Chapter 38 Questions – Flashcards
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A patient received methylprednisolone intravenously for 4 days for acute asthma. The nurse is preparing for the discharge of the patient with a prescription for fluticasone. Which priority instruction should the nurse include while educating the patient before discharge? "Take fluticasone exactly as it is prescribed." "Rinse your mouth with water after using fluticasone." "Avoid situations that can expose you to the infections." "Administer albuterol before other asthma medications."
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"Take fluticasone exactly as it is prescribed."
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A patient is prescribed ipratropium for treatment of chronic obstructive pulmonary disease (COPD). After checking the medical history, the nurse finds that the patient is taking diphenhydramine to treat allergies. What should the nurse anticipate that the provider will prescribe for this patient? Discontinue the ipratropium. Discontinue the dose of diphenhydramine. Administer both medications as prescribed. Administer both medicines simultaneously.
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Discontinue the dose of diphenhydramine.
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What interaction can occur when an asthmatic patient consumes rifampin along with xanthine derivatives? Theophylline levels are decreased. Theophylline metabolism is decreased. Additive cardiac stimulation is produced. Additive central nervous system stimulation is produced.
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Theophylline levels are decreased.
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A patient with a history of asthma is short of breath and says, "I feel like I'm having an asthma attack." What is the nurse's highest priority action? Calling a code Administering a beta 2-adrenergic agonist Administering a long-acting glucocorticoid Asking the patient to describe the symptoms
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Administering a beta 2-adrenergic agonist
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A patient with a history of asthma is brought to the clinic with acute dyspnea, wheezing, hypercapnia, and hypoxemia. Which type of medication will be administered first to this patient? Glucocorticoids Beta 2 agonists Anticholinergics Leukotriene modifiers
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Beta 2 agonists
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A patient is prescribed zileuton to treat asthma. Which will be closely monitored in the patient to ensure safe drug administration? Creatinine clearance Liver enzyme levels Complete blood count Uric acid baseline level
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Liver enzyme levels
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A patient is prescribed albuterol. The nurse is explaining the most common route of administration of albuterol to the patient. Which route should the nurse discuss? Inhalation Intravenous Subcutaneous Intramuscular
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Inhalation
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A primary health care provider prescribes omalizumab for a patient. What should the nurse assess to ensure safety of drug administration? Urine frequency Body temperature Gastrointestinal upset Hypersensitivity reactions
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Hypersensitivity reactions
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A nursing student is caring for a patient who is receiving ipratropium therapy. The student asks the nurse about the time required to reach the peak effect after the administration of the drug. What should the nurse tell the student? "It takes about 1.6 hours." "It takes about 1 to 2 hours." "It takes about 4 to 5 hours." "It takes about 5 to 15 minutes."
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"It takes about 1 to 2 hours."
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A patient with asthma has been prescribed albuterol. The patient reports dizziness after taking the medication. What will the nurse assess in the patient? Visual acuity Blood pressure Respiratory rate Balance reactions
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Blood pressure
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The nurse is caring for a child who has been prescribed an inhaler for asthma control. The child is having difficulty using the inhaler. What should the nurse do? Teach the child to use a spacer. Tell the parent to hold the inhaler for the child. Ask the health care provider to switch to oral medications. Tell the parent that young children should not use inhalers.
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Teach the child to use a spacer.
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Which information should the nurse include regarding the use of antileukotriene agents such as zafirlukast in the patient teaching? "Take the medication as soon as you begin wheezing." "It will take about 3 weeks before you notice a therapeutic effect." "Increase fiber and fluid in your diet to prevent the side effect of constipation." "This medication will prevent the inflammation that causes your asthma attack."
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"This medication will prevent the inflammation that causes your asthma attack."
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Which condition is a contraindication for the administration of montelukast? Diabetes Joint pain Peanut allergy Lactose allergy
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Lactose allergy
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The administration of beta agonists is contraindicated in which type of patients? Patients with diabetes mellitus Patients with bronchial asthma Patients with pulmonary disease Patients with a high risk of stroke
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Patients with a high risk of stroke
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The health care provider prescribes albuterol and beclomethasone inhalers for a patient. What is the nurse's best action? Administer each inhaler at 30-minute intervals. Question the prescription; two inhalers should not be given at one time. Administer beclomethasone, wait 2 minutes, and then administer albuterol. Administer the albuterol, wait 5 minutes, and then administer beclomethasone.
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Administer the albuterol, wait 5 minutes, and then administer beclomethasone.
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What are the adverse effects of ipratropium and tiotropium therapy? Headache Dry mouth Nasal congestion Increased urinary frequency Decreased intraocular pressure
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Headache Dry mouth Nasal congestion
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For what adverse effects will the nurse monitor in a patient who is receiving tiotropium? Skeletal pain Hyperglycemia Nasal congestion Heart palpitations Dry mouth or throat
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Nasal congestion Heart palpitations Dry mouth or throat
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What over-the-counter product should the nurse instruct a patient to avoid when taking theophylline? Echinacea St. John's wort Acetaminophen Diphenhydramine
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St. John's wort
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A patient is prescribed omalizumab by the primary health care provider. Which route should the nurse use to administer this drug? Oral Inhalation Intravenous Subcutaneous
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Subcutaneous
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In discharge teaching, the nurse will emphasize to a patient receiving a beta agonist bronchodilator the importance of reporting which side effect? Hypoglycemia Tachycardia Bradycardia Nonproductive cough
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Tachycardia
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The nurse is caring for multiple patients on the pulmonary unit. The nurse should question the administration of prescribed epinephrine to which patient? A patient who is 16 years old A patient with a history of emphysema A patient with a history of type 2 diabetes A patient with atrial fibrillation with a rate of 100 beats/min
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A patient with atrial fibrillation with a rate of 100 beats/min
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Which medication given for asthma can suppress bone growth in children? A beta agonist A corticosteroid An anticholinergic A xanthine derivative
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A corticosteroid
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A patient is prescribed theophylline for the treatment of chronic bronchitis. What instruction should the nurse give to the patient for safe administration of theophylline? "Avoid consumption of citrus fruit." "Avoid intake of a high-protein diet." "Increase fluid intake up to 3 L per day." "Increase intake of low-carbohydrate food."
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"Avoid intake of a high-protein diet."
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A patient taking an oral theophylline drug is due for the next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110 beats/min. The patient is irritable. What is the nurse's best action? Administer oxygen at 2 L per minute via nasal cannula. Continue to monitor the patient and give the medication. Hold the next dose of theophylline and assess the patient. Call the health care provider to request an increased dose.
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Hold the next dose of theophylline and assess the patient.
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A patient with chronic obstructive pulmonary disorder (COPD) is retaining carbon dioxide. Which respiratory therapy should the nurse administer to lower the patient's carbon dioxide concentration? Salmeterol Albuterol nebulizer Fluticasone propionate Oxygen via a nasal cannula, 2 L/min
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Albuterol nebulizer
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A patient is prescribed ipratropium and cromolyn sodium. What should the nurse teach the patient? "Take the ipratropium only in the mornings." "Take the ipratropium 5 minutes before the cromolyn." "Do not take these medications within 4 hours of each other." "Administer both medications together in a metered-dose inhaler."
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"Take the ipratropium 5 minutes before the cromolyn."
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Which condition is characterized by enlargement of air spaces caused by the destruction of the alveolar walls? Rhinitis Emphysema Bronchial asthma Chronic bronchitis
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Emphysema
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A patient reports nausea, shortness of breath, joint pain, weakness, and fatigue. On review of the patient's history, the nurse finds that the patient is prescribed prednisone to treat asthma. The nurse also learns that the patent has abruptly discontinued the medicine shortly after getting some relief from asthma. What should the nurse interpret from the assessment? The patient has Addisonian crisis. The patient has coronary ischemia. The patient has rheumatoid arthritis. The patient has Cushing's syndrome.
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The patient has Addisonian crisis.
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Which antiasthmatic drugs work by preventing the inflammation commonly provoked by the substances released from mast cells? Corticosteroids Anticholinergics Mast cell stabilizers Xanthine derivatives
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Corticosteroids
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A patient who has asthma is prescribed ipratropium. The nurse instructs the patient to rinse the mouth with water immediately after inhaling ipratropium. This is done to prevent which complication of therapy? Oral candidiasis Throat infection Nasal congestion Mucosal irritation and dryness
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Mucosal irritation and dryness
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What are adverse effects of albuterol? Tremors Skin rashes Palpitations Tachycardia Hypoglycemia
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Tremors Palpitations Tachycardia
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A patient is prescribed theophylline to treat emphysema. After reviewing the patient's history, the nurse finds that the patient is taking an oral contraceptive. The nurse recommends that the patient to use another method of contraception. What is the probable reason for this? Oral contraceptives inhibit theophylline action. Theophylline decreases the effectiveness of contraceptives. Oral contraceptives increase the serum level of theophylline. Theophylline and oral contraceptives cause additive toxicity.
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Oral contraceptives increase the serum level of theophylline.
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Which medication is a mast cell stabilizer? Zileuton Cromolyn Montelukast Arformoterol
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Cromolyn
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For what side effects should the nurse ask the patient to be watchful when administering mixed alpha/beta agonists? Anorexia Drowsiness Hypoglycemia Vascular headache Cardiac stimulation
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Anorexia Vascular headache Cardiac stimulation
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A patient with a history of chronic obstructive pulmonary disorder (COPD) experiences acute bronchospasm after being exposed to peanuts on an airplane. Which medications might the patient be using? Albuterol Salmeterol Tiotropium Ipratropium Arformoterol
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Albuterol Tiotropium Ipratropium
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The nurse is caring for a patient with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? Monitor the patient for toxicity. Increase the intravenous (IV) drip rate. Continue to assess the patient's oxygenation. Stop the IV for an hour then restart at a lower rate.
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Continue to assess the patient's oxygenation.
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ID: 10068745075 The nurse receives laboratory values for a client with a theophylline level of 14 mcg/mL. How does the nurse interpret this theophylline level? Toxic Therapeutic Subtherapeutic Life threatening
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Therapeutic
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Discharge teaching to a patient receiving a beta-agonist bronchodilator should emphasize reporting which side effect? Tachycardia Nonproductive cough Hypoglycemia Sedation
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Tachycardia
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Which herbal product, when taken with theophylline, can decrease theophylline's serum drug levels? Garlic Echinacea Peppermint oil St. John's wort
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St. John's wort
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The nurse is providing care to a client prescribed a nonselective adrenergic agonist bronchodilator. Which condition documented in the client's medical history would alert the nurse to question this prescription? Thrombocytopenia Coronary artery disease Mycobacterium tuberculosis Chronic obstructive pulmonary disease
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Coronary artery disease
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A nurse is providing education to a client taking two different bronchodilator medications. The nurse identifies which characteristic as the advantage of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil)? Quicker peak action Shorter onset of action Extended time of action Longer duration of action
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Longer duration of action
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Client teaching regarding the use of leukotriene receptor antagonists (LTRAs) drugs such as zafirlukast (Accolate) would include which statement by the nurse? "It will take about 3 or 4 weeks before you notice a therapeutic effect." "Take the medication when you are short of breath and begin wheezing." "This medication works by preventing the inflammation that causes your asthma attack." "Increase fiber and fluid in your diet to prevent the common adverse effect of constipation."
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"This medication works by preventing the inflammation that causes your asthma attack."
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What is the role of corticosteroids in the treatment of acute respiratory disorders? They decrease inflammation. They directly dilate the bronchi. They stimulate the immune system. They increase gas exchange in the alveoli.
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They decrease inflammation.
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Which statement by a client best indicates an understanding of the teaching on flunisolide (AeroBid)? "I will rinse my mouth with water after each use." "I will wash the plastic inhaler casing once a month." "I will take two puffs to treat an acute asthma attack." "I will not use my albuterol inhaler while I am taking AeroBid."
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"I will rinse my mouth with water after each use."
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Which statement by the nurse should be included when teaching a client about the proper use of metered-dose inhalers? "After you inhale the medication once, repeat until you obtain relief." "Wait 1 to 2 minutes before you take a second puff of the same drug." "Make sure that you puff out air several times after you inhale the medication." "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."
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"Wait 1 to 2 minutes before you take a second puff of the same drug."
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The nurse performs discharge teaching with a client who is prescribed the anticholinergic inhaler ipratropium bromide (Atrovent). Which statement by the client indicates to the nurse that teaching has been successful? "I will not drink grapefruit juice while taking this drug." "I may gain weight as a result of taking this medication." "This inhaler is not to be used alone to treat an acute asthma attack." "Nausea and vomiting are common adverse effects of this medication."
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"This inhaler is not to be used alone to treat an acute asthma attack."
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Which laboratory value would the nurse assess before administering zafirlukast (Accolate) to a client? Liver enzymes Cardiac enzymes Renal function tests Complete blood count
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Liver enzymes
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Before administering an LTRA medication, the nurse would assess the client for allergies to which substance? (Select all that apply.) Latex Lactose Cellulose Povidone Chlorhexidine
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Lactose Cellulose Povidone
