Week 9: Chapter 21

Question 1

What is the goal for drug therapy for asthma and or COPD?

Answer 1

To improve airflow and reduce symptoms

Question 2

Which drugs are long-acting beta agonists?

Answer 2

1. formoterol (Floradil)

2. Salmetrol (Serevent)

Question 3

Which beta-adrenergic agonist is most effective as a rescue drug?

Answer 3

Levalbuterol (Xopenex)

Question 4

A pt who rx a bronchodilator 20 min ago now has all of the following response. For which of the following do you notify the prescriber immediately?

Answer 4

Chest pain on exertion

Question 5

Which symptoms or conditions are S/E of cholinergic antagonist drugs?

Answer 5

1. Blurred vision
2. Constipation
3. Urinary retention

Question 6

Which drug classes are used as therapy for pulmonary artery hypertension (PAH)?

Answer 6

1. Endothelin-receptor antagonist
2. Phosphodiesterase inhibitors
3. Prostacyclin agents
4. Vitamin K antagonists

Question 7

When a pt is prescribed an inhaled bronchodilator and an inhaled corticosteroid at the same time, why must he/she wait 5 min after using the bronchodilator before using the inhaled corticosteroid?

Answer 7

Giving the bronchodilator first allows the inhaled corticosteroid to be more effective

Question 8

Which S/S in a pt who is using a short-acting beta agonist (SABA) as a rescue drug indicates that he/she is using the inhaler very frequently?

Answer 8

Tremors

Question 9

A pt who has COPD asks what exactly guaifenesin (Mucinex) does to help him breathe better. What is your best answer?

Answer 9

It thins your lung secretions making it easier for you to cough them out

Question 10

Which problem indicates that a pt may be excessively using his/her beclomethasone (QVAR) inhaler?

Answer 10

The presence of thick white cheesy material on the tongue and roof of the mouth

Question 11

What is the most important point to teach a pt using a long-acting beta agonist (LABA)?

Answer 11

Take the drug daily as prescribed even when you have no symptoms

Question 12

Which precaution should you teach a woman taking bosentan (Tracleer)?

Answer 12

Use a reliable form of contraception

Question 13

A nurse just administered a prescribed rescue bronchodilator to a patient experiencing an asthma attack. What signs indicate that the drug is effective? (select all that apply)

Answer 13

1. Decrease RR
2. Improved positive expiratory rate flow (PERF) by at least 15%
3. Decreased or absent wheezes

Question 14

A nurse is discharging a patient with a new prescription for an aerosol inhaler without a spacer. What are accurate teaching tips for this patient? (select all that apply)

Answer 14

1. “Open your mouth and place the mouthpiece 1 to 2 inches away.”
2. “Wait 1 minute between puffs of the medication.”
3. “Clean the plastic case and cap of the inhaler with warm running water.”

Question 15

Why are mucolytics helpful in the management of chronic obstructive pulmonary disease (COPD)?

Answer 15

Mucus becomes less sticky and is easier to cough up.

Question 16

A patient asks how prescribed corticosteroids help with her breathing. What is your best response?

Answer 16

“They reduce inflammation that narrows the airways.”

Question 17

The nurse is performing discharge teaching to a patient with a prescription for an aerosol inhaler with a spacer. What teaching tip for using an aerosol inhaler with a spacer is correct?

Answer 17

Insert the mouthpiece of the inhaler into the non-mouthpiece end of the spacer.

Question 18

A nurse is teaching a patient whose peak expiratory rate flow (PERF) reading is 85% of the patient’s personal best. What should the nurse teach the patient to do next with regard to his or her prescribed asthma medications?

Answer 18

Take controller medications as ordered.

Question 19

The nurse is providing discharge instructions to a patient prescribed an inhaled anti-inflammatory. What side effect is the patient at risk for when taking this drug?

Answer 19

Thrush

Question 20

A nurse is caring for a patient with asthma who has been ordered to receive a bronchodilator and another inhalation drug. How should the nurse administer both drugs at the same time to this patient?

Answer 20

Give the bronchodilator 5 minutes before the other drug.

Question 21

A patient with COPD is being given a mucolytic. What drug is typically administered using a nebulizer face mask?

Answer 21

Acetylcysteine (Mucomyst)

Question 22

The nurse is caring for a patient with a new diagnosis of asthma. The nurse tells the patient what factors can trigger an asthma attack? (select all that apply)

Answer 22

1. Cold dry air
2. Aspirin
3. Microorganism

Question 23

A patient with asthma has a positive expiratory rate flow reading of 60% of the personal best. Which type of medication would you expect the patient to take at this point?

Answer 23

Short-acting beta2-adrenergic agonist (SABA)

Question 24

A nurse is performing an admission assessment on a patient admitted with a respiratory diagnosis. What respiratory disorder is actually a combination of two disorders?

Answer 24

Chronic obstructive pulmonary disease (COPD)

Question 25

A nurse has been ordered to administer a dry-powder inhaler to a patient. What should be done first before giving this drug?

Answer 25

Keep the inhaler in a dry place at room temperature.

Question 26

A patient is taking an inhaled anticholinergic agent. What side effect can occur if this agent reaches the bloodstream?

Answer 26

Headache