patient who is prescribed diphenhydramine that the most common side effect associated with the drug is:

Sedation; The most common adverse effect of diphenhydramine, a first-generation antihistamine, is sedation.

You are monitoring plasma drug levels in a patient who is taking theophylline (a methylxanthine). Which of the following adverse effects should you expect to see if the patient's level indicates toxicity?

Seizures; Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

Which of the following should you include when advising a patient about the use of montelukast (Singulair)?

Take the drug once a day in the evening; Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

A healhcare professional who is advising a patient about the use of a mucolytic to treat a cough should explain that this type of drug is effective because it performs which of the following actions?

Thins and loosens mucus; Mucolytics make mucus less viscous to increase a cough's productivity.

For which of the following reasons should a patient attach a spacer to a metered-dose inhaler?

To increase the amount of drug delivered to the lungs; A spacer increases the amount of drug that reaches the lungs.

Which of the following information should you include when teaching a patient about using an albuterol (Proventil) inhaler for asthma?

Use for exercise-induced asthma

When explaining how a patient should use ipratropium (Atrovent), you should include which of the following instructions?

Wait 5 mins between using this drug and another inhaled drug to allow for its bronchodilating effects; Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for its bronchodilating effects.

You are instructing your patient on the use of a MDI, what should you tell them?

Wait at least 1 minute before inhaling the second puff.

A healthcare professional cautions a patient who is taking guaifenesin (Mucinex) about using combination OTC cold products because...

They can also contain guaifenesin; Many combination over-the-counter cold products contain guaifenesin; a patient taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, all of which might not be present. Virtually all drugs have potential adverse effects so the patient should use only those drugs required to treat existing symptoms and only in the recommended amounts.