Exam 4 Practice Questions

Which outcome would be most appropriate for a nurse to establish for a patient with a cough who takes an antitussive with codeine? a. Warm, dry, pink skin b. Oriented to time, place, and person c. Respiratory rate of 12 to 24 breaths per minute d. Effective productive cough

c. Respiratory rate of 12 to 24 breaths per minute

Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma? a. Increases the daily intake of vitamin D and calcium b. Records daily peak expiratory flow rates c. Supplements additional doses at times of stress d. Uses alternate-day therapy to reduce adverse effects

c. Supplements additional doses at times of stress

Which information should the nurse include when teaching a patient about inhaled glucocorticoids? a. Inhaled glucocorticoids have many significant adverse effects b. The principal side effects of inhaled glucocorticoids include hypertension and weight gain. c. Use of a spacer can minimize side effects. d. Patients should rinse the mouth and gargle before administering inhaled glucocorticoids

c. Use of a spacer can minimize side effects.

A patient with asthma is prescribed albuterol [Proventil], 2 puffs 3 times a day. The nurse should teach the patient to do what? a. Rinse the mouth after taking the prescribed dose b. Take an extra dose if breathing is compromised c. Wait 1 minute between puffs from the inhaler d. Take adequate amounts of calcium and vitamin D

c. Wait 1 minute between puffs from the inhaler

Which statement about the BCG vaccine does the nurse identify as true? a. BCG is a live preparation of attenuated Mycobacterium bovis b. BCG is routinely administered in the United States. c. BCG has no effect on tuberculin skin tests. d. BCG vaccine can be used to treat carcinoma of the bladder

d. BCG vaccine can be used to treat carcinoma of the bladder

A child is born prematurely and requires respiratory support. The child experiences neonatal lung injury and several weeks later develops hypoxemia and hypercapnia. Which of the following is the most likely diagnosis? a. Pneumonia b. Bronchiolitis c. Aspiration pneumonitis d. Bronchopulmonary dysplasia

d. Bronchopulmonary dysplasia

A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which substance to prevent a complication? a. Echinacea b. Cimetidine [Tagamet] c. Sunscreen products d. Caffeine

d. Caffeine

A patient is taking a first-generation H1 blocker for the treatment of allergic rhinitis. It is most important for the nurse to assess for which adverse effect? a. Skin flushing b. Wheezing c. Insomnia d. Dry mouth

d. Dry mouth

A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan? a. Oral theophylline [Elixophyllin] b. Subcutaneous omalizumab [Xolair] c. Inhaled mometasone furoate [Asmanex] d. High-dose albuterol [Proventil] via nebulizer treatment

d. High-dose albuterol [Proventil] via nebulizer treatment

Which class of drugs is most effective in preventing and treating seasonal and allergic rhinitis? a. Antitussives b. Oral antihistamines c. Oral sympathomimetics d. Intranasal glucocorticoids

d. Intranasal glucocorticoids

Which information should the nurse include when teaching a patient about rifampin therapy? a. Oral contraceptives are safe to use with rifampin therapy. b. Contact your healthcare provider immediately if the color of your body fluids changes to reddish orange c. Rifampin is safe to use in patients who have hepatic disease d. Rifampin may be administered intravenously

d. Rifampin may be administered intravenously

Which statement should the nurse include when teaching a patient about rifampin (Rifadin)? a. "A harmless side effect will be a red-orange discoloration of body fluids." b. "Oral contraception is the preferred method of birth control when using rifampin." c. "Take vitamin B6 to relieve numbness and tingling in the fingers and toes." d. "Treatment length for the medication is 3 times per day for an 8-week period."

a. "A harmless side effect will be a red-orange discoloration of body fluids."

Which instruction should be included in the teaching for a patient for whom fluticasone propionate [Flovent] MDI has been ordered? a. "Gargle after using your inhaler." b. "Take the medication immediately at the onset of an attack." c. "Take your albuterol first, followed by the Flovent 5 minutes later." d. "Make sure you monitor your fingerstick blood glucose level each morning."

a. "Gargle after using your inhaler."

A patient has right ventricular enlargement secondary to pulmonary hypertension. Which of the following would be the most likely diagnosis? a. Cor pulmonale b. Acute bronchitis c. Pulmonary embolism d. Pulmonary thromboembolism

a. Cor pulmonale

A patient has bulbous enlargement of the distal segments of the fingers. Which disease is associated with this condition? a. Cystic fibrosis b. Acute pneumonia c. Sickle cell disease d. Acute myocardial infarction

a. Cystic fibrosis

A patient who has tuberculosis is treated with isoniazid. The nurse should monitor for which symptoms, which could indicate a vitamin B6 deficiency caused by the medication? a. Numbness and tingling in the fingers and toes b. Alopecia and flaking scalp c. Dry skin and brittle nails d. Oral ulcers and tongue fissures

a. Numbness and tingling in the fingers and toes

A patient is prescribed codeine as an antitussive. Which symptom will the nurse observe for as an adverse effect of this medication? a. Respiratory depression b. Increased heart rate c. Productive cough d. Restlessness

a. Respiratory depression

1. Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 to use albuterol MDI [Proventil] at which of these times? a. Whenever needed (PRN) as a quick-relief agent b. Twice daily combined with an inhaled glucocorticoid c. Only with a long-acting beta2 agonist (LABA) d. If nighttime awakenings occur more than 2 days a week

a. Whenever needed (PRN) as a quick-relief agent

Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray [Flonase]? a. "I'll gradually stop taking this so I don't have any problems with withdrawal." b. "This drug will help prevent the inflammation and irritation from my allergies." c. "I'll have to be more careful about not falling, because my bones may break more easily." d. "I realize that I only need to take this when my symptoms are really bad."

b. "This drug will help prevent the inflammation and irritation from my allergies."

A nurse is teaching a patient about montelukast [Singulair]. Which statement by the patient would indicate that the nurse's teaching was effective? a. "I'll take a dose as soon as I feel short of breath and start to cough." b. "While taking this medicine, I may be able to reduce my steroid medication." c. "This is the priority medication for preventing exercise-induced asthma symptoms." d. "If I have nosebleeds or excessive bruising, I'll stop the medication immediately."

b. "While taking this medicine, I may be able to reduce my steroid medication."

A nurse obtains a specimen from which body fluid when performing the QuantiFERON-TB Gold (QFT-G) test for latent tuberculosis? a. Saliva b. Blood c. Urine d. Sputum

b. Blood

The nurse identifies which symptom as a result of activation of histamine1 (H1) by allergic reaction? a. Hypertension b. Bronchoconstriction c. Sweating d. Pupillary dilation

b. Bronchoconstriction

The nurse develops a care plan for a patient in the continuation phase of treatment for active tuberculosis (TB). The care plan includes teaching about which medication regimen? a. Pyrazinamide and ethambutol b. Isoniazid and rifampin c. Ethambutol and isoniazid d. Rifampin and ethambutol

b. Isoniazid and rifampin

Which of the following is TRUE regarding acute respiratory distress syndrome (ARDS)? a. It is caused by injury to the bronchioles b. It can cause severe pulmonary edema c. It is most commonly caused byexposure to inhaled irritants d. Macrophages are not involved in response

b. It can cause severe pulmonary edema

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule? a. Only in an emergency b. On a continuing, daily basis c. To abort an asthma attack d. 2 weeks on, 2 weeks off

b. On a continuing, daily basis

A history of allergy to which substance is a contraindication to the use of ipratropium/albuterol [Combivent]? a. Mold b. Peanuts c. Penicillin d. Dairy products

b. Peanuts

A nurse is planning care for a patient who takes fexofenadine (Allegra) for allergic rhinitis. Which outcome should the nurse anticipate? a. No complaints of dry mouth b. Relief of sneezing and itching c. Use limited to allergy season d. Absence of rebound congestion

b. Relief of sneezing and itching

A nurse is planning care for a patient who takes fexofenadine [Allegra] for allergic rhinitis. Which outcome should the nurse anticipate? a. No complaints of dry mouth b. Relief of sneezing and itching c. Use limited to allergy season d. Absence of rebound congestion

b. Relief of sneezing and itching

A patient has received a toxic dose of an antihistamine. It is most important for the nurse to assess the patient for what? a. Tinnitus Incorrect b. Seizure activity c. Lethargy d. Visual disturbances

b. Seizure activity

A patient with asthma is prescribed triamcinolone acetonide [Azmacort]. What should the nurse do? a. Take the patient's pulse before administering the medication. b. Teach the patient to use a spacer to prevent a fungal infection. c. Instruct the patient to use this drug to treat an acute attack. d. Encourage the patient to avoid weight-bearing activity

b. Teach the patient to use a spacer to prevent a fungal infection.

A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of these instructions? a. "Restrict cold fluids to promote reduced mucus production." b. "Take the medication once a day only, usually at bedtime." c. "Increase your fluid intake to reduce the viscosity of secretions." d. "Increase your fiber and fluid intake to prevent constipation

c. "Increase your fluid intake to reduce the viscosity of

A nurse is teaching a patient who is to start taking an expectorant. The nurse provides the patient with which of these instructions? a. "Restrict cold fluids to promote reduced mucus production." b. "Take the medication once a day only, usually at bedtime." c. "Increase your fluid intake to reduce the viscosity of secretions." d. "Increase your fiber and fluid intake to prevent constipation."

c. "Increase your fluid intake to reduce the viscosity of secretions."

A patient with asthma is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler? a. "After you inhale the medication once, repeat until you obtain symptomatic relief." b. "Wait no longer than 30 seconds after the first puff before taking the second one." c. "Use a spacer with the inhaler and rinse your mouth after each dose administration." d. "Breathe in through the nose and hold for 2 seconds just before activating the inhaler."

c. "Use a spacer with the inhaler and rinse your mouth after each dose administration."

Which information should the nurse include when teaching a patient about isoniazid (INH) therapy? a. Tubercle bacilli cannot develop resistance to isoniazid during treatment b. Isoniazid is administered intravenously c. An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine d. The dose of isoniazid should be lowered if the patient is also taking phenytoin

c. An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine

A patient asks what medication would be most effective in the treatment of seasonal hay fever. The nurse will teach the patient about the use of which drug? a. Azelastine [Astelin] b. Chlorpheniramine [Chlor-Trimeton] c. Fluticasone [Flonase] d. Pseudoephedrine [Sudafed]

c. Fluticasone [Flonase]

Which of the following is TRUE regarding the pathophysiology of asthma? a. IgA is the major factor. b. There is decreased vascular permeability c. Inflammation results in hyper responsiveness d. The inflammatory process is caused by the loss of bronchial smooth muscle spasm

c. Inflammation results in hyper responsiveness

Which of the following is TRUE regarding asthma in children? a. It affects 20% to 25% of children b. Prepubertal girls are more likely than boys to have it c. It is the most prevalent chronic disease in childhood d. White children have higher mortality than black and Hispanic children

c. It is the most prevalent chronic disease in childhood

A patient who takes cromolyn for exercise-induced bronchospasm should follow which approach for maximum therapeutic effectiveness? a. It should be used infrequently because of systemic adverse effects. b. One 10-mg tablet should be taken at least 2 hours before exercising. c. It should be administered by inhalation 15 minutes before anticipated exertion. d. It should be used as a quick-relief agent if exercise triggers asthma symptoms.

c. It should be administered by inhalation 15 minutes before anticipated exertion.