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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 39

Question 1 Type: MCSA The client receives albuterol (Proventil) via inhaler. He asks the nurse why he can't just take a pill. best response by the nurse! hat is the

1. " hen you inhale the #ru$ the bloo# supply in your lun$s picks it up rapi#ly% resultin$ in &uicker e''ects.( 2. ")ecause pills cannot help your illness* you +ust have inhale# +e#ications 'or relie' o' sy+pto+s." 3. ,)ecause pills woul# pro#uce too +any si#e e''ects* you will have very 'ew si#e e''ects with inhale# +e#ications.( 4. ")ecause this +e#ication cannot be absorbe# 'ro+ your -. tract* the aci# in your sto+ach woul# #estroy it." Correct Answer: / ationa!e 10 The respiratory syste+ o''ers a rapi# an# e''icient +echanis+ 'or #eliverin$ #ru$s. The enor+ous sur'ace area o' the bronchioles an# alveoli% an# the rich bloo# supply to these areas% results in an al+ost instantaneous onset o' action 'or inhale# substances. ationa!e 20 Albuterol (Proventil) can be $iven orally (P1)% but has a 'aster onset o' action i' inhale#. ationa!e 30 .nhale# +e#ications also pro#uce si#e e''ects. ationa!e 40 1ral +e#ications are e''ective with so+e sy+pto+s o' respiratory #isor#ers% but inhale# +e#ications work 'aster. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 3453 Question 2 Type: MCSA The nurse teaches a +e#ication class on broncho#ilators 'or clients with asth+a. The nurse evaluates that learnin$ has occurre# when the clients +ake which state+ent! 1. "The +e#ication wi#ens the airways because it #ecreases the pro#uction o' +ucous that narrows the+."
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

2. "The +e#ication wi#ens the airways because it #ecreases the pro#uction o' hista+ine that narrows the+." 3. "The +e#ication wi#ens the airways because it acts on the parasy+pathetic nervous syste+." 4. "The +e#ication wi#ens the airways because it sti+ulates the 'i$ht5or5'li$ht response o' the nervous syste+." Correct Answer: 6 ationa!e 10 )roncho#ilators #o not #ecrease the pro#uction o' +ucous. ationa!e 20 )roncho#ilators #o not #ecrease the pro#uction o' hista+ine. ationa!e 30 )roncho#ilators act on the sy+pathetic nervous syste+% not the parasy+pathetic nervous syste+. ationa!e 40 ;urin$ the 'i$ht5or5'li$ht response% beta95a#rener$ic receptors o' the sy+pathetic nervous syste+ are sti+ulate#% the bronchiolar s+ooth +uscle rela<es% an# broncho#ilation occurs. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 8valuation &earnin$ *utcome: 3459 Question 3 Type: MCSA The client asks the nurse why she +ust continue takin$ her asth+a +e#ication even thou$h she has not ha# an asth+a attack in several +onths. hat is the best response by the nurse! 1. "The +e#ication nee#s to be taken in#e'initely accor#in$ to your #octor% so you shoul# #iscuss this with hi+." 2. "The +e#ication is still nee#e# to #ecrease in'la++ation in your airways an# help prevent an attack." 3. "The +e#ication nee#s to be taken or your lun$s will be severely #a+a$e# an# we will not be able to stop an acute attack." 4. "The +e#ication nee#s to be taken 'or at least a year* then% i' you have not ha# an acute attack% you can stop it." Correct Answer: 9 ationa!e 10 The nurse is able to answer the client's &uestion* it #oes not nee# to be re'erre# to the physician. ationa!e 20 8''ective treat+ent o' asth+a inclu#es lon$5ter+ treat+ent to prevent attacks an# #ecrease in'la++ation% as well as short5ter+ treat+ent when an attack occurs.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

ationa!e 30 Tellin$ a client that his or her lun$s will be severely #a+a$e# is nontherapeutic* the inability to prevent an acute attack in this client is not true. ationa!e 40 >on$5ter+ treat+ent o' asth+a continues in#e'initely% not 'or just one year. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 345? Question 4 Type: MCSA The nurse plans to teach an a#olescent about inhalation therapy as part o' the treat+ent plan 'or the client's asth+a. hat #oes the best plan by the nurse inclu#e! 1. .nhalation therapy is e''ective because it provi#es aroun#5the5clock therapy% as oppose# to oral +e#ications. 2. .nhalation therapy is the pre'erre# treat+ent 'or a#olescents because it is easier 'or the+ to +ana$e. 3. .nhalation therapy is e''ective because it provi#es syste+ic relie' o' sy+pto+s as well as local relie'. 4. .nhalation therapy is e''ective because it $oes to the #irect site o' action in the respiratory tract. Correct Answer: 6 ationa!e 10 .nhalation therapy #oes not provi#e aroun#5the5clock therapy. ationa!e 20 .nhalation therapy is use# 'or a#olescents because it is e''ective% not because it is easier 'or the+ to +ana$e. ationa!e 30 .nhalation therapy #oes not provi#e syste+ic relie' o' sy+pto+s. ationa!e 40 The +ajor a#vanta$e o' aerosol therapy is that it #elivers the #ru$s to their #irect site o' action. .nhalation therapy #oes not provi#e aroun#5the5clock therapy. .nhalation therapy #oes not provi#e syste+ic relie' o' sy+pto+s. .nhalation therapy is use# 'or a#olescents because it is e''ective% not because it is easier 'or the+ to +ana$e. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Plannin$
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

&earnin$ *utcome: 3453 Question + Type: MCSA A client receives theophylline (Theo5;ur) an# calls the clinic to say he has ha# nausea an# vo+itin$ 'or two #ays. hat is the best action by the nurse! 1. Tell the client to co+e to the clinic 'or an assess+ent. 2. Ask the client i' he has eaten at any unclean restaurants. 3. Ask the client i' he has been e<pose# to anyone with the 'lu. 4. @eco++en# that the client be$in a clear li&ui# #iet. Correct Answer: / ationa!e 10 2ausea an# vo+itin$ are sy+pto+s o' theophylline to<icity* the client nee#s to co+e to the clinic 'or an assess+ent. ationa!e 20 Aoo# poisonin$ coul# be the cause o' the client's sy+pto+s% but he nee#s to be assesse# 'or theophylline to<icity. ationa!e 30 Alu coul# be the cause o' the client's sy+pto+s% but he nee#s to be assesse# 'or theophylline to<icity. ationa!e 40 A clear5li&ui# #iet +i$ht help% but the client nee#s to be assesse# 'or theophylline to<icity. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 345B Question , Type: MCSA The nurse teaches the client about the use o' a +etere#5#ose inhaler (M;.) an# spacer. The nurse evaluates that a##itional teachin$ is re&uire# when the client +akes which state+ent! 1. ". nee# to 'ollow the instructions about usin$ the +etere#5#ose inhaler (M;.)." 2. ". nee# to rinse +y +outh each ti+e a'ter usin$ the +etere#5#ose inhaler (M;.)."
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

3. ". nee# to #rink a lot o' 'lui#s while . a+ usin$ the +etere#5#ose inhaler (M;.)." 4. ,. shoul# keep the spacer +oist between uses by storin$ it in a plastic =ipba$.( Correct Answer: 6 ationa!e 10 Aollowin$ instructions in#icates co+pliance with use o' the +etere#5#ose inhaler (M;.). ationa!e 20 @insin$ the +outh a'ter usin$ the +etere#5#ose inhaler (M;.) is correct* it will help re#uce oral absorption o' the #ru$. ationa!e 30 Alui#s are encoura$e# to li&ue'y pul+onary secretions when usin$ the +etere#5#ose inhaler (M;.). ationa!e 40 The spacer an# inhaler shoul# be rinse# with water an# allowe# to air5#ry. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 8valuation &earnin$ *utcome: 345 Question Type: MCMA The client receives beclo+ethasone ()econase). hat will the best assess+ent by the nurse inclu#e!

Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply. 1. Assess the client's +outh 'or any si$n o' 'un$al in'ection. 2. Assess the client's bloo# $lucose prior to a#+inistration o' nasal spray. 3. Assess i' the client has blown his nose prior to a#+inistration o' nasal spray. 4. Assess i' the client has ha# a chan$e in taste. +. Assess the client 'or any hoarseness or chan$e in voice. Correct Answer: /%3%6%? ationa!e 10 Clients +ay #evelop can#i#iasis so the +outh shoul# be assesse#. ationa!e 20 There is no nee# to assess the client's bloo# $lucose.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

ationa!e 30 The client shoul# $ently blow the nose prior to use to clear the nasal passa$es. ationa!e 40 Clients +ay e<perience a chan$e in taste. ationa!e +0 Clients +ay e<perience a chan$e in voice as a local e''ect. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: 345B Question / Type: MCMA The client receives ipratropiu+ (Atrovent) via inhalation 'or the treat+ent o' chronic asth+a. The nurse plans to #o +e#ication e#ucation with the client. hat will the best plan by the nurse inclu#e! Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply. 1. ait /? +inutes be'ore usin$ any other inhale# +e#ications.

2. The +e#ication +ay also be use# 'or acute asth+a attacks. 3. @eport any increase# #yspnea. 4. @eport any chan$es in urinary pattern. +. Cse the +e#ication consistently% not occasionally. Correct Answer: 3%6%? ationa!e 10 .t is only necessary to wait 9D3 +inutes% not /? +inutes% between inhale# +e#ications. ationa!e 20 Anticholiner$ic #ru$s will not ter+inate an acute asth+a attack% as peak e''ects +ay take / to 9 hours. ationa!e 30 The client shoul# be a#vise# to report any sy+pto+s o' #eterioratin$ respiratory status such as increase# #yspnea. ationa!e 40 Anticholiner$ic #ru$s can result in urinary retention% an# the client shoul# report any chan$es in urinary patterns.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

ationa!e +0 To $et the +ost bene'it 'ro+ ipratropiu+ (Atrovent)% it +ust be use# consistently. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Plannin$ &earnin$ *utcome: 345E Question 9 Type: MCSA The client receives isoproterenol (.suprel) via inhalation. The nurse #eter+ines that the client is e<periencin$ a si#e e''ect o' this +e#ication when reviewin$ which laboratory test! 1. AST o' 9: units7> 2. So#iu+ o' /F: 3. -lucose o' /6? 4. Creatinine o' /.: +$7#l Correct Answer: 3 ationa!e 10 A si#e e''ect o' isoproterenol (.suprel) is hyper$lyce+ia. A creatinine o' /.: +$7#l is a nor+al creatinine level% an# isoproterenol (.suprel) is not nephroto<ic. A so#iu+ o' /F: is an elevate# so#iu+ level% but isoproterenol (.suprel) #oes not cause hypernatre+ia. An AST o' 9: units7> is a nor+al AST% an# isoproterenol (.suprel) is not hepatoto<ic. ationa!e 20 A si#e e''ect o' isoproterenol (.suprel) is hyper$lyce+ia. A creatinine o' /.: +$7#l is a nor+al creatinine level% an# isoproterenol (.suprel) is not nephroto<ic. A so#iu+ o' /F: is an elevate# so#iu+ level% but isoproterenol (.suprel) #oes not cause hypernatre+ia. An AST o' 9: units7> is a nor+al AST% an# isoproterenol (.suprel) is not hepatoto<ic. ationa!e 30 A si#e e''ect o' isoproterenol (.suprel) is hyper$lyce+ia. A creatinine o' /.: +$7#l is a nor+al creatinine level% an# isoproterenol (.suprel) is not nephroto<ic. A so#iu+ o' /F: is an elevate# so#iu+ level% but isoproterenol (.suprel) #oes not cause hypernatre+ia. An AST o' 9: units7> is a nor+al AST% an# isoproterenol (.suprel) is not hepatoto<ic. ationa!e 40 A si#e e''ect o' isoproterenol (.suprel) is hyper$lyce+ia. A creatinine o' /.: +$7#l is a nor+al creatinine level% an# isoproterenol (.suprel) is not nephroto<ic. A so#iu+ o' /F: is an elevate# so#iu+ level% but isoproterenol (.suprel) #oes not cause hypernatre+ia. An AST o' 9: units7> is a nor+al AST% an# isoproterenol (.suprel) is not hepatoto<ic. "!o#a! ationa!e:
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: Question 10 Type: MCSA The physician has or#ere# ipratropiu+ (Atrovent) 'or the client. nurse to ask prior to a#+inisterin$ this +e#ication! 1. ";o you have $lauco+a!" 2. ";o you have #iabetes +ellitus!" 3. ";o you have sei=ures!" 4. ";o you have $out!( Correct Answer: / ationa!e 10 Anticholiner$ic #ru$s can worsen narrow an$le $lauco+a. ationa!e 20 Anticholiner$ic #ru$s #o not i+pact $lucose levels% so havin$ #iabetes +ellitus is not a concern. ationa!e 30 Anticholiner$ic #ru$s #o not a''ect sei=ure #isor#ers* this is not a concern. ationa!e 40 Anticholiner$ic #ru$s are not contrain#icate# in clients with $out. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: 345E Question 11 Type: MCSA The client receives =a'irlukast (Accolate) as treat+ent 'or asth+a. The nurse has co+plete# +e#ication e#ucation an# evaluates that learnin$ has occurre# when the client +akes which state+ent! 1. "This +e#ication activates +y 'i$ht5or5'li$ht response." 2. "This +e#ication is $oo# when . have an acute attack o' asth+a."
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

hat is a priority assess+ent &uestion 'or the

3. "This +e#ication #ilates +y airways so . can breathe better." 4. "This +e#ication #ecreases the in'la++ation in +y lun$s." Correct Answer: 6 ationa!e 10 Ga'irlukast (Accolate) #oes not sti+ulate the sy+pathetic nervous syste+. ationa!e 20 Ga'irlukast (Accolate) is ine''ective 'or acute asth+a attacks. ationa!e 30 Ga'irlukast (Accolate) is not a broncho#ilator. ationa!e 40 Ga'irlukast (Accolate) prevents airway e#e+a an# in'la++ation by blockin$ leukotriene receptors in the airways. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 8valuation &earnin$ *utcome: 345B Question 12 Type: MCSA The physician has prescribe# cro+olyn (.ntal) 'or the client with asth+a. The nurse plans to #o +e#ication e#ucation. hat will the best plan by the nurse inclu#e! 1. This +e#ication is in#icate# 'or acute asth+a attacks. 2. This +e#ication can a''ect bloo# $lucose levels. 3. This +e#ication will help prevent asth+a attacks. 4. This +e#ication can result in hypertension. Correct Answer: 3 ationa!e 10 Cro+olyn (.ntal) is ine''ective 'or acute asth+a attacks. ationa!e 20 Cro+olyn (.ntal) #oes not a''ect bloo# $lucose levels. ationa!e 30 )y re#ucin$ in'la++ation% cro+olyn (.ntal) is able to prevent asth+a attacks. ationa!e 40 Cro+olyn (.ntal) #oes not cause hypertension.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

"!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Plannin$ &earnin$ *utcome: 345B Question 13 Type: MCSA The nurse is preparin$ to a#+inister beclo+ethasone ()econase) to several clients. Aor which client woul# the nurse hol# the #ru$ an# contact the physician! 1. The client who has ha# a +yocar#ial in'arction (M.) 2. The client who has +ethicillin resistant Staphylococcus aureus (M@SA) 3. The client who has #iabetes +ellitus 4. The client who has ter+inal cancer Correct Answer: 9 ationa!e 10 )eclo+ethasone ()econase) is not contrain#icate# in clients who have ha# a +yocar#ial in'arction. ationa!e 20 -lucocorticoi#s can +ask the si$ns o' in'ection% an# are contrain#icate# i' active in'ection is present. ationa!e 30 )eclo+ethasone ()econase) is not contrain#icate# in clients who have #iabetes +ellitus. ationa!e 40 )eclo+ethasone ()econase) is not contrain#icate# in clients who have ter+inal cancer. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 345B Question 14 Type: MCSA The client receives ipratropiu+ (Atrovent). She tells the nurse she is $oin$ to stop it because o' the bitter taste in her +outh a'ter usin$ the +e#ication. hat is the best response by the nurse!
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

1. "That is a $oo# i#ea* you are e<periencin$ a serious si#e e''ect." 2. "That is a co++on si#e e''ect* it will $o away in ti+e." 3. "Hou can #ecrease that si#e e''ect by rinsin$ your +outh a'ter use." 4. "Are you sure you are usin$ the +e#ication properly!" Correct Answer: 3 ationa!e 10 The client is not e<periencin$ a serious si#e e''ect* there is no nee# to stop the +e#ication. ationa!e 20 The bitter taste will not $o away in ti+e* the client +ust rinse her +outh. ationa!e 30 .pratropiu+ (Atrovent) pro#uces a bitter taste% which +ay be relieve# by rinsin$ the +outh a'ter use. ationa!e 40 Askin$ how the client uses the +e#ication +ay be a $oo# option% but not with the co++on si#e e''ect o' bitter taste. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 345B Question 1+ Type: MCSA )ronchoconstriction in the airways is sti+ulate# by 1. per'usion. 2. ventilation. 3. the sy+pathetic nervous syste+. 4. parasy+pathetic nervous syste+. Correct Answer: 6 ationa!e 10 Per'usion is the 'low o' bloo# in the lun$s. ationa!e 20 Ientilation +oves air in an# out. ationa!e 30 The sy+pathetic nervous syste+ sti+ulates #ilation.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

ationa!e 40 The parasy+pathetic nervous syste+ sti+ulates bronchoconstriction. "!o#a! ationa!e: Co$niti%e &e%e!: @e+e+berin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: 3459 Question 1, Type: MCSA The nurse un#erstan#s that one a#vanta$e o' inhale# pul+onary #ru$s over oral #ru$s is that inhale# #ru$s 1. increase a#verse e''ects. 2. allow 'or convenience to the client. 3. are #elivere# to syste+ic locations. 4. allow 'or &uick absorption. Correct Answer: 6 ationa!e 10 .nhale# #ru$s #ecrease a#verse e''ects. ationa!e 20 .nhale# #ru$s are not as convenient as oral. ationa!e 30 .nhale# #ru$s are #elivere# to local sites. ationa!e 40 .nhalation is the +ost co++on route o' a#+inistration* it is rapi#% an# allows 'or &uick absorption to #irect airway. "!o#a! ationa!e: Co$niti%e &e%e!: Cn#erstan#in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 8valuation &earnin$ *utcome: 3453 Question 1Type: MCSA hich o' the 'ollowin$ is true re$ar#in$ #ry pow#er inhalers (;P.)!
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

1. The +e#ication is #elivere# by tablet orally. 2. The +e#ication is #elivere# by 'ine +ist. 3. The #evice is activate# by inhalation. 4. The +e#ication is applie# topically. Correct Answer: 3 ationa!e 10 .nhalers are not oral tablets. ationa!e 20 2ebuli=ers #eliver +e#ications in 'ine +ist. ationa!e 30 The client activates the #evice by inhalin$. ationa!e 40 .nhalers are not applie# topically. "!o#a! ationa!e: Co$niti%e &e%e!: Cn#erstan#in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 3456 Question 1/ Type: MCSA >eukotriene +o#i'iers are pri+arily use# 'or 1. status asth+aticus. 2. in'ection. 3. broncho#ilation in asth+a. 4. prophyla<is o' asth+a sy+pto+s. Correct Answer: 6 ationa!e 10 >eukotrienes are not use# 'or treat+ent o' status asth+aticus. ationa!e 20 >eukotrienes #o not re#uce in'ection. ationa!e 30 Anticholiner$ics are broncho#ilators. ationa!e 40 >eukotriene +o#i'iers are use# pri+arily 'or prophyla<is an# re#ucin$ in'la++atory co+ponents.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

"!o#a! ationa!e: Co$niti%e &e%e!: @e+e+berin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Plannin$ &earnin$ *utcome: 345? Question 19 Type: MCSA hich o' the 'ollowin$ state+ents is true re$ar#in$ asth+a! 1. .t has both in'la++atory an# bronchoconstriction co+ponents. 2. Asth+a is cause# by a virus. 3. Asth+a cannot be treate#. 4. Sy+pto+s +ost o'ten occur with rest. Correct Answer: / ationa!e 10 Asth+a has an in'la++atory an# a bronchoconstriction co+ponent. ationa!e 20 Asth+a is not cause# by a virus% althou$h a virus can be a tri$$er. ationa!e 30 Asth+a can be treate# by several #ru$ classes. ationa!e 40 Sy+pto+s occur with e<posure to tri$$ers or e<ertion. "!o#a! ationa!e: Co$niti%e &e%e!: @e+e+berin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: 345? Question 20 Type: MCSA The nurse woul# observe 'or 'un$al in'ection o' the throat with which class o' +e#ications! 1. Methyl<anthines 2. )eta5a#rener$ic a$onists
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

3. Mast cell inhibitors 4. -lucocorticoi#s Correct Answer: 6 ationa!e 10 Methyl<anthines #o not cause 'un$al in'ection. ationa!e 20 )eta5a#rener$ic a$onists can cause throat irritation% but not in'ection. ationa!e 30 Mast cell inhibitors #o not cause 'un$al in'ection. ationa!e 40 -lucocorticoi#s weaken the i++une syste+ an# cause can#i#iasis o' the throat. "!o#a! ationa!e: Co$niti%e &e%e!: Cn#erstan#in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: 345E Question 21 Type: MCSA hich o' the 'ollowin$ is an a#verse e''ect o' a beta5a#rener$ic a$onist! 1. )ra#ycar#ia 2. Constipation 3. Tachycar#ia 4. @unny nose Correct Answer: 3 ationa!e 10 )eta5a#rener$ic a$onists cause tachycar#ia% not bra#ycar#ia. ationa!e 20 ;iarrhea can occur with so+e leukotrienes. ationa!e 30 Tachycar#ia is co++on% alon$ with restlessness. ationa!e 40 ;ry +ucous +e+branes can occur. "!o#a! ationa!e: Co$niti%e &e%e!: Cn#erstan#in$
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 Assess+ent &earnin$ *utcome: 345B Question 22 Type: MCMA A nurse is e<plainin$ the process o' respiration to a client. hich in'or+ation shoul# be $iven!

Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply. 1. ,Movin$ air in an# out o' the lun$s is really calle# ventilation.( 2. The s+ooth +uscle in the alveoli helps to pull air into the lun$s. 3. 8<chan$e o' o<y$en an# carbon #io<i#e occurs across a thin capillary +e+brane. 4. @espiration is not e''ective without per'usion. +. Hour basic respiratory #rive is #eter+ine# by your brain. Correct Answer: /%3%6%? ationa!e 10 Ientilation is the process o' +ovin$ air into an# out o' the lun$s. ationa!e 20 There is no s+ooth +uscle in the alveoli. ationa!e 30 The bloo# stays in capillaries. A thin +e+brane separates airway 'ro+ capillary. ationa!e 40 Per'usion is the bloo# 'low throu$h the lun$s. e<chan$e #oes not take place. ithout this bloo# 'low% the o<y$enDcarbon #io<i#e

ationa!e +0 The rate is #eter+ine# by neurons in the brainste+ an# can be a''ecte# by a nu+ber o' 'actors. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 34./ Question 23 Type: MCMA
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

A client says% ,My #octor tol# +e that . have C1P; an# +i$ht #evelop e+physe+a. . always thou$ht . ha# chronic bronchitis.( How shoul# the nurse respon# to this state+ent! Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply. 1. ,Are you certain he #i#nJt say you have asth+a!( 2. ,Chronic bronchitis #oesnJt have anythin$ to #o with C1P;.( 3. ,C1P; is either asth+a% chronic bronchitis% or e+physe+a% or a co+bination o' those #isor#ers. 4. ,As C1P; pro$resses it beco+es e+physe+a.( +. ,)oth #ia$noses are correct.( Correct Answer: 3%6%? ationa!e 10 There woul# be no reason to ask this &uestion. .t is lo$ical that a client with chronic bronchitis woul# have a C1P; #ia$nosis. ationa!e 20 The three speci'ic C1P; con#itions are asth+a% chronic bronchitis% an# e+physe+a. ationa!e 30 The three speci'ic C1P; con#itions are asth+a% chronic bronchitis% an# e+physe+a. ationa!e 40 C1P; is pro$ressive% with the ter+inal sta$e bein$ e+physe+a. ationa!e +0 Chronic bronchitis is a 'or+ o' C1P;% so both #ia$noses are plausible. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 34.E Question 24 Type: MCMA A client #ia$nose# with C1P; says% ,. #onJt see why . nee# to stop s+okin$. The #a+a$e to +y lun$s is alrea#y #one.( How shoul# the nurse respon# to this state+ent! Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

1. ,.' you stop s+okin$ now your C1P; +ay not $et worse as 'ast.( 2. ,.' you stop s+okin$% your lun$s will $et better pretty &uickly.( 3. ,Hour sy+pto+s +i$ht not be as ba# i' you arenJt s+okin$.( 4. ,Hou are probably correct% but you shoul# at least try.( +. ,.' . were you% . woul# enjoy what ti+e . have le't.( Correct Answer: /%3 ationa!e 10 S+okin$ cessation has been shown to slow the pro$ression o' C1P;. ationa!e 20 ;epen#in$ upon the e<tent o' #a+a$e% the clientJs lun$s +ay not $et better at all% but +ay just stop $ettin$ worse. ationa!e 30 S+okin$ cessation has been shown to result in 'ewer respiratory sy+pto+s. ationa!e 40 .t is not therapeutic to tell the client that he is correct with this state+ent. ationa!e +0 The nurse shoul# encoura$e the client to stop s+okin$. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 34.F Question 2+ Type: MCMA A client has been prescribe# a leukotriene +o#i'ier. this prescription! hich assess+ent 'in#in$ woul# cause the nurse to &uestion

Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply. 1. The client is ?6 years ol#. 2. The client reports 're&uent 'oot cra+ps. 3. The client reports #rinkin$ two or three +i<e# alcohol #rinks each #ay.
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

4. The client has chronic hepatitis C. +. The client has a history o' a CIA two years a$o. Correct Answer: 3%6 ationa!e 10 The concern woul# be 'or persons over a$e F? who +ay e<perience increase# 're&uency o' in'ections. ationa!e 20 There is no reason to avoi# $ivin$ this +e#ication to a client who has 'oot cra+ps. ationa!e 30 Chronic alcohol users +ay not tolerate these +e#ications as they are e<tensively +etaboli=e# by the liver. ationa!e 40 Si$ni'icant hepatic #ys'unction is a contrain#ication to this +e#ication as it is e<tensively +etaboli=e# by the liver. ationa!e +0 There is no contrain#ication 'or the use o' this +e#ication in a client with history o' CIA. "!o#a! ationa!e: Co$niti%e &e%e!: Analy=in$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Phar+acolo$ical an# Parenteral Therapies 'ursin$/)nte$rated Concepts: 2ursin$ Process0 8valuation &earnin$ *utcome: 34.F Question 2, Type: MCMA An E5year5ol# chil# was just #ia$nose# with asth+a. an# parents! hich assess+ent &uestions shoul# the nurse ask the chil#

Note: Credit will be given only if all correct choices and no incorrect choices are selected. (tandard Te.t: Select all that apply. 1. ,Have you eaten any new 'oo#s!( 2. ,Are you e<pose# to anyone who s+okes!( 3. ,Have you ha# your carpet cleane# lately!( 4. ,Have you $rown taller since last year!( +. ,Has there been a chan$e in laun#ry pro#ucts recently!(
A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.

Correct Answer: /%9%3%? ationa!e 10 @ecent #iet chan$es shoul# be investi$ate# as a potential source o' asth+a. ationa!e 20 Ci$arette s+oke can tri$$er asth+a. ationa!e 30 @ecent carpet cleanin$ +ay release substances that tri$$er asth+a. ationa!e 40 -rowth rate woul# not likely be a''ecte# in the last year 'or a client with newly #ia$nose# asth+a. ei$ht woul# be +ore likely to be a''ecte# than hei$ht. ationa!e +0 Chan$es in househol# che+icals +ay be relate# to the onset o' asth+a. "!o#a! ationa!e: Co$niti%e &e%e!: Applyin$ C!ient 'eed: Physiolo$ical .nte$rity C!ient 'eed (u#: Physiolo$ical A#aptation 'ursin$/)nte$rated Concepts: 2ursin$ Process0 .+ple+entation &earnin$ *utcome: 34.F

A#a+s, Pharmacology for Nurse: A Pathophysiologic Approach, 678 Copyri$ht 9:/6 by Pearson 8#ucation% .nc.