NUR 311 Pharmacology Exam 2 Review Questions and Correct Answers
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Course
NUR 311
Institution
NUR 311
What are MDIs and how should they be used? Metered dose inhalers: small, hand-held, pressurized devices. Begin slow inhalation before activation, hold medicine in lungs for 10 seconds, and wait 1 minutes between activations.
What are two advantages of inhalers using the HFA propellant? Don't affec...
NUR 311 Pharmacology Exam 2 Review
Questions and Correct Answers
What are MDIs and how should they be used? ✅Metered dose inhalers: small, hand-
held, pressurized devices.
Begin slow inhalation before activation, hold medicine in lungs for 10 seconds, and wait
1 minutes between activations.
What are two advantages of inhalers using the HFA propellant? ✅Don't affect ozone
layer
Smaller droplets do not require space
What is the advantage of DPIs? Disadvantage? How fast should the patient inhale?
✅Advantage: no hand-lung coordination needed; breathing activated
Disadvantage: must have adequate inspiratory flow to inhale powder
Inhale rapidly
What are SVNs and how are they used? What are the advantages? ✅Small-volume
nebulizers
Convert a solution into a mist
Advantages: does not require timing of dose with inhalation, rapid deep inspiration, or
hand strength
List 3 ways glucocorticoids treat asthma. ✅Suppress inflammation & bronchial
reactivity
Decrease mucus production
Increase number and responsiveness of beta-adrenergic receptors
What is the first-line treatment for moderate to severe-persistent asthma? ✅Inhaled
glucocorticoids
Drug ending: -terol ✅Drug classification: bronchodilator
Drug example: albuterol
Which is the drug of choice for an acute asthma attack?
1. Spiriva (tiotropium bromide)
2. Symbicort - formoterol (Foradil) & budesonide (pulmicort)
3. Proventil - albuterol
4. Atrovent - ipratropium bromide ✅3. Proventil - albuterol
,J.M., an 18-year-old patient complains of wheezing after running 50 feet on the track,
but otherwise does not wheeze, cough, or is short of breath. You suspect she may
have:
1. Moderate asthma
2. Severe asthma
3. Exercise-induced asthma ✅3. Exercise-induced asthma
The prescriber decides to treat J.M. for wheezing. The order you expect is:
1. Iprapropium (Atrovent) 2 inhalations 15 minutes before exercise
2. Albuterol (Ventolin, Proventil) 2 inhalations immediately before exercise
3. Salmeterol (Serevent) Diskus 1 inhalation 15 minutes before exercise ✅2. Albuterol
(Ventolin, Proventil) 2 inhalations immediately before exercise
Two years later, J.M. is short of breath four times per week without exercise. You
suspect inflammation and expect the following order:
1. Fluticasone (Flovent) 110mcg 2 inhalations every 12 hours
2. Salmeterol (Serevent) Diskus 1 inhalation every 12 hours
3. Formoterol (Foradil) 1 inhalation every 12 hours ✅1. Fluticasone (Flovent) 110mcg
2 inhalations every 12 hours
J.M. returns in one month and is extremely hoarse and has a sore tongue. Upon
inspection, you notice his mouth is very red, uvula is swollen, and tongue is white with
plaques. You respond:
1. "Be sure to rinse your mouth with water or fluid after using Flovent and call your
provider for an antifungal drug"
2. "Use mouthwash three times per day to treat stomatitis"
3. "Talk to provider about getting an antibiotic for Strep." ✅1. "Be sure to rinse your
mouth with water or fluid after using Flovent and call your provider for an antifungal
drug"
J.M. returns two months later and complains of coughing every night between 2-4am.
He is using Flovent 110mcg 2inh every 12 hours and rinsing mouth after use. You
suspect cough-variant asthma and expect an order of:
1. Cough syrup before bedtime
2. Salmeterol (Serevent) Diskus or Advair 100/50 1inh every 12 hours
3. Albuterol (Ventolin, Proventil) 2inh before bedtime ✅2. Salmeterol (Serevent) Diskus
or Advair 100/50 1inh every 12 hours
J.M. calls; he is out of albuterol (Ventolin, Proventil) and asks if he can take Primatene
mist (an over-the-counter asthma inhaler). You respond:
1. "You may take the OTC inhaler until you can get to the pharmacy. I will get you a
renewal for albuterol"
2. "The OTC inhaler will work as well as albuterol; use whatever is cheaper"
3. "The OTC inhaler affects your heart more than albuterol. It may cause chest pain,
increased heart rate, or increased blood pressure" ✅3. "The OTC inhaler affects your
, heart more than albuterol. It may cause chest pain, increased heart rate, or increased
blood pressure"
A patient has a best PEF of 2000mL and her current PEF is 1100mL. What PEF zone
does she fall in?
1. Green
2. Yellow
3. Red ✅2. Yellow
Discuss the proper way to administer inhaled glucocorticoids. Why? ✅Gargle & spit
after use. Use the beta-adrenergic inhaler first is one is used. The beta-adrenergic
inhaler opens the airways so the glucocorticoid can penetrate deeper into the lungs.
Gargling and spitting decreases the chance of an oropharyngeal infection.
Why might oral glucocorticoids be necessary during stress even if asthma symptoms
are controlled? ✅May need to supplement because stressful events require bursts of
steroids. Patient may develop adrenal crisis without supplementation.
What are the four mechanisms of action for leukotriene modifiers? ✅Bronchodilation
Decreased mucus
Decreased edema
Decreased eosinophil infiltration
How does Cromolyn, a mast cell stabilizer, work? ✅Prevents mast cells from lysing
and releasing histamine & other mediators
How long must mast cell stabilizers be used to obtain a therapeutic effect? ✅May take
4 weeks
How does omalizumab (Xolair) work? Why are patients asked to stay in the clinic after
injections? ✅Myoclonal antibody binds free IgE so that it cannot bind to mast cells and
cause their lysis.
Risk for anaphylaxis.
Why are beta2-adrenergic agonists used? ✅Relieve bronchospasm
Prevent exercise-induced bronchospasm
What are the 3 mechanisms of action for beta2-adrenergic agonists? ✅Bronchodilation
Suppression of histamine release
Increased ciliary motility
What is the difference between short-acting and long-acting adrenergic agonists?
✅Short-acting: lasts 3-5 hours, immediate effect; used for relief of bronchospasm and
before exercise
Long-acting: given every 12 hours, used to prevent bronchospasm
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