Question 1

A nurse is teaching an asthmatic patient about his steroid inhaler prior to discharge.The expected outcome of this therapy is:

Accepted Answer

Steroid inhalers are primarily used to reduce inflammation, swelling, and mucus production in the airways, leading to decreased bronchospasm, which aligns with option A.

Question 2

A patient in acute respiratory distress on a medical unit is receiving a nebulizer albuterol treatment.The patient is annoyed because he already has an albuterol MDI.The nurse's response to the patient's concern is based on the knowledge that:

Accepted Answer

A

Question 3

The nurse is admitting a patient with a provisional diagnosis of asthma.The patient reports that she has asthma attacks about every other day.She has had three episodes that awakened her at night in the last month.She reports that she has trouble working on days when she has an attack.The nurse concludes this patient's care will be planned on the assumption that the patient has a certain level of asthma, namely:

Accepted Answer

The patient's symptoms, including asthma attacks every other day and nighttime awakenings three times a month, align with mild persistent asthma, which is characterized by symptoms more than twice a week but not daily, and nighttime symptoms 3-4 times a month.

Question 4

A patient with degenerative arthritis is provided with a spacer along with a steroid-based metered-dose inhaler.The nurse recognizes that the use of the spacer assists this patient to:

Accepted Answer

The spacer helps patients with decreased dexterity, such as those with degenerative arthritis, to use inhalers more effectively by making it easier to coordinate inhalation with the release of the medication.

Question 5

A patient with limited strength in his hands is being prepared for discharge with a dry powder inhaler.The discharge nurse teaches the patient the advantage of this inhaler.This teaching is based on the knowledge that:

Accepted Answer

Dry powder inhalers are activated by the patient's inhalation, which requires less manual strength compared to pressing a metered-dose inhaler.

Question 6

A nurse in an intensive care unit is planning care for a patient with severe bronchospasms triggered by a known allergy to peanuts he consumed at a party.The nurse recognizes that these abrupt spasms are related to antibodies that trigger:

Accepted Answer

Bronchospasms are caused by the contraction of the muscles in the walls of the bronchioles, which are part of the airway. This reaction can be triggered by allergic reactions, such as to peanuts, leading to the abrupt narrowing of the airways and difficulty breathing.

Question 7

A nurse is advising a patient about techniques for management of his exercise-induced asthma.The nurse's presentation will focus on ways to:

Accepted Answer

Avoiding bronchoconstriction is a key strategy in managing exercise-induced asthma, as it directly addresses the underlying issue of airway constriction triggered by physical activity.

Question 8

Over the course of treatment for chronic asthma, a patient develops an allergy to the propellants in metered-dose inhalers.What option would the nurse expect to be used to address this problem after discharge?

Accepted Answer

A dry powder inhaler does not use propellants, making it a suitable alternative for patients who develop allergies to the propellants in metered-dose inhalers.

Question 9

The nurse is triaging patients through the ED.An adult admission has a respiratory rate of 32 breaths per minute.The patient is not injured, but was brought to the ED because she started gasping after witnessing a drive-by shooting.The nurse recognizes that the patient's rapid breathing is probably driven by:

Accepted Answer

The patient's rapid breathing is likely driven by brainstem activity, specifically the respiratory center in the brainstem, which can be activated by stress or emotional responses, such as fear or anxiety experienced after witnessing a traumatic event like a drive-by shooting.

Question 10

The nurse is caring for a patient who is taking a non-selective beta blocker preparation for hypertension.The patient starts to complain of shortness of breath.The nurse realizes that this kind of beta blocker:

Accepted Answer

Non-selective beta blockers can trigger bronchoconstriction because they block beta-2 adrenergic receptors found in the lungs, which normally mediate bronchodilation. This can lead to shortness of breath, especially in patients with underlying respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD).

Question 11

The nurse is planning care for a patient with chronic lung disease.The patient is wheezing, with a HR of 130 and respiratory rate of 26 per minute; is using his accessory muscles of respiration; is coughing up yellow mucous; and has a pulse oximetry reading of 86%.The highest-priority nursing diagnosis is:

Accepted Answer

The highest-priority nursing diagnosis is "Impaired Gas Exchange related to low pulse oximeter reading" because the patient's pulse oximetry reading of 86% indicates a significant impairment in the ability to oxygenate the blood, which is a critical and immediate concern.

Question 12

A nurse is caring for several patients receiving beta blocker therapy.The nurse has noted that some patients develop wheezing after beta blocker therapy.Which preparation would the nurse consider most problematic?

Accepted Answer

Propranolol (Inderal) is a non-selective beta blocker, meaning it blocks both β1 (beta-1) and β2 (beta-2) adrenergic receptors. Blocking β2 receptors can lead to bronchoconstriction, which can cause wheezing, making it more problematic for patients with respiratory issues compared to beta-1 selective blockers (like Atenolol, Metoprolol, and Bisoprolol) that primarily affect the heart and have less impact on the lungs.

Question 13

The nurse is collaboratively setting goals for the inpatient management of new-onset asthma in a child.The nurse prioritizes the patient's nursing diagnoses, and gives which goal the highest priority?

Accepted Answer

Maintaining adequate oxygenation, as indicated by pulse oximetry values remaining above 92%, is the highest priority to ensure the child's physiological stability and prevent complications related to hypoxemia.

Question 14

A small child with an RSV infection and bronchiolitis is being sent home from the ED with a prescription for albuterol.The parents are to obtain a nebulizer from a medical equipment rental store.In order to ensure that the treatments will relieve the child's bronchospasm, the nurse will emphasize:

Accepted Answer

Continuing each treatment until all the medication is gone from the reservoir ensures that the child receives the full dose of medication, which is crucial for relieving bronchospasm associated with RSV infection and bronchiolitis.

Question 15

A patient is learning metered-dose inhaler technique.The patient says, "I don't understand why I have to use this thing.Can't I just take pills?" The nurse's response is based on the knowledge that:

Accepted Answer

The inhalation route for medications, especially in conditions like asthma or chronic obstructive pulmonary disease (COPD), delivers the drug directly to the site of action (the lungs), making it safer and more effective than systemic administration through pills. This direct delivery allows for lower doses and reduces systemic side effects.

Question 16

The nurse is caring for an elective orthopedic surgery patient with mild intermittent asthma.During the second postoperative day, the patient has an asthmatic episode while eating lunch.When contacting the physician for orders, the nurse is seeking an order for:

Accepted Answer

A short-acting selective beta-agonist inhaler, such as albuterol, is the first-line treatment for an acute asthma attack because it quickly relaxes the bronchial smooth muscle, leading to rapid relief of symptoms.

Question 17

The nurse is caring for a patient with severe asthma.When evaluating the outcomes of the patient's care, the nurse recognizes the most important outcome is associated with:

Accepted Answer

The patient's blood gases are the most important outcome to evaluate in a patient with severe asthma because they directly reflect the effectiveness of gas exchange and the severity of the asthma exacerbation. Blood gases help in assessing the patient's oxygenation and carbon dioxide elimination, which are critical in managing severe asthma.

Question 18

A patient with asthma is experiencing difficulty with copious amount of tenacious sputum.A mucolytic drug is prescribed.The outcome the nurse would track is:

Accepted Answer

Mucolytic drugs work by breaking down the mucus, making it less thick and sticky, and easier to cough up. Therefore, the expected outcome is increased clearance of sputum.

Question 19

A nurse is assisting a patient to master the use of a steroid inhaler.The patient says, "I don't think I should be using steroids.I see steroids labeled as bad in the news at least once a week." The nurse's response is based on the fact that:

Accepted Answer

The answer of A nurse is assisting a patient to...

Question 20

A trauma patient has experienced a ruptured diaphragm.The nurse would anticipate that this patient would have difficulty:

Accepted Answer

A ruptured diaphragm impairs the ability to carry out the respiratory cycle effectively because the diaphragm is a major muscle involved in breathing.

Quiz 73: Pharmacotherapy of Asthma and Other Pulmonary Disorders