NUR 398 NONINFECTIOUS LOWER RESPIRATORY
PROBLEMS: ASTHMA & COPD QUESTIONS
Which medication is an example of a long-acting beta 2 agonist (LABA) used in asthma
management?
1
Albuterol
2
Salmeterol
3
Terbutaline
4
Levalbuterol - Answers - 2
Salmeterol is a LABA. Albuterol, levalbuterol, and terbutaline are all short-acting beta 2
agonists (SABAs).
What is the rationale behind prescribing digoxin and diuretics to a patient with
pulmonary arterial hypertension?
1
To reduce dyspnea
2
To prevent clot formation
3
To improve cardiac function
4
To cure pulmonary arterial hypertension - Answers - 3
The heart of a patient with pulmonary arterial hypertension undergoes hypertrophy and
decreased cardiac function. Therefore, digoxin and diuretics are prescribed to improve
cardiac function. Calcium channel blockers are prescribed to dilate blood vessels.
Oxygen therapy is used to reduce dyspnea and to ensure proper oxygen supply.
Digoxin and diuretics do not cure pulmonary arterial hypertension completely.
Why are agonist and beta-adrenergic drugs ineffective in treating asthma in older
adults?
1
Because of decreased sensitivity of receptors
2
Because of quick response to reliever therapy
3
Because of no response from reliever therapy
4
Because of the receptors causing bronchodilation - Answers - 1
With increasing age, the agonist and beta-adrenergic receptors become less sensitive.
The decreased sensitivity of receptors leads to diminished response to agonist and beta
,receptor drugs. Aging slows, not quickens, response to reliever drug therapy, so the
expected smooth muscle relaxation and bronchodilation is less. Despite the aging
process, older adults still retain some response to reliever therapy. Bronchodilation is
the desired response, so it is not a sign of ineffective drug therapy.Test-Taking Tip:
Identify option components as correct or incorrect. This may help you identify a wrong
answer.
Which individual does the nurse identify as being more likely to have primary pulmonary
arterial hypertension?
1
A male child of 10 years
2
An adult male of 40 years
3
A female child of 14 years
4
An adult woman of 30 years - Answers - 4
Primary pulmonary arterial hypertension is common in women between the ages of 20
and 40 years. Therefore, an adult woman of 30 years is most likely to have primary
pulmonary arterial hypertension. A male child of 10 years, an adult male of 40 years,
and a female child of 14 years are less likely to have primary pulmonary arterial
hypertension.
Which non-pulmonary manifestation of cystic fibrosis is commonly seen in this patient
population?
1
Vitamin toxicity
2
Increased weight
3
Excessive fat in stools
4
Increased insulin production - Answers - 3
Cystic fibrosis causes steatorrhea, a non-pulmonary manifestation which is
characterized by excessive fat in the stools resulting from malabsorption and
malnourishment. Vitamin deficiencies, not vitamin toxicities, also contribute to this. A
patient with cystic fibrosis is thin, not overweight, as a result of malabsorption.
Pancreatic function is decreased in cystic fibrosis patients resulting in diabetes mellitus;
therefore insulin production is decreased.Test-Taking Tip: Identify option components
as correct or incorrect. This may help you identify a wrong answer.
Inhaled corticosteroids are typically used to treat which symptom of asthma?
1
Bronchial spasms
2
Airway inflammation
,3
Bronchial secretions
4
Airway hyperresponsiveness - Answers - 2
Inhaled corticosteroids are given to minimize inflammation and do so partly by
preventing the synthesis of chemical mediators of inflammation. By preventing
inflammation, they indirectly make hyperresponsive episodes less frequent and will
decrease bronchial spasms and possibly bronchial secretions.
How does chest physiotherapy benefit a patient with cystic fibrosis (CF) through
relieving symptoms?
1
It increases vascular resistance in the lungs.
2
It stops excess production of mucus in the lungs.
3
It creates mini-coughs to dislodge the mucus from the lungs.
4
It decreases the constriction of the bronchiolar smooth muscle. - Answers - 3
Chest physiotherapy uses chest percussion, chest vibration, and dependent drainage to
loosen secretions and promote drainage. This therapy encourages mini-coughs that
dislodge the mucus from the bronchial walls and increase mobilization. This mucus
moves toward the central airways where it can be removed by coughing or suctioning.
Vascular resistance in the lungs is seen in patients with pulmonary arterial hypertension
(PAH). Drug therapy helps in the management of excess mucus production in patients
with cystic fibrosis (CF). Bronchodilator drugs help in the relaxation of the smooth
muscles in patients with asthma.Test-Taking Tip: Read the question, and relate the
patient's condition to the management performed. Then select the option which shows
the effective outcome.
Which symptom would be found in a patient with respiratory muscle fatigue?
1
Silent chest on auscultation
2
Slow breathing with deep respirations
3
Respiratory rate of 25 to 35 per minute
4
Sucked-in abdominal wall during inspiration - Answers - 4
In patients with respiratory muscle fatigue, the abdominal wall is sucked in during
inspiration. Patients with serious airflow obstruction or pneumothorax may have a silent
chest on auscultation. Patients with respiratory muscle fatigue breathe with rapid,
shallow respirations, and the respiratory rate could be as high as 40 to 50 breaths/min.
The patient is a marathon runner who has asthma. Which category of medication is
used as a rescue inhaler?
, 1
Corticosteroids
2
Long-acting beta agonists
3
Short-acting beta agonists
4
Nonsteroidal anti-inflammatory drugs (NSAIDs) - Answers - 3
Short-acting beta agonist medications have a rapid onset and cause bronchodilation;
they would be excellent for marathon running because some types of asthma may be
exercise induced. Corticosteroids disrupt production pathways of inflammatory
mediators. Maximum effectiveness requires 48 to 72 hours of continued use, therefore,
they are not appropriate as a rescue medication. Long-acting beta agonists do cause
bronchodilation but have a slow onset; they are not used as rescue inhalers. NSAIDs
stabilize the membranes of mast cells and prevent release of inflammatory mediators.
They have a slow onset of action and are used for prevention of symptoms, not as
rescue medication.
The nurse is caring for patient with severe emphysema who asks for assistance with
meal and snack choices for the next day. Which snack selection is best for the nurse to
advise this patient to make?
1
Bean soup with crackers
2
Apple slices and caramel dip
3
Chocolate ice cream shake
4
Salted cheese crackers - Answers - 3
High-calorie, high-protein meals are recommended to prevent weight loss in patients
with severe lung disease. A chocolate ice cream shake is the best snack of those listed
because it is high in calories and protein and it is thick and cool on the throat which
promotes safer swallowing. Apple slices are low-calorie and low in protein. Beans are
gas-producing foods that can cause abdominal bloating. Salted cheese crackers are dry
and can induce coughing.Test-Taking Tip: Study wisely, not hard. Use study strategies
to save time and be able to get a good night's sleep the night before your exam.
Cramming is not smart, and it is hard work that increases stress while reducing learning.
When you cram, your mind is more likely to go blank during a test. When you cram, the
information is in your short-term memory so you will need to relearn it before a
comprehensive exam. Relearning takes more time. The stress caused by cramming
may interfere with your sleep. Your brain needs sleep to function at its best.
Which statements are correct regarding the drug management of asthma? Select all
that apply.
1
Anti-inflammatory medications are used to cause bronchodilation.
PROBLEMS: ASTHMA & COPD QUESTIONS
Which medication is an example of a long-acting beta 2 agonist (LABA) used in asthma
management?
1
Albuterol
2
Salmeterol
3
Terbutaline
4
Levalbuterol - Answers - 2
Salmeterol is a LABA. Albuterol, levalbuterol, and terbutaline are all short-acting beta 2
agonists (SABAs).
What is the rationale behind prescribing digoxin and diuretics to a patient with
pulmonary arterial hypertension?
1
To reduce dyspnea
2
To prevent clot formation
3
To improve cardiac function
4
To cure pulmonary arterial hypertension - Answers - 3
The heart of a patient with pulmonary arterial hypertension undergoes hypertrophy and
decreased cardiac function. Therefore, digoxin and diuretics are prescribed to improve
cardiac function. Calcium channel blockers are prescribed to dilate blood vessels.
Oxygen therapy is used to reduce dyspnea and to ensure proper oxygen supply.
Digoxin and diuretics do not cure pulmonary arterial hypertension completely.
Why are agonist and beta-adrenergic drugs ineffective in treating asthma in older
adults?
1
Because of decreased sensitivity of receptors
2
Because of quick response to reliever therapy
3
Because of no response from reliever therapy
4
Because of the receptors causing bronchodilation - Answers - 1
With increasing age, the agonist and beta-adrenergic receptors become less sensitive.
The decreased sensitivity of receptors leads to diminished response to agonist and beta
,receptor drugs. Aging slows, not quickens, response to reliever drug therapy, so the
expected smooth muscle relaxation and bronchodilation is less. Despite the aging
process, older adults still retain some response to reliever therapy. Bronchodilation is
the desired response, so it is not a sign of ineffective drug therapy.Test-Taking Tip:
Identify option components as correct or incorrect. This may help you identify a wrong
answer.
Which individual does the nurse identify as being more likely to have primary pulmonary
arterial hypertension?
1
A male child of 10 years
2
An adult male of 40 years
3
A female child of 14 years
4
An adult woman of 30 years - Answers - 4
Primary pulmonary arterial hypertension is common in women between the ages of 20
and 40 years. Therefore, an adult woman of 30 years is most likely to have primary
pulmonary arterial hypertension. A male child of 10 years, an adult male of 40 years,
and a female child of 14 years are less likely to have primary pulmonary arterial
hypertension.
Which non-pulmonary manifestation of cystic fibrosis is commonly seen in this patient
population?
1
Vitamin toxicity
2
Increased weight
3
Excessive fat in stools
4
Increased insulin production - Answers - 3
Cystic fibrosis causes steatorrhea, a non-pulmonary manifestation which is
characterized by excessive fat in the stools resulting from malabsorption and
malnourishment. Vitamin deficiencies, not vitamin toxicities, also contribute to this. A
patient with cystic fibrosis is thin, not overweight, as a result of malabsorption.
Pancreatic function is decreased in cystic fibrosis patients resulting in diabetes mellitus;
therefore insulin production is decreased.Test-Taking Tip: Identify option components
as correct or incorrect. This may help you identify a wrong answer.
Inhaled corticosteroids are typically used to treat which symptom of asthma?
1
Bronchial spasms
2
Airway inflammation
,3
Bronchial secretions
4
Airway hyperresponsiveness - Answers - 2
Inhaled corticosteroids are given to minimize inflammation and do so partly by
preventing the synthesis of chemical mediators of inflammation. By preventing
inflammation, they indirectly make hyperresponsive episodes less frequent and will
decrease bronchial spasms and possibly bronchial secretions.
How does chest physiotherapy benefit a patient with cystic fibrosis (CF) through
relieving symptoms?
1
It increases vascular resistance in the lungs.
2
It stops excess production of mucus in the lungs.
3
It creates mini-coughs to dislodge the mucus from the lungs.
4
It decreases the constriction of the bronchiolar smooth muscle. - Answers - 3
Chest physiotherapy uses chest percussion, chest vibration, and dependent drainage to
loosen secretions and promote drainage. This therapy encourages mini-coughs that
dislodge the mucus from the bronchial walls and increase mobilization. This mucus
moves toward the central airways where it can be removed by coughing or suctioning.
Vascular resistance in the lungs is seen in patients with pulmonary arterial hypertension
(PAH). Drug therapy helps in the management of excess mucus production in patients
with cystic fibrosis (CF). Bronchodilator drugs help in the relaxation of the smooth
muscles in patients with asthma.Test-Taking Tip: Read the question, and relate the
patient's condition to the management performed. Then select the option which shows
the effective outcome.
Which symptom would be found in a patient with respiratory muscle fatigue?
1
Silent chest on auscultation
2
Slow breathing with deep respirations
3
Respiratory rate of 25 to 35 per minute
4
Sucked-in abdominal wall during inspiration - Answers - 4
In patients with respiratory muscle fatigue, the abdominal wall is sucked in during
inspiration. Patients with serious airflow obstruction or pneumothorax may have a silent
chest on auscultation. Patients with respiratory muscle fatigue breathe with rapid,
shallow respirations, and the respiratory rate could be as high as 40 to 50 breaths/min.
The patient is a marathon runner who has asthma. Which category of medication is
used as a rescue inhaler?
, 1
Corticosteroids
2
Long-acting beta agonists
3
Short-acting beta agonists
4
Nonsteroidal anti-inflammatory drugs (NSAIDs) - Answers - 3
Short-acting beta agonist medications have a rapid onset and cause bronchodilation;
they would be excellent for marathon running because some types of asthma may be
exercise induced. Corticosteroids disrupt production pathways of inflammatory
mediators. Maximum effectiveness requires 48 to 72 hours of continued use, therefore,
they are not appropriate as a rescue medication. Long-acting beta agonists do cause
bronchodilation but have a slow onset; they are not used as rescue inhalers. NSAIDs
stabilize the membranes of mast cells and prevent release of inflammatory mediators.
They have a slow onset of action and are used for prevention of symptoms, not as
rescue medication.
The nurse is caring for patient with severe emphysema who asks for assistance with
meal and snack choices for the next day. Which snack selection is best for the nurse to
advise this patient to make?
1
Bean soup with crackers
2
Apple slices and caramel dip
3
Chocolate ice cream shake
4
Salted cheese crackers - Answers - 3
High-calorie, high-protein meals are recommended to prevent weight loss in patients
with severe lung disease. A chocolate ice cream shake is the best snack of those listed
because it is high in calories and protein and it is thick and cool on the throat which
promotes safer swallowing. Apple slices are low-calorie and low in protein. Beans are
gas-producing foods that can cause abdominal bloating. Salted cheese crackers are dry
and can induce coughing.Test-Taking Tip: Study wisely, not hard. Use study strategies
to save time and be able to get a good night's sleep the night before your exam.
Cramming is not smart, and it is hard work that increases stress while reducing learning.
When you cram, your mind is more likely to go blank during a test. When you cram, the
information is in your short-term memory so you will need to relearn it before a
comprehensive exam. Relearning takes more time. The stress caused by cramming
may interfere with your sleep. Your brain needs sleep to function at its best.
Which statements are correct regarding the drug management of asthma? Select all
that apply.
1
Anti-inflammatory medications are used to cause bronchodilation.
