Chapter 55: Drugs Acting on the Lower Respiratory Tract, prepU (GRADED A) Questions and Answers REF, Karch, A. M., Focus on Nursing Pharmacology, 8th ed | 100% VERIFIED.

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Question 1 See full question31s Report this Question A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The... nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.) You Selected: Exercise Allergens Pollutants Correct response: Exercise Allergens Pollutants Explanation: Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Box 55.2 Focus on Drug Therapy across the Lifespan, p. 963. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 963 Add a Note Question 2 See full question15s Report this Question A neonate is receiving beractant. The nurse understands that this agent is administered by which route? You Selected: Intratracheal Correct response: Intratracheal Explanation: Beractant is administered intratracheally. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Table 55.5 Drugs in Focus: Lung Surfactants, p. 979. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 979 Add a Note Question 3 See full question29s Report this Question A 6-year-old child weighing 52 pounds has had a loading dose of aminophylline (Truphylline). The nurse is ready to administer the regular prescribed dose of 4 mg/kg every 4 hours for 3 doses. How many mg will the patient receive in 12 hours? You Selected: 284 mg Correct response: 284 mg Explanation: First, using the formula: 2.2 lb: 1 kg = 52 lb: times kg, determine the child's weight in kg (52/2.2 = 23.64). Next, using the formula: amount of drug prescribed times weight in kg, determine the amount the child will receive in one dose (4 times 23.64 = 94.56). To determine the mg in a 12-hour period multiply 94.56 times 3 = 283.68. Round to 284 mg. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract. Add a Note Question 4 See full question33s Report this Question A patient presents at the Emergency Department (ED) in acute respiratory distress. A quick assessment by the triage nurse indicates that the patient experienced difficulty breathing immediately after taking Combivent for the first time. The nurse suspects that the patient may be allergic to what? You Selected: Peanuts Correct response: Peanuts Explanation: Combivent is a combination drug of ipratropium and albuterol. The propellant used to make ipratropium has a cross-sensitivity to the antigen that causes peanut allergies. Aspirin, penicillin, or ragweed pollen are not associated with this drug. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Fixed- Combination Respiratory Drugs, p. 975. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 975 Add a Note Question 5 See full question1m 4s Report this Question A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following? You Selected: Coffee Correct response: Coffee Explanation: The nurse should assess the patient's intake of caffeine, including coffee, tea, soda, cocoa, candy, and chocolate. Caffeine has sympathomimetic effects that may increase the risk for adverse effects. Alcohol, salt, and vitamin C intake is important to assess, but does not potentiate the effects of albuterol. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 6 See full question45s Report this Question A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient You Selected: has a high coffee intake. Correct response: has a high coffee intake. Explanation: Caffeine has sympathomimetic effects that may increase the risk for adverse effects with albuterol. The nurse should assess the patient's intake of caffeine through coffee, tea, soda, cocoa, candy, and chocolate. The patient's age, history of pneumonia, and preference for high-calorie food would not have important implications for his albuterol drug therapy. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 7 See full question30s Report this Question A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation? You Selected: Salmeterol is contraindicated based on his wife’s condition. Correct response: Salmeterol is contraindicated based on his wife’s condition. Explanation: The FDA has issued a black box warning that initiating salmeterol in people with significantly worsening or acutely deteriorating asthma may be life threatening. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Sympathomimetics, pp. 969-970. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 969-970 Add a Note Question 8 See full question20s Report this Question Which of the following would a nurse identify as a surfactant? You Selected: Beractant Correct response: Beractant Explanation: Beractant is a lung surfactant. Cromolyn is a mast cell stabilizer. Zileuton is a leukotriene receptor antagonist. Theophylline is a xanthine. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Lung Surfactants, p. 979. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 979 Add a Note Question 9 See full question57s Report this Question A client diagnosed with asthma is being prescribed a leukotriene receptor antagonist as part of their mediation therapy. The nurse should encourage the client to report incidence of what events as possible adverse effects of the new medication? Select all that apply. You Selected: headache diarrhea fever muscle aches Correct response: diarrhea headache fever muscle aches Explanation: Adverse effects associated with leukotriene receptor antagonists include headache, dizziness, nausea, diarrhea, abdominal pain, elevated liver enzyme concentrations,vomiting, generalized pain, fever, and myalgia. Tinnitus (ringing in the ears) is not associated with adverse effects of this classification of medications. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Adverse Effects, p. 977. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 977 Add a Note Question 10 See full question1m 8s Report this Question The nurse is reviewing a client’s morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take? You Selected: Contact the care provider and inform him or her that the client has toxic theophylline levels. Correct response: Contact the care provider and inform him or her that the client has toxic theophylline levels. Explanation: To determine theophylline dosage, prescribers should measure serum theophylline levels. Therapeutic range is 5 to 15 mcg/mL (27.75 to 83.25 µmol/L); toxic levels are 20 mcg/mL (111 µmol/L) or above. The care provider must be informed of this elevated serum level. Question 1 See full question48s Report this Question After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example? You Selected: Fluticasone Correct response: Fluticasone Explanation: Fluticasone is an inhaled steroid. Montelukast is a leukotriene receptor antagonist. Zileuton is a leukotriene receptor antagonist. Zafirkulast is a leukotriene receptor antagonist. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Leukotriene Receptor Antagonists, p. 977. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 977 Add a Note Question 2 See full question32s Report this Question A patient who is prescribed ipratropium administers the drug at 9:15 AM. The patient should begin to notice the drug beginning to act at which time? You Selected: 9:30 AM Correct response: 9:30 AM Explanation: Inhaled ipratropium has an onset of action of 15 minutes, so the patient should begin to feel the effects of the drug at 9:30 AM. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Pharmacokinetics, p. 973. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 973 Add a Note Question 3 See full question34s Report this Question A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer? You Selected: Cromolyn Correct response: Cromolyn Explanation: Cromolyn is a mast cell stabilizer. Montelukast is a leukotriene receptor antagonist. Calfactant is a lung surfactant. Triamcinolone is an inhaled steroid. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Mast Cell Stabilizer, p. 978. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 978 Add a Note Question 4 See full question49s Report this Question Why are inhaled steroids used to treat asthma and COPD? You Selected: They act locally to decrease release of inflammatory mediators Correct response: They act locally to decrease release of inflammatory mediators Explanation: When administered into the lungs by inhalation, steroids decrease the effectiveness of the inflammatory cells. This has two effects, which are decreased swelling associated with inflammation and promotion of beta-adrenergic receptor activity, that may promote smooth muscle relaxation and inhibit bronchoconstriction. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Inhaled Steroids, p. 974. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 974 Add a Note Question 5 See full question28s Report this Question How do inhaled corticosteroid agents assist in the treatment of asthma? You Selected: Inhaled corticosteroid agents will reduce airway inflammation. Correct response: Inhaled corticosteroid agents will reduce airway inflammation. Explanation: Inhaled corticosteroid agents suppress the release of inflammatory mediators, block the generations of cytokines, and decrease the recruitment of airway eosinophils. Inhaled corticosteroid agents do not depress the central nervous system or affect either bronchodilation or constriction. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Key Points, p. 978. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 978 Add a Note Question 6 See full question32s Report this Question A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid? You Selected: Chocolate Correct response: Chocolate Explanation: Chocolate contains caffeine and is also a xanthine; thus chocolate should be avoided when the client is taking theophylline. Restriction of bananas, orange juice, and cranberry juice is not required. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 7 See full question39s Report this Question The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication? You Selected: SABA Correct response: SABA Explanation: Albuterol is a short-acting beta-2 agonist (SABA). It is used to treat and prevent bronchospasm. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Sympathomimetics, p. 969. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 969 Add a Note Question 8 See full question43s Report this Question The nurse is caring for a client who is receiving IV theophylline for treatment of severe bronchospasm. The nurse will ensure that which item on the client’s food tray will be held while the client is receiving theophylline? You Selected: Coffee Correct response: Coffee Explanation: Theophylline is a xanthine, which has properties that are close to caffeine; therefore, the nurse will ensure that the client doesn’t have anything on the tray that has caffeine in it. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 9 See full question34s Report this Question A client is experiencing an acute asthmatic attack. Which agent would be most effective? You Selected: Beta-2 selective adrenergic agonist Correct response: Beta-2 selective adrenergic agonist Explanation: A beta-2 selective adrenergic agonist or sympathomimetic would be most appropriate because these agents are rapidly distributed after injection and rapidly absorbed after inhalation. An inhaled steroid would require 2 to 3 weeks to reach effective levels. Leukotriene receptor antagonists and mast cell stabilizers do not have immediate effects. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Therapeutic Actions and Indications, p. 969. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 969 Add a Note Question 10 See full question24s Report this Question A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition? You Selected: Asthma Correct response: Asthma Explanation: Leukotriene receptor antagonists block or antagonize receptors for the production of leukotrienes D4 and E4, thus blocking many of the signs and symptoms of asthma. This class of medication is not typically associated with the long term management of any of the other options. Question 1 See full question37s Report this Question A patient with acute respiratory symptoms is receiving a loading dose of theophylline. Which of the following signs of toxicity should alert the nurse to notify the primary health care provider immediately? You Selected: Abdominal cramps Correct response: Abdominal cramps Explanation: It is important for the nurse to closely monitor the patient for signs of theophylline toxicity. The nurse should notify the primary health care provider immediately if any of the following signs of theophylline toxicity develop: anorexia, nausea, vomiting, diarrhea, confusion, abdominal cramping, headache, restlessness, insomnia, tachycardia, arrhythmias, or seizures. Constipation, bradycardia, or mental depression are not signs of theophylline toxicity. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, p. 967. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967 Add a Note Question 2 See full question44s Report this Question What is the most common first-line therapy for relief of an acute asthma attack? You Selected: beta2-adrenergic agonist Correct response: beta2-adrenergic agonist Explanation: A client experiencing an acute asthma attack should be administered a beta2-adrenergic agonist. The client can receive an inhaled steroid, but it is not the first-line therapy. Leukotriene modifiers are used for maintenance in asthma, not during acute exacerbation. Xanthines are not the drug of choice in acute asthma attack. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Sympathomimetics, p. 969. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 969 Add a Note Question 3 See full question1m 25s Report this Question A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family provider. What effect will the client's smoking status have on the therapeutic use of theophylline? You Selected: The client may require higher doses of theophylline than a nonsmoker Correct response: The client may require higher doses of theophylline than a nonsmoker Explanation: Smoking cigarettes may decrease serum theophylline levels. In fact, some clients who smoke require an increase in theophylline dosage of up to 50%. Theophylline is not associated with a risk of anaphylactoid reaction. Theophylline doses do not need to be concurrent with the use of bronchodilators. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 4 See full question1m 6s Report this Question When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements? You Selected: "When I am short of breath, I will increase the use of my fluticasone." Correct response: "When I am short of breath, I will increase the use of my fluticasone." Explanation: Fluticasone is an inhaled steroid and should not be used during acute asthmatic attacks. Washing linens weekly will decrease the incidence of dust mites. When clients can participate in some, but not all of usual activities, they are in the yellow zone. Once medication is inhaled, the client should hold his or her breath for 10 seconds so that medication can reach deep into the lungs. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Therapeutic Actions and Indications, pp. 974-976. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 974-976 Add a Note Question 5 See full question2m 4s Report this Question A female client is prescribed systemic corticosteroids for her asthma. The nurse knows that the client is at risk for what problem? You Selected: Adrenal insufficiency Correct response: Adrenal insufficiency Explanation: Adrenal insufficiency is most likely to occur with systemic or high doses of inhaled corticosteroids. Question 1 See full question28s Report this Question A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.) You Selected: Damaged airway mucosa Airway inflammation Correct response: Airway inflammation Damaged airway mucosa Explanation: Inflammation and damaged airway mucosa are chronically present in asthma, even when clients appear symptom free. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Drugs Acting on the Lower Respiratory Tract, p. 961. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 961 Add a Note Question 2 See full question31s Report this Question The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler? You Selected: Nervousness Correct response: Nervousness Explanation: Frequent use of sympathomimetic inhalers can cause nervousness, hypertension, tachycardia, and anxiety. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 3 See full question20s Report this Question A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client’s history, what would the nurse expect the health care provider to order? You Selected: A modified dose of aminophylline Correct response: A modified dose of aminophylline Explanation: Cigarette smoking and drugs that stimulate drug-metabolizing enzymes in the liver (e.g., phenobarbital, phenytoin) increase the rate of metabolism and, therefore, the dosage requirements of aminophylline. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract. Add a Note Question 4 See full question20s Report this Question An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications? You Selected: "I need to take the medication when I start to have problems breathing." Correct response: "I need to take the medication when I start to have problems breathing." Explanation: These drugs are not indicated for the treatment of acute asthmatic attacks because they do not provide any immediate effects on the airways. Patients need to be cautioned that they should not rely on these drugs for relief from an acute asthmatic attack. The remaining statements are all accurate information regarding this classification of medications. Reference: Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Leukotriene Receptor Antagonists, p. 977. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 977 Add a Note Question 5 See full question1m 9s Report this Question An older adult client, diagnosed with chronic obstructive pulmonary disease (COPD), is being considered for corticosteroid therapy. The nurse should anticipate that these drugs may be administered by what routes? Select all that apply. You Selected: oral parenteral Correct response: oral parenteral Explanation: In early stages of progressive COPD, clients are unlikely to need corticosteroids. In later stages, however, they usually need periodic short-course therapy for episodes of respiratory distress. When corticosteroids are needed, administration is oral or parenteral because effectiveness of inhaled corticosteroids has not been established in COPD. Such medications are not administered sublingually. Question 1 See full question 19s Report this Question When describing the action of xanthines, which would the nurse include? (Select all that apply.) You Selected: • Block the action of acetylcholine at vagal mediated receptor sites • Selectively act at beta-2 receptor sites as agonists • Direct effect on the mobilization of calcium within the cell Correct response: • Direct effect on the mobilization of calcium within the cell • Stimulation of 2 prostaglandins leading to smooth muscle relaxation • Inhibition of release of slow-reacting substance of anaphylaxis Explanation: Although the exact action is unknown, it is thought that xanthines work by directly affecting the mobilization of calcium within the cell by stimulating two prostaglandins, resulting in smooth muscle relaxation. Xanthines also inhibit the release of slow-reacting substance of anaphylaxis (SRSA) and histamine. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Xanthines, pp. 962-963. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 962-963 Add a Note Question 2 See full question 1m 43s Report this Question A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to You Selected: • rebound bronchoconstriction. Correct response: • rebound bronchoconstriction. Explanation: Patients who self-administer albuterol may use their MDIs more frequently than recommended. This practice can result in rebound bronchoconstriction, which may motivate the patient to increase MDI use, stimulating the cycle of rebound congestion. Overuse of albuterol is not linked to pneumonia or hepatotoxicity. Albuterol is not an anticholinergic drug. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Nursing Considerations for Patients Receiving Sympathomimetics, p. 971. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 971 Add a Note Question 3 See full question 1m 15s Report this Question The client has been prescribed cromolyn (Intal) for the treatment of asthma, and the nurse is evaluating the client's understanding of the medication. Which statement by the client indicates the need for further education? You Selected: • "This medication may also be used for allergy disorders." Correct response: • "I will use this medication when I am having an asthma attack." Explanation: Cromolyn (Intal) is a mast cell stabilizer used in combination with other drugs in the treatment of asthma and other allergic disorders. Adverse reactions include drying of the throat and coughing or wheezing. It should not be used during an acute asthma attack because it may worsen the bronchospasm. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Mast Cell Stabilizer, p. 978. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 978 Add a Note Question 4 See full question 12s Report this Question A client who smokes is receiving theophylline orally. Because of his history of smoking, the nurse expects the health care provider to do what with the theophylline dosing? You Selected: • Decrease Correct response: • Increase Explanation: Nicotine from smoking interferes with the ability of the body to metabolize theophylline. Due to decreased metabolism, the dosage of theophylline would be increased. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, CRITICAL THINKING SCENARIO Toxic Reaction to Theophylline, pp. 967-968. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 967-968 Add a Note Question 5 See full question 49s Report this Question A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation? You Selected: • Salmeterol is contraindicated based on his wife’s condition. Correct response: • Salmeterol is contraindicated based on his wife’s condition. Explanation: The FDA has issued a black box warning that initiating salmeterol in people with significantly worsening or acutely deteriorating asthma may be life threatening. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Sympathomimetics, pp. 969-970. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 969-970 Add a Note Question 6 See full question 11s Report this Question Which of the following would be most important to assess before administering calfactant? (Select all that apply.) You Selected: • Lung sounds • Endotracheal tube placement • Oxygen saturation levels Correct response: • Endotracheal tube placement • Lung sounds • Oxygen saturation levels Explanation: Before administering calfactant, it would be important to ensure proper endotracheal tube placement because the drug is instilled directly into the trachea. In addition, lung sounds and oxygen saturation levels would be important as a baseline to evaluate effectiveness of the drug. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Nursing Considerations for Patients Receiving Lung Surfactants, pp. 979-980. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 979-980 Add a Note Question 7 See full question 55s Report this Question A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy? You Selected: • Enhancement of alveolar expansion Correct response: • Relaxation of smooth muscle Explanation: Anticholinergics can be used as bronchodilators because of their effect on the vagus nerve, resulting in relaxation of smooth muscle in the bronchi, which leads to bronchodilation. None of the other options describe the bronchial dilation affected of the anticholinergic classification of medications. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract, Therapeutic Actions and Indications, p. 973. Chapter 55: Drugs Acting on the Lower Respiratory Tract - Page 973 Add a Note Question 8 See full question 20s Report this Question What medical condition is likely to be exacerbated by the medication therapy associated with asthma? You Selected: • cataracts Correct response: • gastroesophageal reflux disease (GERD) Explanation: Asthma, may aggravate GERD, because antiasthma medications that dilate the airways also relax muscle tone in the gastroesophageal sphincter and may increase acid reflux. The relationship between asthma medications and the other options is not supported by research data. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract. Add a Note Question 9 See full question 30s Report this Question Where should the nurse initially direct a client who is interested in learning more about the management of asthma? You Selected: • National Association of Educational Pulmonologists Correct response: • Global Initiative for Asthma (GINA) Explanation: Management of asthma involves prevention of airway inflammation and avoidance of triggers for better symptom control. Because of asthma’s significance as a world health problem, the Global Initiative for Asthma (GINA) published asthma guidelines of diagnosis, management, and education. These guidelines emphasize the importance of classifying asthma severity and the assessment of asthma control. While the other options may provide information on asthma, the GINA is most inclusive. Reference: • Karch, A. M., Focus on Nursing Pharmacology, 8th ed., Philadelphia, Wolters Kluwer, 2020, Chapter 55: Drugs Acting on the Lower Respiratory Tract. Add a Note Question 10 See full question 10s Report this Question What is considered a possible trigger for an asthma attack? Select all that apply. You Selected: • cigarette smoke • exercise • pollutants • allergens Correct response: • exercise • allergens • pollutants • cigarette smoke Explanation: Precipitants may include allergens (e.g., pollens, molds), airway irritants and pollutants (e.g., chemical fumes, cigarette smoke, automobile exhaust), cold air, and exercise. [Show More]

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