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Respiratory drugs play a crucial role in managing conditions such as c...
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Pathophysiology (NSG 211)
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Marian University
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Chapter 37: Respiratory Drugs
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive
pulmonary disease. The nurse will assess for which therapeutic response?
a. Increased sputum production
b. Increased heart rate
c. Increased respiratory rate
d. Increased ease of breathing
ANS: D
The therapeutic effects of bronchodilating drugs such as xanthine derivatives include
increased ease of breathing. The other responses are incorrect.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient is taking a xanthine derivative as part of treatment for chronic obstructive
pulmonary disease. The nurse will monitor for which adverse effects associated with the use
of xanthine derivatives?
a. Diarrhea
b. Palpitations
c. Bradycardia
d. Drowsiness
ANS: B
The common adverse effects of the xanthine derivatives include nausea, vomiting, and
anorexia. In addition, gastroesophageal reflux has been observed to occur during sleep in
patients taking these drugs. Cardiac adverse effects include sinus tachycardia, extrasystole,
palpitations, and ventricular dysrhythmias. Transient increased urination and hyperglycemia
are other possible adverse effects.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient is in an urgent care center with an acute asthma attack. The nurse expects that which
medication will be used for initial treatment?
a. An anticholinergic such as ipratropium
b. A short-acting beta 2 agonist such as albuterol
c. A long-acting beta 2 agonist such as salmeterol
d. A corticosteroid such as fluticasone
ANS: B
The short-acting beta 2 agonists are commonly used during the acute phase of an asthmatic
attack to reduce airway constriction quickly and to restore airflow to normal levels. The other
drugs listed are not appropriate for acute asthma attacks. Anticholinergic drugs and
long-acting beta 2 agonists are used to prevent attacks; corticosteroids are used to reduce
airway inflammation.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. The prescriber has changed the patient’s medication regimen to include the leukotriene
receptor antagonist (LTRA) montelukast to treat asthma. The nurse will emphasize which
point about this medication?
a. The proper technique for inhalation must be followed.
b. The patient needs to keep it close by at all times to treat acute asthma attacks.
c. It needs to be taken every day on a continuous schedule, even if symptoms
improve.
d. When the asthma symptoms improve, the dosage schedule can be tapered and
eventually discontinued.
ANS: C
LTRAs are indicated for chronic, not acute, asthma and are to be taken every day on a
continuous schedule, even if symptoms improve. These drugs are taken orally.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. After receiving a nebulizer treatment with a beta agonist, the patient states she is feeling
slightly nervous and wonders if her asthma is getting worse. What is the nurse’s best
response?
a. “This is an expected adverse effect. Let me take your pulse.”
b. “The next scheduled nebulizer treatment will be skipped.”
c. “I will notify the physician about this adverse effect.”
d. “We will hold the treatment for 24 hours.”
ANS: A
Nervousness, tremors, and cardiac stimulation are possible and expected adverse effects of
beta agonists. The other options are incorrect responses.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a
corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?
a. “Take the corticosteroid inhaler first.”
b. “Take the bronchodilator inhaler first.”
c. “Take these two drugs at least 2 hours apart.”
d. “It does not matter which inhaler you use first.”
ANS: B
An inhaled bronchodilator is used before the inhaled corticosteroid to provide bronchial
relaxation/dilation before administration of the anti-inflammatory drug.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
ANS: D
Salmeterol is a long-acting beta 2 agonist bronchodilator, while fluticasone is a corticosteroid.
In combination, they are used for the maintenance treatment of asthma and COPD. As a
long-acting inhaler, Advair is not appropriate for treatment of acute bronchospasms. The other
statements are incorrect.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
MULTIPLE RESPONSE
1. The nurse is reviewing medications for the treatment of asthma. Which drugs are used for
quick relief of asthma attacks? (Select all that apply.)
a. Salmeterol inhaler
b. Albuterol nebulizer solution
c. Intravenous systemic corticosteroids
d. Montelukast
e. Fluticasone inhaler
ANS: B, C
Albuterol (a short-acting beta 2 agonist) and intravenous systemic corticosteroids are used to
provide quick relief for asthma. See Box 37-2. Salmeterol is a long-acting beta 2 agonist that is
indicated for maintenance treatment, not acute episodes. Fluticasone is an inhaled
corticosteroid; montelukast is a leukotriene receptor antagonist (LTRA). These types of
medications are used for asthma prophylaxis.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. The nurse is providing instructions to a patient who has a new prescription for a corticosteroid
metered-dose inhaler. Which statement by the patient indicates that further instruction is
needed? (Select all that apply.)
a. “I will rinse my mouth with water after using the inhaler and then spit out the
water.”
b. “I will gargle after using the inhaler and then swallow.”
c. “I will clean the plastic inhaler casing weekly by removing the canister and then
washing the casing in warm soapy water. I will then let it dry before
reassembling.”
d. “I will use this inhaler for asthma attacks.”
e. “I will continue to use this inhaler, even if I am feeling better.”
f. “I will use a peak flow meter to measure my response to therapy.”
ANS: B, D
The inhaled corticosteroid is a maintenance drug used to prevent asthma attacks; it is not
indicated for acute asthma attacks. Rinsing the mouth with water is appropriate and necessary
to prevent oral fungal infections; the water is not to be swallowed after rinsing. The patient
needs to be given instructions about keeping the inhaler clean, including removing the canister
from the plastic casing weekly and washing the casing in warm soapy water. Once the casing
is dry, the canister and mouthpiece may be put back together and the cap applied. The
glucocorticoid may predispose the patient to oral fungal overgrowth, thus the need for implicit
instructions about cleaning inhaling devices. Use of a peak flow meter assists in monitoring
the patient’s response to therapy. The medication needs to be taken as ordered every day,
regardless of whether the patient is feeling better.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
COMPLETION
1. A patient has a metered-dose inhaler that contains 200 actuations (‘puffs’), and it does not
have a dose counter. He is to take two puffs two times a day. If he does not take any extra
doses, identify how many days will this inhaler last at the prescribed dose. _______
ANS:
50 days
Note the number of doses in the canister, and then calculate the number of days that the
canister will last. For this question, assuming that two puffs are taken two times a day, and the
inhaler has a capacity of 200 inhalations. Two puffs two times a day equal four inhalations per
day. Four divided into 200 yields 50; that is, the inhaler will last approximately 50 days.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient will be receiving oral theophylline, 600 mg/day, in three divided doses. Identify how
many milligrams the patient will receive per dose. _______
ANS:
200 mg
600 mg/day divided by 3 doses per day = 200 mg/dose.
DIF: Cognitive Level: Applying (Application)
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
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37 - dsfdsfds
Course: Pathophysiology (NSG 211)
33 Documents
Students shared 33 documents in this course
University: Marian University
Was this document helpful?
Chapter 37: Respiratory Drugs
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. A patient is taking intravenous aminophylline for a severe exacerbation of chronic obstructive
pulmonary disease. The nurse will assess for which therapeutic response?
a.
Increased sputum production
b.
Increased heart rate
c.
Increased respiratory rate
d.
Increased ease of breathing
ANS: D
The therapeutic effects of bronchodilating drugs such as xanthine derivatives include
increased ease of breathing. The other responses are incorrect.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. A patient is taking a xanthine derivative as part of treatment for chronic obstructive
pulmonary disease. The nurse will monitor for which adverse effects associated with the use
of xanthine derivatives?
a.
Diarrhea
b.
Palpitations
c.
Bradycardia
d.
Drowsiness
ANS: B
The common adverse effects of the xanthine derivatives include nausea, vomiting, and
anorexia. In addition, gastroesophageal reflux has been observed to occur during sleep in
patients taking these drugs. Cardiac adverse effects include sinus tachycardia, extrasystole,
palpitations, and ventricular dysrhythmias. Transient increased urination and hyperglycemia
are other possible adverse effects.
DIF: Cognitive Level: Remembering (Knowledge) TOP: Nursing Process: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. A patient is in an urgent care center with an acute asthma attack. The nurse expects that which
medication will be used for initial treatment?
a.
An anticholinergic such as ipratropium
b.
A short-acting beta2 agonist such as albuterol
c.
A long-acting beta2 agonist such as salmeterol
d.
A corticosteroid such as fluticasone
ANS: B
The short-acting beta2 agonists are commonly used during the acute phase of an asthmatic
attack to reduce airway constriction quickly and to restore airflow to normal levels. The other
drugs listed are not appropriate for acute asthma attacks. Anticholinergic drugs and
long-acting beta2 agonists are used to prevent attacks; corticosteroids are used to reduce
airway inflammation.
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