Chapter 75: Drugs for Asthma

Chapter 75: Drugs for Asthma

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse has received an order for an asthmatic patient for a metered-dose inhaler (MDI), 2 puffs BID. While instructing the asthmatic patient in the proper use of an MDI, the nurse should include which of the following instructions?

a.	“Inhale after activating the device.”
b.	“Administer 2 puffs, wait 1 minute, and administer 2 more.”
c.	“Wait 1 minute between the first and second puff.”
d.	“Puff the inhaled doses in rapid succession.”

 

 

ANS:   C

When 2 puffs are needed, an interval of at least 1 minute should separate the first puff from the second.

The inhale should be just prior to activation of the device.

If the medication is ordered 2 puffs BID, the patient would not administer 2 puffs followed by 2 more puffs in 1 minute.

There should be at least a 1 minute interval between puffs. They should not be taken in rapid succession.

 

DIF:    Cognitive Level: Application             REF:    p. 889

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. An asthmatic patient has right-sided paralysis caused by a stroke 3 years ago. The prescriber orders an inhaler. Which type of inhaled device would the nurse expect to be ordered for this patient?

a.	Inhaler without a spacer
b.	Dry-powder inhaler
c.	Glucocorticoid
d.	Nebulizer

 

 

ANS:   B

Dry powder inhalers are breath activated and do not require the hand-lung coordination needed with MDIs. They would be easier for a patient with hemiparesis to use.

Use of an MDI requires hand-lung coordination and would not be the best choice for a patient with hemiparesis.

A glucocorticoid is not necessarily an inhaled device.

A nebulizer must be set up and would be more difficult for a patient with hemiparesis.

 

DIF:    Cognitive Level: Analysis                  REF:    p. 889

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. The nurse is preparing to administer albuterol (Proventil) and beclomethasone (Beconase) inhalers to an asthmatic patient, as ordered by the prescriber. The nurse should administer

a.	the albuterol only; these meds should not be given concurrently.
b.	the albuterol first, wait 5 minutes, and then administer the beclomethasone.
c.	either inhaler, wait 5 full minutes, then administer the other.
d.	the beclomethasone first, wait 5 minutes, then administer the albuterol.

 

 

ANS:   B

Delivery of the glucocorticoid to the bronchial tree may be enhanced by inhaling a short-acting beta₂ agonist 5 minutes before the glucocorticoid is inhaled.

Administering albuterol only is not correct. It is given to vasodilate the lungs prior to the administration of the glucocorticoid.

Albuterol should be given prior to beclomethasone.

The albuterol should be administered first to vasodilate the lungs prior to administration of the beclomethasone.

 

DIF:    Cognitive Level: Application             REF:    p. 892

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. An asthmatic patient comes to the emergency department (ED) with edema of the glottis, chest tightening, and wheezing. The nurse suspects severe bronchospasm and should prepare to administer a(n) (Select all that apply.)

a.	nebulized albuterol treatment.
b.	levalbuterol (Xopenex) treatment.
c.	oral beta2 agonist.
d.	inhaled corticosteroid.
e.	leukotriene modifier.

 

 

ANS:   A, B

A nebulizer is the quickest delivery method, and short-acting beta-adrenergic agonists, such as albuterol and levalbuterol, treat acute bronchospasm.

An oral medication would not work quickly enough for a severe bronchospasm attack.

An inhaled corticosteroid would help inflammation but would not be the most effective choice.

A leukotriene modifier is effective as a mucolytic, therefore it would not be the correct choice.

 

DIF:    Cognitive Level: Application             REF:    pp. 895-896

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies