Chapter 37 - Respiratory - Pharmacology &
Nursing Process. Exam Questions With
Correct Answers.
Which medication will the nurse teach a patient with asthma to use when experiencing an acute
asthma attack?
a. albuterol (Ventolin)
b. salmeterol (Serevent)
c. theophylline (Theo-Dur)
d. montelu...
Which medication will the nurse teach a patient with asthma to use when experiencing an acute
asthma attack?
a. albuterol (Ventolin)
b. salmeterol (Serevent)
c. theophylline (Theo-Dur)
d. montelukast (Singulair) - answer✔✔Correct answer: A
Rationale: Albuterol (Ventolin) is a SABA. Patients must be taught to use the SABAs as rescue
treatment. Salmeterol (Serevent) is a long-acting bronchodilator. Because the LABAs have a
longer onset of action, they must never be used for acute treatment . Because of their relatively
slow onset of action, xanthines such as theophylline (Theo-Dur) are more often used for the
prevention of asthmatic symptoms than for the relief of acute asthma attacks. Montelukast
(Singulair) is an LTRA and is used primarily for oral prophylaxis and long-term treatment of
asthma.
A patient with chronic bronchitis calls the office for a refill of his albuterol inhaler. He just had
the prescription filled 2 weeks ago, but he says it is empty. When asked, he tells the nurse, "I use
it whenever I need it, but now when I use it, I feel so sick. I've been needing to use it more
often." What is the most appropriate action by the nurse?
a. The nurse should confirm the pharmacy location for the needed refill.
b. The nurse should ask the patient to come to the office for an evaluation of his respiratory
status.
c. The nurse should tell the patient not to use this drug too often.
d. The nurse should consult the prescriber for a different inhaler prescription. -
answer✔✔Correct answer: B
Rationale: Although it is true that the patient should be reminded about the correct use of this
inhaler, it is evident that he has used it too often and that his respiratory status should be
evaluated to see if an adjustment in the prescription should be made.
A patient is prescribed two different types of inhaled medications for treatment of COPD. After
administering the first medication, how long should the nurse wait to administer the second
medication?
a. 1 minute
b. 5 minutes
c. 10 minutes
d. 15 minutes - answer✔✔Correct answer: B
Rationale: If a second puff of the same drug is ordered, instruct the patient to wait 1 to 2 minutes
between puffs. If a second type of inhaled drug is ordered, instruct the patient wait 2 to 5 minutes
between the medications or to take as prescribed. Bronchodilators are usually administered first.
The nurse is providing teaching to a group of individuals with COPD at a community center.
Which statement by one of the attendees indicates that further teaching is needed?
a. "If I develop a puffy face, I will stop taking methylprednisolone (Medrol) immediately."
b. "I will inform my prescriber of any weight gain of 2 lb or more in 24 hours or 5 lb or more in
1 week."
c. "I use omalizumab (Xolair) to control my asthma but not for an acute asthma attack."
d. "When taking theophylline (Theo-Dur), I will advise my prescriber if I experience epigastric
pain." - answer✔✔Correct answer: A
Rationale: Patients should be taught to not stop systemic corticosteroids abruptly. Patients should
be educated about the possibility of Addisonian crisis, which may occur if a systemic
corticosteroid is abruptly discontinued. These drugs require weaning before discontinuation of
the medication. Patients should monitor their weight daily and report the increase stated.
Omalizumab (Xolair) is used for the treatment of moderate to severe asthma and not for aborting
acute asthma attacks. Adverse effects of theophylline (Theo-Dur) that should be reported
immediately to the prescriber include epigastric pain.
One of the attendees expresses concern regarding her granddaughter's asthma. The attendee tells
the nurse that she is afraid that she will not know which of her granddaughter's medications to
give first in case of an asthma attack. Which medication should the nurse inform the attendee to
administer first for an acute asthma attack?
a. ipratropium (Atrovent)
b. albuterol (Proventil)
c. budesonide (Pulmicort Turbuhaler)
d. montelukast (Singulair) - answer✔✔Correct answer: B
Rationale: Albuterol (Proventil) is a short-acting beta2 agonist indicated for treatment of acute
asthma attacks. Ipratropium (Atrovent) is an anticholinergic not indicated for treatment of acute
asthma attacks. Budesonide (Pulmicort Turbuhaler) is an inhaled corticosteroid that should not
be used in an acute asthma attack. Montelukast (Singulair) is a leukotriene receptor agonist used
for long-term management of asthma, not for acute exacerbations.
One of the attendees tells the nurse that he has asthma and is being treated with a short-acting
inhaled beta2 agonist. The nurse identifies this treatment as which step of the stepwise therapy
for the treatment of asthma?
a. Step 1
b. Step 2
c. Step 3
d. Step 4 - answer✔✔Correct answer: A
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