MEDSCI303 | MEDSCI303 Pharmacy Exam 3
Version 2 | Questions with Correct Answers and
Expert Explanation for Each Question | Rajiv
Gandhi University of Health Sciences
1. A patient with asthma is prescribed Albuterol for PRN use. Which of the following
side effects should the nurse include in the patient teaching?
A. Bradycardia
B. Sedation and lethargy
C. Tachycardia and tremors
D. Hypoglycemia
Correct Answer: C
Expert Explanation: Albuterol is a short-acting beta-2 agonist that works by
relaxing bronchial smooth muscle. While it is selective for beta-2 receptors, high
doses or systemic absorption can lead to beta-1 stimulation. This crossover effect
commonly results in tachycardia, palpitations, and fine muscle tremors. Patients
should be informed that these symptoms are common but should be reported if they
become severe. The medication is intended for rescue use rather than daily
maintenance.
,2. What is the primary rationale for instructing a patient to rinse their mouth after
using a Fluticasone inhaler?
A. To improve the absorption of the medication
B. To prevent the development of oral candidiasis
C. To reduce the risk of systemic hypertension
D. To eliminate the bitter aftertaste of the steroid
Correct Answer: B
Expert Explanation: Inhaled corticosteroids like Fluticasone can suppress local
immune responses in the oropharynx. This suppression creates an environment
conducive to the overgrowth of Candida albicans, resulting in oral thrush. Rinsing
the mouth with water and spitting it out helps remove residual drug particles from
the oral mucosa. Consistent hygiene practices significantly reduce the incidence of
this common side effect in long-term therapy. Patients should also be taught to clean
their inhaler spacers regularly to maintain hygiene.
3. A patient is prescribed Salmeterol (Serevent). Which statement by the patient
indicates a need for further teaching?
A. I will use this inhaler twice a day every day.
B. This medication will help prevent my asthma symptoms at night.
C. I will use this inhaler immediately if I feel an asthma attack starting.
,D. I need to keep my rescue inhaler with me even while taking this.
Correct Answer: C
Expert Explanation: Salmeterol is a long-acting beta-2 agonist (LABA) and has a
slow onset of action. It is designed for long-term maintenance and prevention of
bronchospasm rather than acute symptom relief. Using a LABA during an acute
attack is dangerous because it does not act quickly enough to reverse airway
obstruction. Patients must always have a short-acting beta-agonist (SABA) available
for emergency rescue situations. Education should emphasize the distinction
between ‘controller’ and ‘reliever’ medications.
4. Ipratropium bromide (Atrovent) belongs to which class of respiratory medications?
A. Methylxanthines
B. Leukotriene modifiers
C. Anticholinergics
D. Mast cell stabilizers
Correct Answer: C
Expert Explanation: Ipratropium is a short-acting muscarinic antagonist that
blocks acetylcholine receptors in the bronchial smooth muscle. By inhibiting
cholinergic bronchoconstriction, it promotes bronchodilation and reduces mucus
secretion. It is frequently used in the management of COPD and as an adjunct in
, acute asthma exacerbations. Common side effects include dry mouth and irritation
of the throat due to its anticholinergic properties. It is often combined with
albuterol to provide synergistic effects in respiratory distress.
5. A patient taking Theophylline has a serum level of 25 mcg/mL. What is the priority
nursing action?
A. Administer the next scheduled dose as ordered.
B. Document the findings as within the therapeutic range.
C. Increase the patient’s intake of caffeinated beverages.
D. Assess the patient for signs of toxicity and notify the provider.
Correct Answer: D
Expert Explanation: The therapeutic range for theophylline is narrow, typically
between 10 and 20 mcg/mL. A level of 25 mcg/mL is considered toxic and puts the
patient at risk for seizures and cardiac arrhythmias. The nurse must prioritize
patient safety by withholding the drug and assessing for neurological or cardiac
symptoms. Caffeine should be avoided as it can further stimulate the central
nervous system and exacerbate toxicity. Monitoring serum drug levels is a critical
component of managing patients on methylxanthines.
Version 2 | Questions with Correct Answers and
Expert Explanation for Each Question | Rajiv
Gandhi University of Health Sciences
1. A patient with asthma is prescribed Albuterol for PRN use. Which of the following
side effects should the nurse include in the patient teaching?
A. Bradycardia
B. Sedation and lethargy
C. Tachycardia and tremors
D. Hypoglycemia
Correct Answer: C
Expert Explanation: Albuterol is a short-acting beta-2 agonist that works by
relaxing bronchial smooth muscle. While it is selective for beta-2 receptors, high
doses or systemic absorption can lead to beta-1 stimulation. This crossover effect
commonly results in tachycardia, palpitations, and fine muscle tremors. Patients
should be informed that these symptoms are common but should be reported if they
become severe. The medication is intended for rescue use rather than daily
maintenance.
,2. What is the primary rationale for instructing a patient to rinse their mouth after
using a Fluticasone inhaler?
A. To improve the absorption of the medication
B. To prevent the development of oral candidiasis
C. To reduce the risk of systemic hypertension
D. To eliminate the bitter aftertaste of the steroid
Correct Answer: B
Expert Explanation: Inhaled corticosteroids like Fluticasone can suppress local
immune responses in the oropharynx. This suppression creates an environment
conducive to the overgrowth of Candida albicans, resulting in oral thrush. Rinsing
the mouth with water and spitting it out helps remove residual drug particles from
the oral mucosa. Consistent hygiene practices significantly reduce the incidence of
this common side effect in long-term therapy. Patients should also be taught to clean
their inhaler spacers regularly to maintain hygiene.
3. A patient is prescribed Salmeterol (Serevent). Which statement by the patient
indicates a need for further teaching?
A. I will use this inhaler twice a day every day.
B. This medication will help prevent my asthma symptoms at night.
C. I will use this inhaler immediately if I feel an asthma attack starting.
,D. I need to keep my rescue inhaler with me even while taking this.
Correct Answer: C
Expert Explanation: Salmeterol is a long-acting beta-2 agonist (LABA) and has a
slow onset of action. It is designed for long-term maintenance and prevention of
bronchospasm rather than acute symptom relief. Using a LABA during an acute
attack is dangerous because it does not act quickly enough to reverse airway
obstruction. Patients must always have a short-acting beta-agonist (SABA) available
for emergency rescue situations. Education should emphasize the distinction
between ‘controller’ and ‘reliever’ medications.
4. Ipratropium bromide (Atrovent) belongs to which class of respiratory medications?
A. Methylxanthines
B. Leukotriene modifiers
C. Anticholinergics
D. Mast cell stabilizers
Correct Answer: C
Expert Explanation: Ipratropium is a short-acting muscarinic antagonist that
blocks acetylcholine receptors in the bronchial smooth muscle. By inhibiting
cholinergic bronchoconstriction, it promotes bronchodilation and reduces mucus
secretion. It is frequently used in the management of COPD and as an adjunct in
, acute asthma exacerbations. Common side effects include dry mouth and irritation
of the throat due to its anticholinergic properties. It is often combined with
albuterol to provide synergistic effects in respiratory distress.
5. A patient taking Theophylline has a serum level of 25 mcg/mL. What is the priority
nursing action?
A. Administer the next scheduled dose as ordered.
B. Document the findings as within the therapeutic range.
C. Increase the patient’s intake of caffeinated beverages.
D. Assess the patient for signs of toxicity and notify the provider.
Correct Answer: D
Expert Explanation: The therapeutic range for theophylline is narrow, typically
between 10 and 20 mcg/mL. A level of 25 mcg/mL is considered toxic and puts the
patient at risk for seizures and cardiac arrhythmias. The nurse must prioritize
patient safety by withholding the drug and assessing for neurological or cardiac
symptoms. Caffeine should be avoided as it can further stimulate the central
nervous system and exacerbate toxicity. Monitoring serum drug levels is a critical
component of managing patients on methylxanthines.
