Mastery EAQ Ch. 37

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Question #1

Which assessment would the nurse perform to ensure safety of drug administration for a patient who is prescribed omalizumab?

A Hypersensitivity reactions

B Gastrointestinal upset

C Urine frequency

D Body temperature

Question #2

Which adverse effect manifesting in nausea, shortness of breath, joint pain, weakness, and fatigue could be caused from a patient abruptly discontinuing prednisone therapy?

A Coronary ischemia

B Rheumatoid arthritis

C Cushing’s syndrome

D Addisonian crisis

Question #3

Which patient would cause the nurse to question a prescription of theophylline?

A A patient with atrial fibrillation with a pulse rate of 100 beats/min

B A patient who is 16 years old

C A patient with a history of emphysema

D A patient with a history of type 2 diabetes

Question #4

Which laboratory value would the nurse monitor to ensure safe drug administration for a patient who is prescribed zileuton?

A Creatinine clearance

B Complete blood count

C Uric acid baseline level

D Liver enzyme levels

Question #5

Which action is the nurse’s highest priority when a patient with a history of asthma reports feeling short of breath?

A Administering a beta2-adrenergic agonist

B Administering a long-acting glucocorticoid

C Calling a code

D Asking the patient to describe the symptoms

Question #6

Which biochemical test may be performed in the patient before administration of an inhaled corticosteroid for treatment of asthma?

A Liver enzyme test

B Hemoglobin test

C Sputum test

D Prothrombin time

Question #7

Which priority instruction would the nurse include for a patient with acute asthma who completed 4 days of intravenous methylprednisolone therapy and has just received a prescription for fluticasone at discharge?

A “Take fluticasone exactly as it is prescribed.”

B “Avoid situations that can expose you to infections.”

C “Administer albuterol before other asthma medications.”

D “Rinse your mouth with water after using fluticasone.”

Question #8

Which will the care provider prescribe to treat a patient with a xanthine overdose?

A Theophylline

B Activated charcoal

C Formoterol

D Arformoterol

Question #9

Which adverse effects will the nurse monitor in a patient who is receiving tiotropium?

A Hyperglycemia, Dry mouth or throat, Skeletal pain

B Heart palpitations, Skeletal pain, Hyperglycemia

C Nasal congestion, Heart palpitations, Dry mouth or throat

D Skeletal pain, Hyperglycemia, Nasal congestion

Question #10

Which instruction would the nurse provide a patient beginning treatment with a fluticasone/salmeterol inhaler to prevent complications?

A Drink 8–10 glasses of water daily, Document daily intake and output, Rinse your mouth out after dose

B Monitor for signs of infection, Do not abruptly stop the drug, Rinse your mouth out after dose

C Drink 8–10 glasses of water daily, Document daily intake and output, Monitor for signs of infection

D Do not abruptly stop the drug, Drink 8–10 glasses of water daily, Document daily intake and output

Question #11

Which medication will the nurse anticipate will be prescribed for a patient in status asthmaticus who continues to have symptoms after administration of epinephrine?

A Albuterol

B Terbutaline

C Aminophylline

D Salmeterol

Question #12

Which side effects would the nurse ask the patient to be watchful when administering mixed alpha/beta agonists?

A Drowsiness, Hypoglycemia, Vascular headache

B Cardiac stimulation, Hypoglycemia, Drowsiness

C Drowsiness, Hypoglycemia, Anorexia

D Anorexia, Vascular headache, Cardiac stimulation

Question #13

Which reason explains why the nurse would recommend an alternate method of contraception to a patient taking theophylline and an oral contraceptive?

A Theophylline decreases the effectiveness of contraceptives.

B Oral contraceptives increase the serum level of theophylline.

C Theophylline and oral contraceptives cause additive toxicity.

D Oral contraceptives inhibit theophylline action.

Question #14

Which instruction would the nurse give to the patient for safe administration of theophylline?

A “Avoid consumption of citrus fruit.”

B “Increase intake of low-carbohydrate food.”

C “Avoid intake of a high-protein diet.”

D “Increase fluid intake up to 3 L per day.”

Question #15

Which item would the nurse advise a patient who is prescribed a zanthine-derivitive drug to avoid?

A Sugar, Low-protein foods, Cigarettes, Low-carbohydrate foods

B Coffee, Charcoal-broiled foods, Cigarettes, Sugar

C Coffee, Charcoal-broiled foods, Cigarettes, Low-carbohydrate foods

D Coffee, Charcoal-broiled foods, Low-protein foods, Low-carbohydrate foods

Question #16

Which medication would the nurse expect to administer to a patient with bronchospasms who develops tachycardia?

A Arformoterol

B Salmeterol

C Formoterol

D Levalbuterol

Question #17

Which step of asthma management involves a prescription for fluticasone and a salmeterol inhaler?

A Step 5

B Step 6

C Step 4

D Step 2

Question #18

Which respiratory therapy would the nurse administer to lower the carbon dioxide concentration of a patient with chronic obstructive pulmonary disorder (COPD)?

A Albuterol nebulizer

B Salmeterol

C Oxygen via a nasal cannula, 2 L/min

D Fluticasone propionate

Question #19

The health care provider has prescribed montelukast for the treatment of allergic rhinitis and allergy-induced asthma. Which cue in the health record would make the use of this drug contraindicated?

Medical Diagnoses
o Seizure disorder
o Allergy-induced asthma
o Depression
o Allergic rhinitis

Medication Administration Record
o Phenobarbital 60 mg PO BID
o Montelukast 10 mg PO daily
o Citalopram 20 mg PO daily

A Phenobarbital

B Hypertension

C Seizure disorder

D Atenolol

Question #20

A patient with a history of asthma reports palpitations, tremors, and anxiety. Based on the home medication profile, which question would the nurse ask first?

Medication Administration Record
o Advair 1 puff twice daily
o Albuterol 2 puffs Q 4 hours PRN
o Cetirizine 10 mg PO QD
o Lisinopril 10 mg PO QD

A “Do you have any pets at home?”

B “What do you do after taking your Advair?”

C “How often do you take your albuterol?”

D “When was the last time you took your Advair?”

Question #21

A 10-year-old child presents to the school nurse’s office experiencing an acute asthma attack. Based on the assessment findings below, which medication would the nurse administer?

Assessment Data
o Alert and oriented x 4
o Temperature 99.1° F
o Heart rate 110 beats/min
o Respiratory rate 32 breaths/min
o Blood pressure 132/82 mm Hg
o Oxygen saturation 90% room air
o Wheezing noted throughout lung fields
o Breathing pattern rapid and labored
o Capillary refill 3 sec

A Albuterol

B Salmetero

C Symbicort

D Epinephrine

Question #22

Which is the nurse’s best action for a patient who is due for a dose of oral theophylline but displays irritability and has a blood pressure of 100/50 mm Hg and a heart rate of 110 beats/min?

A Continue to monitor the patient and give the medication.

B Hold the next dose of theophylline and assess the patient.

C Call the health care provider to request an increased dose.

D Administer oxygen at 2 L per minute via nasal cannula.

Question #23

Which complication would be prevented when the nurse instructs the patient to rinse the mouth with water immedietely after inhaling ipratropium?

A Oral candidiasis

B Throat infection

C Mucosal irritation and dryness

D Nasal congestion

Question #24

Which adjustment to drug therapy would the nurse anticipate the health care provider will make for a patient who has been prescribed epinephrine and is also taking metformin?

A Increase in dose of metformin

B Increase in dose of epinephrine

C Replacement of epinephrine with aminophylline

D Replacement of metformin with aminophylline

Question #25

Which complication would the nurse anticipate in a patient who is prescribed theophylline therapy and complains of gastroesophageal reflux during sleep?

A Insomnia, Ventricular dysrhythmias, Dry mouth

B Insomnia, Dry mouth, Vomiting

C Vomiting, Increased urination, Ventricular dysrhythmias

D Increased urination, Insomnia, Dry mouth

Question #26

Which intervention, if followed, may prevent a fatal outcome for a patient changing from systemic corticosteroids to inhaled corticosteroids?

A Reducing the dose frequency of the inhaled corticosteroid

B Tapering the dose of systemic corticosteroid

C Administering the same dose of systemic corticosteroid

D Providing an initial high dose of inhaled corticosteroid

Question #27

Which order would the nurse anticipate for a patient prescribed ipratropium for treatment of chronic obstructive pulmonary disease (COPD) who also takes diphenhydramine to treat allergies?

A Discontinue the dose of diphenhydramine.

B Administer both medicines simultaneously.

C Discontinue the ipratropium.

D Administer both medications as prescribed.

Question #28

Which action by the patient will improve the absorption of tiotropium into the lung?

A Waiting for 1 to 2 minutes before inhaling the second dose

B Avoiding rinsing the mouth with water after inhaling the medicine

C Taking a higher dose of tiotropium for inhalation

D Inhaling the tiotropium continuously for some time

Question #29

Which action would the nurse implement first for a patient who is taking ipratropium and complains of dry cough?

A Administer 30 mg of dextromethorphan.

B Administer rescue therapy.

C Listen to the patient’s lungs.

D Instruct the patient to drink water.

Question #30

Which interaction can occur when an asthmatic patient consumes rifampin along with xanthine derivatives?

A Additive central nervous system stimulation is produced.

B Additive cardiac stimulation is produced.

C Theophylline metabolism is decreased.

D Theophylline levels are decreased.

Question #31

Which assessment will the nurse perform to evaluate a patient who reports dizziness after taking albuterol?

A Visual acuity

B Blood pressure

C Respiratory rate

D Balance reactions

Question #32

Which instruction would the nurse give to the patient to prevent gastrointestinal (GI) upset when taking oral albuterol?

A “Increase fluid intake up to 2500 mL a day.”

B “Avoid sleeping with the head in an elevated position.”

C “Take the prescribed medication with food.”

D “Take the prescribed medication on an empty stomach.”

Question #33

Which type of medication will be administered first to the patient with a history of asthma who is brought to the clinic with acute dyspnea, wheezing, hypercapnia, and hypoxemia?

A Leukotriene modifiers

B Glucocorticoids

C Beta2 agonists

D Anticholinergics

Question #34

Which is the correct nursing action for a patient who is prescribed albuterol and beclomethasone inhalers?

A Administer beclomethasone, wait 2 minutes, and then administer albuterol.

B Administer the albuterol, wait 5 minutes, and then administer beclomethasone.

C Administer each inhaler at 30-minute intervals.

D Question the prescription; two inhalers should not be given at one time.

Question #35

Which side effect of a beta-agonist bronchodilator will the nurse teach the patient to report to the health care provider?

A Bradycardia

B Increased appetite

C Hypoglycemia

D Tachycardia

Question #36

Which intervention would the nurse implement for a pediatric patient who is having difficulty using a metered-dose inhaler?

A Teach the child to use a spacer.

B Ask the health care provider to switch to oral medications.

C Tell the parent that young children should not use inhalers.

D Tell the parent to hold the inhaler for the child.

Question #37

Which laboratory parameter would the nurse monitor for a patient who is prescribed theophylline?

A Serum uric acid levels

B Serum level of drug

C Serum calcium levels

D Serum creatinine levels

Question #38

The nurse is teaching a patient who has asthma about the frequency of inhalation of salmeterol. Which statement by the patient indicates effective learning?

A “I will inhale it once a day upon waking.”

B “I will inhale it twice a day approximately 12 hours apart.”

C “I will inhale it once a day before bedtime.”

D “I will inhale it twice a day at my convenience.”

Question #39

Which antiasthmatic drugs work by preventing the inflammation commonly provoked by the substances released from mast cells?

A Corticosteroids

B Mast cell stabilizers

C Anticholinergics

D Xanthine derivatives

Question #40

Which condition would the nurse include in the teaching plan for a patient with assessment findings of moon face, acne, increased fat pads, and swelling who is taking methylprednisolone?

A Addisonian crisis

B Cushing’s syndrome

C Thyrotoxicosis

D Hypothyroidism

Question #41

Which antiasthmatic, available only for oral use, is approved for use in children 1 years of age and older?

A Albuterol

B Montelukast

C Terbutaline

D Systemic corticosteroid

Question #42

Which is an adverse effect of albuterol?

A Skin rashes, Tremors, Hypoglycemia

B Skin rashes, Hypoglycemia, Palpitations

C Tremors, Palpitations, Tachycardia

D Tachycardia, Skin rashes, Hypoglycemia

Question #43

Which medication disrupts the inflammatory response and is indicated in the treatment of asthma?

A Ipratropium

B Salmeterol

C Montelukast

D Theophylline

Question #44

Which condition is a contraindication for the administration of montelukast?

A Joint pain

B Diabetes

C Peanut allergy

D Lactose allergy

Question #45

Which time frame describes how long it will take ipratropium to have its maximum effect?

A 5-15 minutes

B 1-2 hours

C 4-5 hours

D 1.6 hours

Question #46

Which is the elimination half-life of theophylline?

A 5.5 hours

B 12 hours

C 6 to 13 hours

D 1 to 2 hours

Question #47

Which drug is a long-acting beta-agonist (LABA) inhaler?

A Levalbuterol

B Formoterol

C Terbutaline

D Metaproterenol

Question #48

Which medication given for the treatment of asthma can suppress bone growth in children?

A A corticosteroid

B An anticholinergic

C A xanthine derivative

D A beta agonist

Question #49

Which complaint would the nurse anticipate from a patient who is taking inhaled ipratropium?

A Anginal pain

B Dry mouth

C Insomnia

D Vascular headache

Question #50

Which condition is characterized by enlargement of air spaces caused by the destruction of the alveolar walls?

A Chronic bronchitis

B Rhinitis

C Bronchial asthma

D Emphysema

Question #51

Which route is most common for albuterol administration?

A Intramuscular

B Intravenous

C Subcutaneous

D Inhalation

Question #52

Which medication is a mast cell stabilizer?

A Montelukast

B Cromolyn

C Arformoterol

D Zileuton

Question #53

Which symptoms would the nurse expect to find in a patient with asthma?

A Rhinorrhea, Shortness of breath, Conjunctival swelling

B Chest tightness, Rhinorrhea, Conjunctival swelling

C Wheezing, Chest tightness, Shortness of breath

D Rhinorrhea, Conjunctival swelling, Wheezing

Question #54

The nurse is reviewing the laboratory results for a patient scheduled to receive theophylline for asthma. Based on a theophylline level of 25 mcg/mL, which action would the nurse take?

A Wait 1 hour to give the dose

B Hold the dose, Contact the health care provider

C Administer the dose, Ask lab to redraw blood

D Wait 1 hour to give the dose, Ask lab to redraw blood

Question #55

Which parameter would the nurse assess after a scheduled dose of albuterol-ipratropium is finished to determine drug effectiveness for a patient with pneumonia?

A Heart rate, Breath sounds, Blood pressure

B Breath sounds, Respiratory rate, Oxygen saturation

C Oxygen saturation, Blood pressure, Heart rate

D Heart rate, Blood pressure, Respiratory rate

Question #56

Which instruction would the nurse provide a patient beginning treatment with a fluticasone/salmeterol inhaler to prevent complications?

A Drink 8–10 glasses of water daily, Document daily intake and output, Monitor for signs of infection

B Monitor for signs of infection, Do not abruptly stop the drug, Rinse your mouth out after dose

C Do not abruptly stop the drug, Drink 8–10 glasses of water daily, Document daily intake and output

D Drink 8–10 glasses of water daily, Rinse your mouth out after dose, Document daily intake and output

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