Chapter 15- Bronchodilators

Question 1

The nurse is preparing to administer intravenous aminophylline drip. The nurse should:

Answer 1

use an intravenous infusion pump for administration.

Question 2

When working with clients with respiratory conditions, the nurse should avoid what:

Answer 2

avoids using talc or bath powder around the clients.

as this can exacerbate the respiratory conditions of these clients.

Question 3

Clients should be advised that the overuse of bronchodilators may cause:

Answer 3

bronchoconstriction. Overdosing of bronchodilators stimulates a rebound bronchoconstriction.

Question 4

Successful resolution of the nursing diagnosis “Gas exchange impaired related to disease process” would be indicated by which of the following outcomes?

Answer 4

Client’s oxygen saturation is greater than or equal to 90%.

Question 5

Xanthine bronchodilators such as theophylline are believed to act by:

Answer 5

increasing the concentration of intracellular cyclic AMP (cAMP). They block the enzyme that breaks down cAMP, thus increasing its concentration.

Question 6

The nurse understands that drugs like propranolol:

Answer 6

block beta-2 receptors and cause bronchoconstriction.

Question 7

The client asks what happens when beta-2 receptors are stimulated. The nurse’s best response would be that this results in:

Answer 7

bronchodilation and smooth muscle relaxation.

When these cells are stimulated, bronchodilation and smooth muscle relaxation occur.

Question 8

A client’s serum theophylline level is 28 mcg/mL. The nurse should:

Answer 8

report the theophylline level to the health care provider.
The normal theophylline level is 10–20 mcg/mL, so the client’s level indicates possible toxicity, and the health care provider should be notified.

Question 9

The nurse is aware that cromolyn sodium (Intal):

Answer 9

inhibits release of histamine from mast cells.

Cromolyn sodium is a mast cell stabilizer that acts by inhibiting the release of histamine

Question 10

The nurse teaches the client with COPD to avoid

Answer 10

warm milk. Milk increases the amount and thickness of secretions.

Question 11

Aminophylline relieves dyspnea by:

Answer 11

relaxing the smooth muscles of the bronchioles, thereby producing bronchodilation.

Question 12

What measure could be taken to prevent the development of pneumonia in clients with COPD?

Answer 12

placing the client on broad-spectrum antibiotics during peak pneumonia season

Question 13

Acetylcysteine (Mucomyst) can best be characterized as a:

Answer 13

mucolytic agent.

Question 14

The nurse should teach clients with COPD to avoid:

Answer 14

beta-adrenergic blocking agents. These agents cause bronchoconstriction and are contraindicated in clients with COPD.

Question 15

The client is prescribed two inhalant medications. One is a bronchodilator, and the other is a corticosteroid. The nurse believes that the client understands proper self-administration when the client relates which of the following statements?

Answer 15

“I should first take the bronchodilator and then the steroid.”

Question 16

A nurse working in the neonatal intensive care unit is caring for a premature infant receiving beractant. The nurse understands that this agent is used as a:

Answer 16

lung surfactant. Lack of surfactant is the most common cause of neonatal respiratory distress syndrome in premature infants. Beractant is a natural lung surfactant administered via an endotracheal tube.

Question 17

The nurse understands that manifestations of respiratory distress differ according to the client’s level of growth and development. The nurse would monitor which of the following clients for sternal retraction?

Answer 17

newborns.

Question 18

The nurse is assisting a client who lacks coordination between hand and inhalation, but who must inhale medications. The nurse would assist the client with the use of a(n):

Answer 18

extender device

Question 19

When assessing the understanding of the client with COPD in using oxygen at home, which comment would indicate the need for further instruction?

Answer 19

“For severe shortness of breath, I can increase my oxygen to 5 liters.”

Because clients with COPD require a certain level of hypoxia for the drive to breath, providing levels of oxygen greater than 2 liters per minute without the health care provider’s input may cause more severe respiratory distress.

Question 20

In the absence of medical contraindications, the nurse should advise clients with COPD to consume how many 8-ounce glasses of oral fluids per day?

Answer 20

12 1/2 to 16 1/2 glasses
In the absence of cardiac or renal health problems, 3 to 4 liters of fluids a day are recommended. 12.5  8  30 = 3,000 mL; 16.5  8  30 = 3,960 mL.

Question 21

The nurse is preparing to administer intravenous aminophylline infusion and should question which of the following orders given by the health care provider?

Answer 21

Infuse at 25 gtts/min using a microdripper.

Question 22

When teaching clients with COPD how to use controlled breathing, the nurse should instruct the clients to:

Answer 22

exhale through pursed lips

Question 23

When evaluating the effectiveness of client teaching regarding the use of an oral inhaler, which of the following client comments indicates an understanding of the instructions?

Answer 23

“I will shake the inhaler before each use.”

Question 24

The client asks the nurse why the health care provider prescribed a metered-dose inhaler with a spacer. The nurse’s best response would be:

Answer 24

“This method decreases the adverse effects of the medication.”

Question 25

The nurse should closely monitor which of the following clients receiving ipratropium?

Answer 25

client with narrow-angle glaucoma

Question 26

Terbutaline should not be used in clients:

Answer 26

taking MAO inhibitors

Question 27

The client is using corticosteroids by inhalation in the treatment of bronchial asthma. How much time should elapse between inhalations?

Answer 27

1 minute

Question 28

When teaching a client receiving metaproterenol, the nurse should include information about which of the following adverse effects of this medication? Select all that apply.

Answer 28

a. anxiety
b. insomnia
c. gastrointestinal disturbances
e. tremor

Question 29

When caring for the client receiving theophylline, the nurse should monitor for which of the following adverse effects? Select all that apply.

Answer 29

a. decreased potassium level
b. cardiac dysrhythmias
e. diuresis

Question 30

Which of the following statements provided by the nurse recruit provides correct information concerning Symbicort? Select all that apply.

Answer 30

a. “Warn the client to avoid exposure to chicken pox or measles.”
b. “Nasopharyngitis is an adverse effect.”
d. “It is used for long-term maintenance of asthma.”
e. “Instruct the client to have ophthamological exams for glaucoma and cataract.”

Question 31

Your client receives a new prescription for Flo-Pred. Which of the following statements by the nurse could be correct? Select all that apply.

Answer 31

b. “It is contraindicated in clients with a fungal infection.”
d. “It can cause a decrease in diabetes control.”
e. “The medication is used for treatment of asthma.”

Question 32

Which of the following statements are true concerning cystic fibrosis (CF)? Select all that apply.

Answer 32

b. A focus of respiratory management is maintaining a patent airway and adequate gas exchange.
d. CPT is performed three to four times per day.
e. Increased secretions serve as an excellent media for bacterial growth.
f. The leading cause of hospitalization related to CF is respiratory infection.

Question 33

The client is receiving the medication bosentan. The nurse would monitor for which of the following adverse effects? Select all that apply.

Answer 33

a. sinusitis
b. peripheral edema
d. nasal congestion
e. palpitations
f. fluid retention