Contains resp Qw/EXP* NURS 504 Exam 3
A patient is taking low-dose corticosteroids on a long-term basis for COPD. What does prolonged use of corticosteroids put the patient at risk for? Adrenal storm Adrenal atrophy Stunted growth Hypothalamic insufficiency
Adrenal atrophy
A client with chronic bronchial asthma is to take montelukast (Singulair). What will the nurse instruct the client to avoid taking? Aspirin Penicillin Sertraline (Zoloft) Nifedipine (Procardia)
Aspirin
Why are inhaled steroids used to treat asthma and COPD? They act locally to decrease release of inflammatory mediators They act locally to improve mobilization of edema They act locally to increase histamine release They act locally to decrease histamine release
They act locally to decrease release of inflammatory mediators
What is the most common first-line therapy for relief of an acute asthma attack? inhaled steroid leukotriene modifier beta2-adrenergic agonist xanthine
beta2-adrenergic agonist
The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching? "I should take a deep breath, hold it while I administer the medication, and then exhale." "I need to shake the inhaler well before taking the medication." "I need to take three short, quick breaths to inhale the medication." "I need to wait at least 30 minutes after the first inhalation before taking a second."
"I need to shake the inhaler well before taking the medication."
A client, newly diagnosed with COPD, calls the clinic and asks the nurse why the client has to take the medication if their lungs don't work right. What would be an appropriate response by the nurse? "The medication that has been ordered for you is what the health care provider thinks will help you the most." "The medication that has been ordered for you is to help you breathe easier." "The medication that has been ordered for you is designed to work together to make it easier for you to breathe." "The medication that has been ordered for you is to help relieve the inflammation and promote dilation of the bronchi."
"The medication that has been ordered for you is to help relieve the inflammation and promote dilation of the bronchi."
What statement by a 61-year-old client who is to take an antitussive with codeine indicates that the teaching has been effective? "I will take this medication anytime I start to cough." "This medication may make me anxious and nervous." "I should call the health care provider if I develop nausea, diarrhea, or stomach cramps while taking this medication." "This medication can cause drowsiness, so I will avoid driving while I use it."
"This medication can cause drowsiness, so I will avoid driving while I use it."
The nurse is preparing to administer 80 mg of Solu-medrol intravenously (IV) to a client with pneumonia. The vial states that it has 120 mg per 2 mL. The nurse would correctly draw up which amount? 0.3 mL 0.6 mL 1.3 mL 1.6 mL
1.3 mL
The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time? 15 minutes prior to exercising One hour before exercise Immediately on beginning to exercise In the morning of the day when exercise is planned
15 minutes prior to exercising
Which client is most likely to benefit from the administration of a nasal steroid. A client with an acute sinus infection. A client who has chronic allergic rhinitis A client who is recovering from a tonsillectomy A client who has a deviated nasal septum
A client who has chronic allergic rhinitis
A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? Antitussives suppress coughing while expectorants loosen bronchial secretions. Both drug types loosen bronchial secretions for ease of removal. Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. Antitussives kill cold viruses while expectorants liquefy bronchial secretions.
Antitussives suppress coughing while expectorants loosen bronchial secretions.
The nursing instructor is discussing cystic fibrosis with his clinical group. What would the instructor cite as the hallmark pathology of CF? Alveolar mucous plugging, infection, and eventual bronchiectasis Bronchial mucous plugging, inflammation, and tissue damage Atelectasis, infection, and eventual COPD Bronchial mucous plugging, infection, and eventual COPD
Bronchial mucous plugging, inflammation, and tissue damage
After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example? Fluticasone Montelukast Zileuton Zafirkulast
Fluticasone
The nurse is caring for a client who is taking an adrenergic bronchodilator. In what disease process should adrenergic bronchodilators be used cautiously? Liver failure Renal failure Respiratory failure Heart failure
Heart failure
The nurse caring for a client taking acetylcysteine is charged with the development of a nursing plan of care. What would be the most appropriate diagnosis for the client with regards to potential side effects of the medication? Alteration in sensation related to the drug effect of neuropathy Alteration in cardiac output related to drug effect or hypotension Ineffective airway clearance related to drug effect or bronchospasm Alteration in urinary elimination related to drug effect or urinary retention
Ineffective airway clearance related to drug effect or bronchospasm
The nurse is teaching a group of clients with allergic rhinitis about the use of their medications. What would be the most essential information to give these clients about preventing possible drug interactions? OTC medications are safe to use. Use only one pharmacy so the pharmacist can check drug interactions for you. Read drug labels before taking OTC medications. Ask the pharmacy tech to assist you in selecting an OTC medication.
Read drug labels before taking OTC medications.
Asthma is characterized by which clinical manifestations? (Select all that apply.) Thick sputum Reversible bronchospasm Inflammation Hyperactive airways Destruction of lung tissue
Reversible bronchospasm Inflammation Hyperactive airways
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to permanent liver damage. rebound bronchoconstriction. community-acquired pneumonia. severe anticholinergic effects.
rebound bronchoconstriction.
A 25-year-old woman comes to the clinic because of a chronic, nonproductive cough. Assessment reveals that she has a history of asthma, and dextromethorphan (Robitussin) is prescribed for her. The nurse will question this order because serotonin syndrome may result. persistent coughing may develop. respiratory secretions may be thickened. secretions may be retained.
secretions may be retained.
The client reports cough, low-grade fever, anorexia, and night sweats. The client has also been coughing up blood at times. What disease does this client most likely have? pneumonia caused by influenza Kaposi sarcoma tuberculosis Pneumonitis interstitial infection
tuberculosis
A client is being assessed by the home care nurse on the appropriate use of her metered-dose inhalers. Instructions concerning which intervention will assist a client in the proper administration of the metered-dose inhaler? using a spacer administrating corticosteroid first pushing fluids exhaling immediately after administration
using a spacer
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication? Albuterol causes stimulation of the bronchial tissue. Albuterol blocks the stimulation of the beta-2 receptors. Albuterol decreases vital capacity. Albuterol causes relaxation of the bronchial smooth muscles.
Albuterol causes relaxation of the bronchial smooth muscles.
The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order? Flunisolide first, wait five minutes and then follow with albuterol Albuterol first, wait five minutes and then follow with flunisolide Flunisolide followed immediately by albuterol Albuterol followed immediately by flunisolide
Albuterol first, wait five minutes and then follow with flunisolide
A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: Antihistamines are not used for this issue. Antihistamines are recommended for extended use, as long as you monitor for adverse effects. Antihistamines are not recommended for this issue; only antibiotics are useful. Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.) Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug Using household measuring devices for dosage measurements Using adult formulation with smaller doses
Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug
A patient with a history of chronic cough is suspected of having pulmonary tuberculosis. Which vaccination is used to prevent the condition? MMR vaccine DPT vaccine BCG vaccine IPV vaccine
BCG vaccine
A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following? Coffee Alcohol Salt Vitamin C
Coffee
A client who has chronic bronchial asthma has had a mast cell stabilizer prescribed. What drug would the health care provider prescribe? Ipratropium or budesonide Isoetharine or montelukast Cromolyn Aminophylline or caffeine
Cromolyn
A patient's history reveals a genetic disorder involving the exocrine glands of the respiratory, gastrointestinal, and reproductive tracts. The nurse identifies this as most likely: Cystic fibrosis Asthma Respiratory distress syndrome Pneumonia
Cystic fibrosis
A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? Dextromethorphan works in the medulla to suppress the cough reflex. Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works by inhibiting allergen response. Dextromethorphan works by relaxing the smooth muscles in the bronchioles.
Dextromethorphan works in the medulla to suppress the cough reflex.
The nurse is caring for a client with pneumonia. The nurse would expect to see which symptoms? Select all that apply. Difficulty breathing Urinary retention Rash Fever Oxygen saturation of 88%
Difficulty breathing Fever Oxygen saturation of 88%
Carbon dioxide combines with which cell types for elimination from the body? Leukocytes Erythrocytes Macrophages Platelets
Erythrocytes
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.) Exercise Allergens Pollutants Warm weather
Exercise Allergens Pollutants
Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines. True False
False
Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug? Dexchlorpheniramine Chlorpheniramine Fexofenadine Diphenhydramine
Fexofenadine
A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? Guaifenesin Acetylcysteine Dextromethorphan Benzonatate
Guaifenesin
Which cholinergic-blocking drugs are used in the treatment of chronic obstructive pulmonary disease (COPD)? (Select all that apply.) Darifenacin (Enablex) Ipratropium (Atrovent) Benztropine (Cogentin) Biperiden (Akineton) Tiotropium (Spiriva)
Ipratropium (Atrovent) Tiotropium (Spiriva)
A client has been using guaifenesin for a cough that accompanied a common cold. The client calls the nurse help line and states that she thinks she is having an adverse reaction to the medication. The nurse knows that which symptoms are adverse effects of this medication? Select all that apply. Nausea Rash Constipation Bleeding Headache
Nausea Rash Headache
The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler? Fatigue Nervousness Bradycardia Hypotension
Nervousness
A 36-year-old client is prescribed inhaled corticosteroid (ICS) for daily use. Which adverse effects should the nurse closely monitor for in this client? Delayed growth Suppression of the hypothalamic-pituitary-adrenal axis Hypotension Oropharyngeal Candida albicans infection
Oropharyngeal Candida albicans infection
When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply. Suck on sugarless hard candy. Administer intravenous fluid bolus. Offer ice chips. Take frequent sips of water. Use a dehumidifier in the home.
Suck on sugarless hard candy. Offer ice chips. Take frequent sips of water.
A patient is prescribed an inhalational corticosteroid therapy along with bronchodilator therapy. Which of the following points should the nurse include in the patient teaching plan? Stop corticosteroid therapy immediately if you notice any adverse effects. Before each dose of corticosteroid, rinse the mouth thoroughly with water. The corticosteroid drug provides rapid relief during an asthma attack. Take the corticosteroid several minutes after the bronchodilator dose.
Take the corticosteroid several minutes after the bronchodilator dose.
A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? Drink ample water before taking the tablet. Take an antacid before the tablet. Take the tablet with food. Take the tablet one hour before food.
Take the tablet with food.
What action by the client would indicate that the client is obtaining maximum benefit from their inhaler? The client inhales as soon as the inhaler enters the mouth. The client holds breath for several seconds after releasing the medication. The client administers 3 doses of medication within a 1-minute time frame. The client exhales as soon as the client compresses the inhaler.
The client holds breath for several seconds after releasing the medication.
Expectorants elicit their effect by which mechanism? Thinning respiratory secretions Breaking down thick mucus in the lower lungs Depressing the cough center in the brain Anesthetizing stretch receptors in the respiratory passages
Thinning respiratory secretions
Cromolyn should not be used during an acute asthmatic attack. True False
True
Leukotriene receptor antagonists are administered orally. True False
True
Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis. True False
True
Which of the following should a patient be advised to do to lessen the likelihood of developing oral thrush with the use of an inhaled corticosteroid or mast cell aerosol? Select all that apply: Avoid eating after administration. Use strict oral hygiene. Cleanse inhaler per package instructions. Use proper technique when administering dose. Only administer a dose every other day.
Use strict oral hygiene. Cleanse inhaler per package instructions. Use proper technique when administering dose.
A client has been diagnosed with chronic obstructive pulmonary disease. The client has been prescribed bronchodilators by nebulizer for home use. The nurse should teach the client to: keep an extra oxygen tank on hand for propelling the medication. sit in a fully upright position when administering the medication. take the exact number of puffs that have been prescribed. gargle with an alcohol-based mouthwash after each dose.
sit in a fully upright position when administering the medication.
