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PCC 2 Exam 3 Questions & Answers

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PCC 2 Exam 3 Questions & Answers A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications? A. The pati...

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  • October 27, 2024
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PCC 2 Exam 3 Questions & Answers
A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long-
term management of asthma. You observe the patient taking these medications. Which
option below best describes the correct order in how to take these medications?

A. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the
Fluticasone.

B. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the
Salmeterol.

C. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the
Fluticasone.

D. The patient inhales the Fluticasone and immediately inhales the Salmeterol. - answer
A.

The bronchodilator inhaler (Salmeterol) is administered first to open up the airways.
Then the patient is to wait five minutes and then administer the corticosteroid
(Fluticasone). The bronchodilator will open the airways so the corticosteroid can easily
enter the airways to decrease inflammation.

You're assisting your patient who has asthma to bed. The patient is experiencing a
frequent cough and chest tightness. You auscultate the patient's lung fields and note
expiratory wheezes. The patient's peak flow rate is 78% less than their best peak flow
reading. Which medication will provide the patient with the fastest relief from these signs
and symptoms of an asthma attack?

A. Theophylline
B. Tiotropium
C. Albuterol
D. Cromolyn - answer C.

During an asthma attack, the patient needs a medication that will quickly open the
airways. Medications that are best for this include short-acting bronchodilators, such as
Albuterol, short-acting beta agonists. Another type of short-acting bronchodilator is an
anticholinergic bronchodilator called Ipratropium (this is given if a patient can't tolerated
short-acting beta agonists like Albuterol). Theophylline is a bronchodilator but given
orally and is NOT for quick relief. Tiotropium is a bronchodilator, as well, but is a LONG-
ACTING anticholinergic bronchodilator. Cromolyn is an inhaled nonsteroidal anti-allergy
medication that doesn't provide quick relief.

,You assist your patient with using their inhaler. The inhaler contains the medication
Budesonide. Before administering the inhaler, you will want to connect what device to
the inhaler to help decrease the patient from developing ________?*

A. Peak flow meter; pneumonia
B. Incentive spirometer; thrush
C. Spacer; thrush
D. Peak flow meter; mouth sores - answer C.

Budesonide is a corticosteroid. Inhaled corticosteroids can cause thrush. Therefore, it is
important to connect a spacer to the inhaler before usage to help prevent the patient
from developing thrush and for the patient to gargle and rinse the mouth with water.

A patient with asthma is receiving a nebulizer of Cromolyn. The patient reports a
burning sensation in the nose along with a horrible taste in their mouth. As the nurse
you will?

A. Immediately stop the nebulizer
B. Re-adjust the nebulizer
C. Call a rapid response because the patient is having a potential anaphylactic reaction
to the medication.
D. Reassure the patient this is a temporary side effect of this medication. - answer
D.

Cromolyn can temporarily cause the following side effects during administration:
sneezing, burning in nose, itchy/watery eyes, bad taste in mouth. Reassure the patient
that these are temporary side effects of this medication.

Your patient's asthma is poorly controlled. The patient reports using their rescue inhaler
4 times a week. In addition, the patient's asthma is not responding to other treatments.
The physician orders the patient to take a medication that works by blocking the role of
the immunoglobulin IgE. This describes which medication below?

A. Montelukast
B. Omalizumab
C. Cromolyn
D. Salmeterol - answer B.

Omalizumab blocks the role of the immunoglobulin IgE, which will decrease the allergic
response...hence asthma attacks. It is given subcutaneously and used when a patient's
asthma is poorly controlled and other treatments are not working. It is NOT used for
quick relief. It is important the patient receives NO LIVE vaccines while receiving this
medication.

, You're providing discharge teaching to a patient who was admitted with asthma. You
discussed the early warning signs of an asthma attack and ask the patient to list some
of them. Select all the correct early warning signs verbalized by the patient:

A. Easily fatigued with physical activity
B. Reduced peak flow meter reading
C. Chest retractions
D. Cyanosis
E. Wheezing with activity
F. Nighttime coughing
G. No relief with short-acting bronchodilator inhaler - answer A, B, E, and F.

These are all early warning signs an asthma attack is imminent. Options C, D, and G
are signs and symptoms of an active asthma attack that requires medical treatment.

Select all the correct options that represent the pathophysiology of an asthma attack.

A. The smooth muscle surrounding the alveoli constricts, limiting oxygenation.

B. The mucosa lining experiences severe inflammation.

C. The goblet cells within the mucosa lining produce excessive amounts of mucous.

D. Too much carbon dioxide is exhaled due to hyperventilation and the patient
experiences respiratory alkalosis. - answer B and C.

Option A is wrong because the smooth muscle surrounding the BRONCHI AND
BRONCHIOLES CONSTRICTS (not alveoli), limiting oxygenation. Option D is wrong
become the patient does NOT experience respiratory alkalosis but respiratory
ACIDOSIS. During an asthma attack, the patient is unable to exhale fully and air
trapping occurs. Therefore, gas exchange does NOT occur, leaving carbon dioxide to
build up in the blood and NO oxygen to enter the bloodstream. The CO2 builds up in the
system and oxygen saturations drop....hence acidosis. Remember CO2 is acidic.

You're educating a patient how to use a peak flow meter to help monitor the status of
their asthma. Which statement by the patient demonstrates they understand how to use
the device?

A. "This device will help keep my lungs strong so I don't have another asthma attack."

B. "I will inhale as hard as I can while using the device."

C. "I will use this device at the same time, either in the morning or before bedtime, and
compare the readings with my personal best reading."

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