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PrepU Ch 33 Drug Therapy for Asthma, Airway Inflammation, and Bronchoconstriction

Terms in this set (55)

The nurse is providing education to a client who has been prescribed theophylline. The nurse interprets what client statement as a sign of successful teaching?
a. "I should limit my fluid intake to 1,000 mL a day."
b. "I should avoid beverages that contain caffeine."
c. "I can expect this drug to have a sedating effect."
d. "I will need to increase my intake of foods high in potassium."
b
A client who has been admitted to the healthcare center has been diagnosed with emphysema. The arterial blood gas results reveal respiratory acidosis. Based on this information, what should the nurse explain to the client that is the cause of the respiratory acidosis?
a. Excess carbon dioxide in the blood
b. Too little carbon dioxide in the blood
c. Presence of food in the respiratory passage
d. Inflammation of the pleura
a
The pulmonologist sees many patients daily who suffer from a variety of respiratory disorders. What are some of the common signs and symptoms many of these patients present? (Select all that apply.)
a. Cough
b. Increased temperature
c. Mucosal congestion
d. Increased secretions
a, c, d
A patient tells you that her friend has recommended using caffeine to treat her asthma. How would you appropriately respond to this patient?
a. "Prescription drugs have been proven effective in treating asthma, and caffeine hasn't been. Since uncontrolled asthma can be deadly, I wouldn't recommend that you switch from your medications to caffeine."
b. "You could try replacing your medications with caffeine for a while, but you should switch back if it doesn't seem to work as well."
c. "Your friend doesn't know what he's talking about. Caffeine doesn't treat any symptoms of asthma."
d. "Caffeine is a bronchodilator, so it might help to use it along with your prescription medications."
a
Respiratory symptoms are treated with many types of drugs, including
a. histamines.
b. bronchoconstrictors.
c. anti-inflammatory agents.
d. analgesics.
c
When describing the action of xanthines, which would the nurse include? (Select all that apply.)
a. Stimulation of 2 prostaglandins leading to smooth muscle relaxation
b. Direct effect on the mobilization of calcium within the cell
c. Selectively act at beta-2 receptor sites as agonists
d. Block the action of acetylcholine at vagal mediated receptor sites
e. Inhibition of release of slow-reacting substance of anaphylaxis
a, b, e
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
a. Oral
b. Inhalation
c. Subcutaneous
d. Intravenous
b
A client is experiencing an episode of status asthmaticus. What is the primary challenge facing the staff as they attempt to manage the client's respiratory crisis?
a. The bronchospasm does not respond to usual treatment measures
b. The client's lungs are reacting to multiple allergens at once
c. The client's underlying medical condition complicates treatment
d. There is an unusually large amount of thick secretions in the airways
a
A male client is experiencing dysphasia secondary to a mild stroke that he had 3 weeks ago. He states that his asthma medications are not working as well or as long as they did in the past. What does the nurse suspect is the reason for this?
a. He is administering the wrong medication.
b. He is experiencing confusion.
c. He is experiencing postural hypotension.
d. He is crushing the medication.
d
The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?
a. Inform the health care provider that an increase in the client's dose of theophylline may be necessary.
b. Administer the scheduled dose of theophylline with as needed (PRN) dose of a bronchodilator.
c. Inform the health care provider that the client has toxic theophylline levels.
d. Withhold the scheduled dose of theophylline pending the next day's blood work results.
c
A client with asthma has been prescribed an anti-inflammatory medication. How does an anti-inflammatory drug reduce this client's bronchoconstriction?
a. Increasing uptake of corticosteroids to medication
b. Decreases formation of mucus secretions
c. Decreasing airway hyperreactivity to stimuli
d. Increasing ability to metabolize medication
c
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
a. Albuterol blocks the stimulation of the beta-2 receptors.
b. Albuterol causes relaxation of the bronchial smooth muscles.
c. Albuterol decreases vital capacity.
d. Albuterol causes stimulation of the bronchial tissue.
b
The nurse is monitoring a premature infant diagnosed with respiratory distress syndrome (RDS). Which assessment finding will serve to demonstrate that the instillation of surfactant as a treatment has been effective?
a. Return of cough reflex
b. Clear breath sounds
c. Infant is interested in surroundings
d. Body temperature within normal range
b
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?
a. "I need to wait at least 30 minutes after the first inhalation before taking a second."
b. "I need to shake the inhaler well before taking the medication."
c. "I should take a deep breath, hold it while I administer the medication, and then exhale."
d. "I need to take three short, quick breaths to inhale the medication."
b
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?
a. Flunisolide followed immediately by albuterol
b. Flunisolide first, wait five minutes and then follow with albuterol
c. Albuterol followed immediately by flunisolide
d. Albuterol first, wait five minutes and then follow with flunisolide
d
During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?
a. Albuterol
b. Epinephrine
c. Omalizumab
d. Salmeterol
a
A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient
a. prefers a high-calorie diet.
b. is a 56-year-old man.
c. has a high coffee intake.
d. has a history of pneumonia.
c
What action by the client would indicate that the client understands how to use an inhaler?
a. The client uses a spacer to administer a powdered medication.
b. The client exhales as soon as he or she compresses the inhaler.
c. The client holds his or her breath for several seconds after compressing the canister.
d. The client inhales as soon as the inhaler enters his or her mouth.
c
The nurse is caring for a 38-year-old client with asthma who has been started on albuterol. What assessment finding should the nurse most likely attribute to adverse medication effects?
a. The client reports excessive thirst.
b. The client's oral temperature is 37.8°C (100°F).
c. The client's heart rate is 99 beats/min.
d. The client had diarrhea this morning.
c
The nursing instructor is discussing common respiratory disorders with the nursing class. Which of the following might the instructor identify as a common sign or symptom?
a. Oxygen saturation of 95%
b. Hallucinations
c. Bronchospasm
d. Drowsiness
c
A 70-year-old client is being treated for chronic obstructive pulmonary disease (COPD) with theophylline. What will be a priority assessment by the nurse?
a. Intake of fatty foods
b. Use of nicotine
c. Weight
d. Activity level
b
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?
a. Alcohol
b. Salt
c. Coffee
d. Vitamin C
c
A client who has been newly diagnosed with chronic obstructive pulmonary disease (COPD) calls the clinic and asks the nurse to explain what the newly prescribed medications are for. What would be the most appropriate response by the nurse?
a. "The medications that have been ordered for you are to help you breathe with less resistance from your diaphragm."
b. "The medications that have been ordered for you are what the physician thinks will help your breathing the most."
c. "The medications that have been ordered for you are to help relieve the inflammation and to open your airways."
d. "The medications that have been ordered for you are designed to work together to reduce your oxygen requirements."
c
What is the most effective method used to monitor clients with asthma that they can use at home?
a. Incentive spirometer
b. Trough-flow monitor
c. Manometer
d. Peak-flow monitor
d
A school-age client with a history of asthma presents to the primary care office with an elevated temperature, bilateral ear pain, and irritability. What instruction should the nurse convey to the parents regarding the use of antipyretics and analgesics?
a. Avoid administering any analgesic if the fever is less than 102°F (39°C).
b. Administer half the recommended dose for the first 2 days.
c. Administer twice the recommended dose for the first 2 days.
d. Avoid administering acetaminophen for fever and discomfort.
d
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?
a. Zafirlukast
b. Montelukast
c. Fluticasone
d. Zileuton
c
Why are inhaled steroids used to treat asthma and COPD?
a. They act locally to decrease histamine release
b. They act locally to improve mobilization of edema
c. They act locally to increase histamine release
d. They act locally to decrease release of inflammatory mediators
d
A client arrives in the emergency room with an attack of acute bronchiectasis. What is the principal pathologic finding in the diagnosis of bronchiectasis?
a. Chronic, irreversible dilation of the bronchi and bronchioles
b. Increase in the red blood cell concentration in the blood
c. Leakage of fluid into the alveolar interstitial spaces
d. Obstruction of the pulmonary vasculature by a clot
a
A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?
a. Emphysema
b. Pneumonia
c. Chronic bronchitis
d. Asthma
d
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:
a. keep an extra oxygen tank on hand for propelling the medication.
b. gargle with an alcohol-based mouthwash after each dose.
c. sit in a fully upright position when administering the medication.
d. take the exact number of puffs that have been prescribed.
c
The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?
a. Antiasthma
b. Leukotriene modifier
c. SABA
d. LABA
c
A client is experiencing an acute asthmatic attack. Which agent would be most effective?
a. Inhaled steroid
b. Beta-2 selective adrenergic agonist
c. Leukotriene receptor antagonist
d. Mast cell stabilizer
b
A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?
a. "I'll try to make sure that I drink plenty of fluids each day."
b. "I'll make sure I don't take my inhalers more often than they've been prescribed."
c. "I'll keep taking my medications until I'm not experiencing any more symptoms."
d. "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this."
c
A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective?
a. Supply supplemental oxygen as prescribed
b. Monitoring respirations for bilateral chest movement
c. Changing the newborn's position frequently to assure effective distribution of medication
d. Suctioning the infant every 30 minutes for 2 hours after the treatment has been initiated
b
A nurse is required to educate a patient prescribed albuterol on the adverse effects associated with the drug. Which of the following symptoms, if experienced, should the nurse instruct the patient to report to the health care provider?
a. Hearing impairment or deficit
b. Fall in blood pressure
c. Headache and flushing
d. Increased nighttime urination
c
An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications?
a. "I need to take the medication when I start to have problems breathing."
b. "This medication is safe for kids like me."
c. "We need to let the health care provider know if the medicine gives me a headache or makes me dizzy."
d. "This is a new kind of asthma medication."
a
An adult client with newly diagnosed asthma presents for client education regarding situations that could precipitate an asthma attack. In this teaching, which precipitants would the nurse state may trigger an attack? Select all that apply.
a. Cigarette smoke
b. Warm weather
c. Mold
d. Exercise
e. Allergens
a, c, d, e
Which would a nurse identify as being involved with acute respiratory distress syndrome?
a. Hyperresponsiveness of the airways
b. Permanent inflammation of the airways
c. Collapse of the alveoli
d. Progressive loss of lung compliance
d
Which statement, made by a client diagnosed with chronic obstructive pulmonary disease (COPD), demonstrates an understanding of the cause of this respiratory disorder?
a. "My allergies trigger a chronic response in my lungs."
b. "It's a genetic disorder that I've had since I was born."
c. "I have a bacterial lung infection that doesn't respond to antibiotics."
d. "Smoking a pack of cigarettes a day for 30 years makes it hard to get air in."
d
A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?
a. The health care provider will most likely order continuation of the salmeterol with increased dosage.
b. Salmeterol is contraindicated based on his wife's condition.
c. The extra doses facilitated bronchodilation and probably saved her life.
d. The husband made the correct decision in giving the extra doses.
b
A client has been diagnosed with asthma and prescribed inhaled steroids. What should the nurse teach the client about this treatment?
a. Systemic adverse effects should be expected and can be serious.
b. Inhaled corticosteroids should not be used on an emergency basis.
c. Effective levels are usually reached within 72 hours of starting treatment.
d. The drug will stimulate the sympathetic nervous system.
b
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?
a. Relaxation of smooth muscle
b. Reduction of the inflammatory response
c. Decrease in the production of leukotrienes D4 and E4
d. Enhancement of alveolar expansion
a
A nurse is caring for a client with chronic bronchiectasis. The nurse should assess the patient for which clinical manifestation?
a. Angina
b. Pulmonary hypertension
c. Pigeon chest
d. Purulent cough
d
A client has been prescribed medication therapy for the treatment of newly diagnosed asthma. During teaching, the nurse should alert the client to potential exacerbation of what concurrent medical condition?
a. cataracts
b. dermatitis
c. urinary retention
d. gastroesophageal reflux disease
d
A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?
a. Cromolyn
b. Calfactant
c. Montelukast
d. Triamcinolone
a
A male client is concerned because ever since he began his antiasthma medication, his GERD symptoms are worse. The nurse explains that his symptoms are worse because his asthma medications have what effect?
a. They stimulate peristalsis.
b. They cause acid indigestion.
c. They relax the gastresophageal sphincter.
d. They tighten the gastresophageal sphincter.
c
A client arrives in the emergency room with an attack of acute bronchiectasis. What is the principal pathologic finding in the diagnosis of bronchiectasis?
a. Obstruction of the pulmonary vasculature by a clot
b. Increase in the red blood cell concentration in the blood
c. Leakage of fluid into the alveolar interstitial spaces
d. Chronic, irreversible dilation of the bronchi and bronchioles
d
An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications?
a. "This is a new kind of asthma medication."
b. "I need to take the medication when I start to have problems breathing."
c. "We need to let the health care provider know if the medicine gives me a headache or makes me dizzy."
d. "This medication is safe for kids like me."
b
A 42-year-old male client has a history of smoking for 20 years. The client states he is feeling fine and asks why stopping smoking is necessary. What information might the nurse share with the client about smoking?
a. Smoking decreases the size of the tubes leading to the lungs
b. Smoking causes the respiratory system to increase oxygen delivery to the lungs
c. The chest becomes more elastic with increased time of smoking
d. Carbon dioxide levels may decrease in the lungs
a
A client who has chronic bronchial asthma has had a mast cell stabilizer prescribed. What drug would the provider prescribe?
a. Aminophylline
b. Cromolyn
c. Ipratropium
d. Isoetharine
b
After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?
a. Salmeterol
b. Formoterol
c. Albuterol
d. Arformoterol
c
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?
a. The standard dose of aminophylline
b. A drug other than aminophylline
c. Phenytoin intravenously
d. A modified dose of aminophylline
d
Which statement demonstrate effective knowledge regarding the body's process of gas exchange? Select all that apply.
a. Involves the exchange of carbon dioxide and oxygen
b. This process of gas exchange is called ventilation
c. It occurs at the alveoli level
d. The gases diffuse through the respiratory membrane
e. The gases are diffused into the capillary blood system.
a, c, d, e
A client is being evaluated for a possible diagnosis of emphysema. What client characteristic should the nurse monitor to provide evidence of the disorder?
a. Respiratory expiration
b. Presence of a fever
c. Evidence of underlying trauma
d. Respiratory inspiration
a
Shane, a 25-year-old man, is diagnosed with asthma. He began an albuterol MDI 2 weeks ago. He reports that his symptoms persist in spite of using albuterol MDI as prescribed. What advice should the nurse give the client?
a. Contact the health care provider to obtain adjunctive medications.
b. Contact the health care provider to obtain an increased dosage of albuterol.
c. Clean the MDI thoroughly on a regular basis.
d. Use the MDI more often.
a
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