drugs exam 3
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 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 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?
"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?
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
Which client is most likely to benefit from the administration of a nasal steroid.
A client who has chronic allergic rhinitis
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 atrophy
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 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?
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 recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
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.
A client with chronic bronchial asthma is to take montelukast (Singulair). What will the nurse instruct the client to avoid taking?
Aspirin
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
A patient with a history of chronic cough is suspected of having pulmonary tuberculosis. Which vaccination is used to prevent the condition?
BCG vaccine
The nursing instructor is discussing cystic fibrosis with his clinical group. What would the instructor cite as the hallmark pathology of CF?
Bronchial mucous plugging, inflammation, and tissue damage
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
A client who has chronic bronchial asthma has had a mast cell stabilizer prescribed. What drug would the health care provider prescribe?
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
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.
The nurse is caring for a client with pneumonia. The nurse would expect to see which symptoms? Select all that apply.
Difficulty breathing Fever Oxygen saturation of 88%
Carbon dioxide combines with which cell types for elimination from the body?
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
Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines.
False
Second-generation antihistamines were developed to remove the sedation of first generation drugs. Which of the following antihistamines is a second-generation drug?
Fexofenadine
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
A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?
Guaifenesin
The nurse is caring for a client who is taking an adrenergic bronchodilator. In what disease process should adrenergic bronchodilators be used cautiously?
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?
Ineffective airway clearance related to drug effect or bronchospasm
Which cholinergic-blocking drugs are used in the treatment of chronic obstructive pulmonary disease (COPD)? (Select all that apply.)
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 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?
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?
Oropharyngeal Candida albicans infection
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?
Read drug labels before taking OTC medications.
Asthma is characterized by which clinical manifestations? (Select all that apply.)
Reversible bronchospasm Inflammation Hyperactive airways
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. 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?
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?
Take the tablet with food.
What action by the client would indicate that the client is obtaining maximum benefit from their inhaler?
The client holds breath for several seconds after releasing the medication.
Why are inhaled steroids used to treat asthma and COPD?
They act locally to decrease release of inflammatory mediators
Expectorants elicit their effect by which mechanism?
Thinning respiratory secretions
Cromolyn should not be used during an acute asthmatic attack.
True
Leukotriene receptor antagonists are administered orally.
True
Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis.
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:
Use strict oral hygiene. Cleanse inhaler per package instructions. Use proper technique when administering dose.
What is the most common first-line therapy for relief of an acute asthma attack?
beta2-adrenergic agonist
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
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
secretions may be retained.
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:
sit in a fully upright position when administering the medication.
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?
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
