Question 1

The nurse helps a client establish goals to control asthma with medications.The nurse emphasizes that the preferred drugs for long-term control of asthma are:

Accepted Answer

Inhaled corticosteroids are the preferred drugs for long-term control of asthma as they reduce airway inflammation and improve symptoms. Inhaled beta 2 agonists are used for quick relief of asthma symptoms. Anticholinergics are used as add-on therapy for severe asthma or in those who cannot tolerate inhaled corticosteroids. Systemic corticosteroids are used only in severe exacerbations of asthma as they have many adverse effects when used long-term.

Question 2

The nurse explains to a client that inhaled corticosteroid medications are used in the long-term management of asthma to decrease:
Select all that apply.

Accepted Answer

Inhaled corticosteroids are used to reduce inflammation (A), decrease mucus production (B), reduce bronchial hyperresponsiveness (C), and decrease edema (E) in the airways, which are all key factors in managing asthma. They do not directly cause bronchodilation (D), which is typically managed by bronchodilators.

Question 3

A client admitted with persistent asthma has a history of hypertension.Which class of asthma drugs must be used cautiously with clients who have hypertension?

Accepted Answer

Oral short-acting beta-adrenergic agonists may increase blood pressure, so caution should be taken when prescribing these drugs to clients with hypertension. Inhaled corticosteroids and mast cell stabilizers have no significant effect on blood pressure, and inhaled anticholinergic medications may even slightly decrease blood pressure.

Question 4

The nurse is discharging an asthma client with a new prescription for nedocromil (Tilade).What should the nurse instruct the client about this drug?
Select all that apply.

Accepted Answer

The nurse should instruct the client that nedocromil may cause a bitter taste and may take up to a week of therapy before benefits are obtained. Option B is incorrect because nedocromil is not used to terminate an acute asthma attack. Option D is incorrect because nedocromil should be used regularly as a preventative medication, not just as needed. Option E is incorrect because headache is not a common side effect of nedocromil.

Question 5

When planning care for a client newly diagnosed with asthma,the nurse is aware that heavy caffeine intake could make the client intolerant of certain respiratory medications,including:

Accepted Answer

Heavy caffeine intake can decrease the effectiveness of certain respiratory medications, including albuterol, a bronchodilator commonly used in the treatment of asthma. Caffeine can also exacerbate the symptoms of asthma, so it is generally recommended that individuals with asthma limit their caffeine intake. The other medications listed (cromolyn, budesonide, and montelukast) are not affected by caffeine intake.

Question 6

A client asks the nurse why the health care provider has ordered the asthma medication in inhalant rather than oral form.What is the nurse's best response?
Select all that apply.

Accepted Answer

Inhaling an asthma medication allows the medication to directly target the lungs, resulting in a rapid and efficient onset of action that can relieve symptoms quickly. It also allows for smaller doses to be used, reducing the risk of systemic side effects. The cost and onset of medication are not relevant factors in the nurse's response.

Question 7

The nurse has taught a group of clients with asthma the importance of knowing when to use quick-relief medications and when to use long-acting medications.The nurse knows the clients have understood the teaching when they identify which medications as long acting?
Select all that apply.

Accepted Answer

Budesonide, nedocromil, and zafirlukast are all long-acting medications used as controller medications in the management of asthma, while albuterol and ipratropium are short-acting medications used for quick relief of symptoms.

Question 8

A client has been prescribed beclomethasone (Beconase)for long-term management of persistent asthma.Prior to discharge,the nurse teaches the client about possible side effects,including:
Select all that apply.

Accepted Answer

Beclomethasone is an inhaled corticosteroid, and common side effects include hoarseness, dry mouth, and changes in taste due to its local effects in the mouth and throat. Nervousness and insomnia are not typical side effects of inhaled corticosteroids.

Question 9

The admitting nurse suspects a client has moderate persistent asthma because:
Select all that apply.

Accepted Answer

According to the National Asthma Education and Prevention Program (NAEPP) guidelines, moderate persistent asthma is characterized by symptoms occurring daily, symptoms occurring more than one night per week, and symptoms affecting daily activity. Therefore, choices A, B, and C apply to moderate persistent asthma, while choices D and E suggest a lower severity level.

Question 10

A client is prescribed zafirlukast (Accolate)for persistent,chronic asthma.Which nursing interventions take priority?
Select all that apply.

Accepted Answer

- Zafirlukast can interact with aspirin, potentially causing adverse effects, so patients should be advised not to take aspirin while on this medication.- Zafirlukast should be taken on an empty stomach to enhance its absorption.- Headache is a common side effect of zafirlukast, and patients should be informed about this possibility.

Question 11

The nurse in a pulmonary clinic knows that theophylline (Theo-Dur)should not be prescribed for:
Select all that apply.

Accepted Answer

The answer of The nurse in a pulmonary clinic knows...

Question 12

The nurse is caring for a client with chronic bronchitis and a history of glaucoma.The nurse recognizes that which drug would not be an appropriate choice for the control of the client's bronchospasm?

Accepted Answer

Ipratropium (Atrovent) is not an appropriate choice for a client with a history of glaucoma because it is an anticholinergic medication that can increase intraocular pressure, potentially worsening glaucoma.

Question 13

The nurse in a pulmonary clinic is evaluating several clients' theophylline levels.Which levels would take the highest priority?
Select all that apply.

Accepted Answer

The answer of The nurse in a pulmonary clinic is...

Question 14

The nurse instructs a client with asthma that quick-relief medications that should be used for acute symptoms include:
Select all that apply.

Accepted Answer

Albuterol and ipratropium are both quick-relief medications commonly used for acute asthma symptoms. Beclomethasone and cromolyn are maintenance medications used to prevent asthma symptoms, while montelukast is a controller medication used to manage asthma symptoms over time.

Question 15

The nurse is planning strategies for managing a new asthma client's symptoms.Which strategies will decrease the risk for bronchospasms?
Select all that apply.

Accepted Answer

Educating the client regarding asthma medications, environmental control measures, and successfully managing comorbidities can all help to decrease the risk for bronchospasms. Not making changes once asthma control has been achieved and using the maximum amount of medication allowed to achieve asthma control are not necessarily helpful strategies and can actually increase the risk for side effects and adverse reactions.

Question 16

An asthmatic client has been taking Accolate (zafirlukast)for a number of years.Coumadin is being added to the client's medications because of atrial fibrillation.What concern does the nurse have related to this addition?

Accepted Answer

Zafirlukast (Accolate) can increase the levels of warfarin (Coumadin) in the body, leading to a potentiated effect of the anticoagulant. This means less warfarin may be needed to achieve the desired prothrombin time (PT), increasing the risk of bleeding if not monitored and adjusted appropriately.

Question 17

A pediatric nurse is educating a 6-year-old and the mother on the use of a metered-dose inhaler (MDI)with a spacer.The mother asks what the spacer is for.The nurse responds:
Select all that apply.

Accepted Answer

Spacers are used with metered-dose inhalers to help deliver medication more effectively to the lungs. They address the problem of coordinating inhalation with actuation of the inhaler, ensuring that medication does not just deposit in the mouth or throat but reaches the lungs. Spacers do not vaporize medication or activate automatically upon inhalation; they simply hold the medication momentarily, allowing for easier inhalation.

Question 18

A client with persistent asthma has a history of multiple allergies,including peanuts and soy.The nurse knows that,given this history,which prophylactic medication should be avoided?

Accepted Answer

The answer of A client with persistent asthma has a...

Question 19

The nurse is providing discharge instruction to a client newly diagnosed with asthma.The client has been prescribed albuterol (Proventil)for bronchospasm.Which side effects should the nurse explain to the client?
Select all that apply.

Accepted Answer

Restlessness, tremor, and nervousness are common side effects of albuterol. Abnormal EKG and hypertensive crisis are rare side effects and not typically explained in discharge instructions unless the patient has a specific medical history that puts them at risk for these complications.

Question 20

The nurse is reviewing the admission history of a client taking zileuton (Zyflo CR)in the emergency department.Which patient reports would take highest priority during the physical assessment?
Select all that apply.

Accepted Answer

The answer of The nurse is reviewing the admission history...

Quiz 44: Pharmacotherapy of Asthma and Other Pulmonary Disorders

The nurse helps a client establish goals to control asthma with medications.The nurse emphasizes that the preferred drugs for long-term control of asthma are:

The nurse explains to a client that inhaled corticosteroid medications are used in the long-term management of asthma to decrease: Select all that apply.

A client admitted with persistent asthma has a history of hypertension.Which class of asthma drugs must be used cautiously with clients who have hypertension?

The nurse is discharging an asthma client with a new prescription for nedocromil (Tilade) .What should the nurse instruct the client about this drug? Select all that apply.

When planning care for a client newly diagnosed with asthma,the nurse is aware that heavy caffeine intake could make the client intolerant of certain respiratory medications,including:

A client asks the nurse why the health care provider has ordered the asthma medication in inhalant rather than oral form.What is the nurse's best response? Select all that apply.

The nurse has taught a group of clients with asthma the importance of knowing when to use quick-relief medications and when to use long-acting medications.The nurse knows the clients have understood the teaching when they identify which medications as long acting? Select all that apply.

A client has been prescribed beclomethasone (Beconase) for long-term management of persistent asthma.Prior to discharge,the nurse teaches the client about possible side effects,including: Select all that apply.

The admitting nurse suspects a client has moderate persistent asthma because: Select all that apply.

A client is prescribed zafirlukast (Accolate) for persistent,chronic asthma.Which nursing interventions take priority? Select all that apply.

The nurse in a pulmonary clinic knows that theophylline (Theo-Dur) should not be prescribed for: Select all that apply.

The nurse is caring for a client with chronic bronchitis and a history of glaucoma.The nurse recognizes that which drug would not be an appropriate choice for the control of the client's bronchospasm?

The nurse in a pulmonary clinic is evaluating several clients' theophylline levels.Which levels would take the highest priority? Select all that apply.

The nurse instructs a client with asthma that quick-relief medications that should be used for acute symptoms include: Select all that apply.

The nurse is planning strategies for managing a new asthma client's symptoms.Which strategies will decrease the risk for bronchospasms? Select all that apply.

An asthmatic client has been taking Accolate (zafirlukast) for a number of years.Coumadin is being added to the client's medications because of atrial fibrillation.What concern does the nurse have related to this addition?

A pediatric nurse is educating a 6-year-old and the mother on the use of a metered-dose inhaler (MDI) with a spacer.The mother asks what the spacer is for.The nurse responds: Select all that apply.

A client with persistent asthma has a history of multiple allergies,including peanuts and soy.The nurse knows that,given this history,which prophylactic medication should be avoided?

The nurse is providing discharge instruction to a client newly diagnosed with asthma.The client has been prescribed albuterol (Proventil) for bronchospasm.Which side effects should the nurse explain to the client? Select all that apply.

The nurse is reviewing the admission history of a client taking zileuton (Zyflo CR) in the emergency department.Which patient reports would take highest priority during the physical assessment? Select all that apply.