ATI Pharmacology Made Easy: Respiratory Drill Questions

Which of the following information should you include when teaching a patient about using an albuterol (Proventil) inhaler for asthma?
Use it periodically to prevent exercise-induced asthma.

Albuterol is a short-acting beta2 agonist and should be used only as needed to stop an acute asthma exacerbation or 30 min prior to exercising to prevent exercise-induced bronchospasm. Salmeterol (Serevent) is an example of a drug that should be taken every 12 hours for long-term asthma management. Albuterol canisters should be kept away from heat and direct sunlight, but refrigerating them is not recommended. Inhaled glucocorticoids, such as beclomethasone (QVAR), may cause oral yeast infections. They are not an adverse effect of albuterol.

Which of the following information indicates to you that a patient who is taking theophylline (Theo-24) needs further instruction?
The patient drinks two cups of coffee each morning.

Caffeine may increase central nervous system stimulation, causing nervousness, insomnia, and tremors. It may also increase cardiac stimulation and cause tachycardia. Patients taking methylxanthines should be instructed to avoid caffeine intake. Alcohol use is not contraindicated for patients taking theophylline. Exercise is not contraindicated for patients who have asthma. Theophylline should not impair the patient’s ability to operate a motor vehicle.

You should instruct a patient who is taking zileuton (Zyflo) to report which of the following possible indications of a serious adverse effect of the drug?
Abdominal pain

Zileuton may cause liver damage and hepatitis. Patients should report any signs of hepatic toxicity, such as abdominal pain or jaundice. Dysphagia, or difficulty swallowing, is not likely to result from taking zileuton, although this drug can cause neck pain and rigidity. Zileuton is unlikely to cause blurred vision, although it can cause conjunctivitis. Bradycardia is unlikely to result from taking zileuton, although this drug can cause chest pain.

You are obtaining a health history from a patient who is to start using a new ipratropium (Atrovent) inhaler. Which of the following information from the patient’s history should alert you to take further action? (Select all that apply.)
Peanut Allergy
Glaucoma

Ipratropium, an anticholinergic drug, is contraindicated for patients who are allergic to peanuts or soybeans because the medication preparation may contain peanut oil and soy lecithin. This drug should be used with caution in patients who have glaucoma due to the risk for increased intraocular pressure. Patients who have a seizure disorder or who take MAOIs or thyroid hormones can take ipratropium.

You should advise a patient who is taking beclomethasone (QVAR) to monitor for which of the following possible indications of an adverse effect of the drug?
White coating in the mouth

Beclomethasone, an inhaled glucocorticoid, may cause oropharyngeal candidiasis. Patients should gargle after each use, use a spacer to reduce the amount of drug in the mouth and throat, and report any white patches inside the mouth or on the tongue. Leukotriene modifiers are more likely to cause liver injury and abdominal pain. Muscle twitching and palpitations may indicate methylxanthine toxicity.

You should recognize that codeine is contraindicated for patients who have which of the following?
Emphysema

Codeine is contraindicated for patients who have decreased respiratory reserve, such as with emphysema or asthma. Codeine is not contraindicated for patients who have cataracts, although it can exacerbate some types of glaucoma due to a possible increase in intraocular pressure. Codeine may cause constipation, hypotension, and reduced respirations. It should be used with caution in patients with hypothyroidism because the drug can worsen bradycardia. Codeine can help suppress a nonproductive cough.

You are instructing a patient about using cromolyn via inhalation to treat exercise-induced asthma. You should should advise the patient to take the drug
15 min before exercising.

Cromolyn may prevent exercise-induced asthma if used 15 min before exercising. Cromolyn is not effective at stopping bronchospasm. Cromolyn via nebulizer may be used up to four times per day to prevent bronchospasm. Using the inhaler at bedtime will not prevent exercise-induced asthma.

You should monitor a patient taking dextromethorphan (Robitussin DM and others) due to the potential for which of the following?
Drug abuse

Dextromethorphan may cause euphoria and hallucinations at high doses. Patients taking it should be monitored for the potential for abuse. Dextromethorphan is unlikely to cause tachycardia, fluid retention, or blurred vision; however, it can cause dizziness, dyspepsia, and constipation.

You are instructing a patient who is taking cetirizine (Zyrtec) how to treat allergic rhinitis. Which of the following information should the provider include?
Administer the drug prophylactically during allergy seasons.

Cetirizine, an oral antihistamine, may or may not cause drowsiness, so it is safest to avoid driving and activities that require mental alertness until the amount of drowsiness the patient experiences has been determined. Increasing fluids may help reduce dry mouth and constipation. Cetirizine may cause drowsiness and sedation. Taking cetirizine in the morning will not minimize its adverse effects. Taking antihistamines with food may help reduce gastric distress.

You should instruct a patient using phenylephrine (Neo-Synephrine) spray for nasal congestion to do which of the following to avoid rebound congestion? (Select all that apply.)
Limit the drug’s use to 3 to 5 days.
Add an intranasal glucocorticoid.
Taper the dose prior to discontinuation.
Restrict the drug’s use to one nostril at a time.

Phenylephrine, a topical sympathomimetic, should be used short-term to prevent rebound congestion. Limiting the drug’s use to 3 to 5 days, adding an intranasal glucocorticoid, tapering the dose prior to discontinuation, and restricting the drug’s use to one nostril at a time are all methods that can be used to avoid rebound congestion. Adding a beta2 adrenergic agonist will not have an effect on the nasal mucosa.

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a. Asthma A client is diagnosed with a pulmonary disorder that causes COPD. Lungs tissue changes are normally reversible with this condition. The nurse understands that which is the client’s most likely diagnosis? a. Asthma b. Emphysema c. Bronchiectasis d. …

Chronic inflammatory reversible disease of tracheobronchial airways characterized by airflow obstruction and increased responsiveness to a variety of stimuli asthma – inflammation of bronchial wall – increased mucus secretion – bronchiolar smooth muscle constriction List 3 s/s of bronchoconstriction. chest …

A health care professional is caring for a patient who is having difficulty mobilizing thick respiratory secretions. which of the following drugs should the health care professional expect to administer? -Acetylcysteine A health care professional is monitoring plasma drug levels …

A health care professional is caring for a patient who is having difficulty mobilizing thick respiratory secretions. which of the following drugs should the health care professional expect to administer? -Acetylcysteine A health care professional is advising a patient about …

What is Viral Rhinitis and what are its symptoms? The Common Cold – virus invades mucosa of upper respiratory tract sneezing, coughing, sore throat, runny nose, congestion What is Allergic Rhinitis and how is it different than Viral Rhinitis? Airborne …

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