UNDERSTANDING PATHO EXAM SUCCESS: ULTIMATE
A+, QUESTIONS AND ANSWERS BREAKDOWN
A patient is prescribed two different types of inhaled medications for treatment of chronic obstructive
pulmonary disease (COPD). After administering the first medication, how long should the nurse wait
to administer the second medication?
Five minutes
Rationale: If a second puff of the same drug is ordered, instruct the patient to wait 1 to 2 minutes
between puffs. If a second type of inhaled drug is ordered, instruct the patient wait 2 to 5 minutes
between the medications or to take as prescribed. Bronchodilators are usually administered first.
The nurse is providing teaching to a group of individuals with chronic obstructive pulmonary disease
(COPD) at a community center. Which statement by one of the attendees indicates that further
teaching is needed?
"If I develop a puffy face, I will stop taking methylprednisolone (Medrol) immediately."
Rationale: Patients should be taught to not stop systemic corticosteroids abruptly. The patient should be
educated about the possibility of Addisonian crisis, which may occur if a systemic corticosteroid is
abruptly discontinued. These drugs require weaning prior to discontinuation of the medication. Patients
should monitor their weight daily and report the increase stated. Omalizumab (Xolair) is used for the
treatment of moderate to severe asthma and not for aborting acute asthma attacks. Adverse effects of
theophylline (Theo-Dur) that should be reported immediately to the prescriber include epigastric pain.
One of the attendees expresses concern regarding her granddaughter's asthma. The attendee tells the
nurse that she is afraid that she will not know which of her granddaughter's medications to give first
in case of an asthma attack. Which medication should the nurse inform the attendee to administer
first for an acute asthma attack?
albuterol (Proventil)
Rationale: Albuterol (Proventil) is a short-acting beta2 agonist indicated for treatment of acute asthma
attacks. Ipratropium (Atrovent) is an anticholinergic not indicated for treatment of acute asthma attacks.
Budesonide (Pulmicort Turbuhaler) is an inhaled corticosteroid that should not be used in an acute
asthma attack. Montelukast (Singulair) is a leukotriene receptor agonist used for long-term management
of asthma, not for acute exacerbations.
A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug
will most likely be ordered for this patient?
captopril.
Which statement about angiotensin II receptor blockers does the nurse identify as being true?
Upper respiratory infection is a common adverse effect.
,A patient is mowing his lawn on a hot Saturday afternoon. He begins to notice chest pain. What
should his first action be?
Stop mowing and sit or lie down.
A patient with extremely high blood pressure is in the emergency department. The physician will be
ordering therapy with nitroglycerin to manage the patient's blood pressure. Which form of
nitroglycerin is most appropriate?
IV infusion
A patient who was walking his dog developed chest pain and sat down. He continues to experience
chest pain when sitting down. When should he call 911?
If one sublingual tablet does not relieve the pain after 5 minutes.
A patient who has had a myocardial infarction is on a beta blocker. What is the main benefit of beta
blocker therapy for this patient?
Slowing of the heart rate
One of the patients asks the nurse to tell her more about a new drug the patient has been prescribed
called ranolazine (Ranexa). Which response by the nurse is accurate?
"We do not know how Ranexa works."
What information will the nurse include when teaching the patients about taking beta2-blocking
drugs for the treatment of angina?
"Call your health care provider if you experience a weight gain of 2 pounds or more in 24 hours or 5
pounds or more in 1 week."
A patient asks how to apply transdermal nitroglycerin. What is the nurse's best response?
"Apply the patch to hairless areas of the body."
Angiotensin II Receptor Blockers (ARBs) end with?
sartan, Examples: valsartan, candesartan.
The patient is prescribed an ACE inhibitor. The nurse understands the primary mechanism by which
the ACE inhibitors exert their therapeutic effect in a patient in heart failure is:
to inhibit aldosterone secretion.
A patient is receiving digoxin 0.25 mg daily as part of treatment for heart failure. The nurse assesses
the patient before medication administration. Which assessment finding would be of most concern?
Serum potassium level of 2.9 mEq/L.
A patient has received an IV dose of adenosine, and almost immediately the heart monitor shows
asystole. What should the nurse do next?
Continue to monitor the patient
, A patient is in the emergency department with an unspecified supraventricular dysrhythmia. The
physician orders a dose of diltiazem (Cardizem) IV push. While the nurse administers the medication
through the IV lock, the patient states she feels something wet spilling on her arm. Her heart rate was
unchanged. What will the nurse do next?
Check the IV lock to see if it is functioning properly.
Prior to administering an antihistamine to a patient, it is most important for the nurse to assess the
patient for a history of which condition?
Urinary retention.
A 94-year-old patient has a severe dry cough. He has coughed so hard that the muscles in his chest are
hurting. He is unsteady on his feet and slightly confused. Which drug would be the best choice for this
patient's cough?
dextromethorphan (Robitussin-DM) oral solution.
A patient with a tracheostomy developed pneumonia. It is very difficult for the patient to cough up
the thick, dry secretions he has developed. The nurse identifies which drug as being most effective in
helping this patient?
.guaifenesin (Mucinex).
Which medication will the nurse teach a patient with asthma to use when experiencing an acute
asthma attack?
albuterol (ventolin)
A patient with chronic bronchitis calls the office for a refill of his albuterol inhaler. He just had the
prescription filled 2 weeks ago, but he says it is empty. When asked, he tells the nurse, "I use it
whenever I need it, but now when I use it I feel so sick. I've been needing to use it more often." What
is the most appropriate action by the nurse?
The nurse should ask the patient to come to the office for an evaluation of his respiratory status.
A patient is prescribed two different types of inhaled medications for treatment of chronic obstructive
pulmonary disease (COPD). After administering the first medication, how long should the nurse wait
to administer the second medication?
5 minutes
What is the most important thing for the nurse to teach a patient who is switching allergy medications
from diphenhydramine (Benadryl) to loratadine (Claritin)?
1
Loratadine can potentially cause dysrhythmias.
2
Loratadine has fewer sedative effects.
3
Loratadine has increased bronchodilating effects.
A+, QUESTIONS AND ANSWERS BREAKDOWN
A patient is prescribed two different types of inhaled medications for treatment of chronic obstructive
pulmonary disease (COPD). After administering the first medication, how long should the nurse wait
to administer the second medication?
Five minutes
Rationale: If a second puff of the same drug is ordered, instruct the patient to wait 1 to 2 minutes
between puffs. If a second type of inhaled drug is ordered, instruct the patient wait 2 to 5 minutes
between the medications or to take as prescribed. Bronchodilators are usually administered first.
The nurse is providing teaching to a group of individuals with chronic obstructive pulmonary disease
(COPD) at a community center. Which statement by one of the attendees indicates that further
teaching is needed?
"If I develop a puffy face, I will stop taking methylprednisolone (Medrol) immediately."
Rationale: Patients should be taught to not stop systemic corticosteroids abruptly. The patient should be
educated about the possibility of Addisonian crisis, which may occur if a systemic corticosteroid is
abruptly discontinued. These drugs require weaning prior to discontinuation of the medication. Patients
should monitor their weight daily and report the increase stated. Omalizumab (Xolair) is used for the
treatment of moderate to severe asthma and not for aborting acute asthma attacks. Adverse effects of
theophylline (Theo-Dur) that should be reported immediately to the prescriber include epigastric pain.
One of the attendees expresses concern regarding her granddaughter's asthma. The attendee tells the
nurse that she is afraid that she will not know which of her granddaughter's medications to give first
in case of an asthma attack. Which medication should the nurse inform the attendee to administer
first for an acute asthma attack?
albuterol (Proventil)
Rationale: Albuterol (Proventil) is a short-acting beta2 agonist indicated for treatment of acute asthma
attacks. Ipratropium (Atrovent) is an anticholinergic not indicated for treatment of acute asthma attacks.
Budesonide (Pulmicort Turbuhaler) is an inhaled corticosteroid that should not be used in an acute
asthma attack. Montelukast (Singulair) is a leukotriene receptor agonist used for long-term management
of asthma, not for acute exacerbations.
A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug
will most likely be ordered for this patient?
captopril.
Which statement about angiotensin II receptor blockers does the nurse identify as being true?
Upper respiratory infection is a common adverse effect.
,A patient is mowing his lawn on a hot Saturday afternoon. He begins to notice chest pain. What
should his first action be?
Stop mowing and sit or lie down.
A patient with extremely high blood pressure is in the emergency department. The physician will be
ordering therapy with nitroglycerin to manage the patient's blood pressure. Which form of
nitroglycerin is most appropriate?
IV infusion
A patient who was walking his dog developed chest pain and sat down. He continues to experience
chest pain when sitting down. When should he call 911?
If one sublingual tablet does not relieve the pain after 5 minutes.
A patient who has had a myocardial infarction is on a beta blocker. What is the main benefit of beta
blocker therapy for this patient?
Slowing of the heart rate
One of the patients asks the nurse to tell her more about a new drug the patient has been prescribed
called ranolazine (Ranexa). Which response by the nurse is accurate?
"We do not know how Ranexa works."
What information will the nurse include when teaching the patients about taking beta2-blocking
drugs for the treatment of angina?
"Call your health care provider if you experience a weight gain of 2 pounds or more in 24 hours or 5
pounds or more in 1 week."
A patient asks how to apply transdermal nitroglycerin. What is the nurse's best response?
"Apply the patch to hairless areas of the body."
Angiotensin II Receptor Blockers (ARBs) end with?
sartan, Examples: valsartan, candesartan.
The patient is prescribed an ACE inhibitor. The nurse understands the primary mechanism by which
the ACE inhibitors exert their therapeutic effect in a patient in heart failure is:
to inhibit aldosterone secretion.
A patient is receiving digoxin 0.25 mg daily as part of treatment for heart failure. The nurse assesses
the patient before medication administration. Which assessment finding would be of most concern?
Serum potassium level of 2.9 mEq/L.
A patient has received an IV dose of adenosine, and almost immediately the heart monitor shows
asystole. What should the nurse do next?
Continue to monitor the patient
, A patient is in the emergency department with an unspecified supraventricular dysrhythmia. The
physician orders a dose of diltiazem (Cardizem) IV push. While the nurse administers the medication
through the IV lock, the patient states she feels something wet spilling on her arm. Her heart rate was
unchanged. What will the nurse do next?
Check the IV lock to see if it is functioning properly.
Prior to administering an antihistamine to a patient, it is most important for the nurse to assess the
patient for a history of which condition?
Urinary retention.
A 94-year-old patient has a severe dry cough. He has coughed so hard that the muscles in his chest are
hurting. He is unsteady on his feet and slightly confused. Which drug would be the best choice for this
patient's cough?
dextromethorphan (Robitussin-DM) oral solution.
A patient with a tracheostomy developed pneumonia. It is very difficult for the patient to cough up
the thick, dry secretions he has developed. The nurse identifies which drug as being most effective in
helping this patient?
.guaifenesin (Mucinex).
Which medication will the nurse teach a patient with asthma to use when experiencing an acute
asthma attack?
albuterol (ventolin)
A patient with chronic bronchitis calls the office for a refill of his albuterol inhaler. He just had the
prescription filled 2 weeks ago, but he says it is empty. When asked, he tells the nurse, "I use it
whenever I need it, but now when I use it I feel so sick. I've been needing to use it more often." What
is the most appropriate action by the nurse?
The nurse should ask the patient to come to the office for an evaluation of his respiratory status.
A patient is prescribed two different types of inhaled medications for treatment of chronic obstructive
pulmonary disease (COPD). After administering the first medication, how long should the nurse wait
to administer the second medication?
5 minutes
What is the most important thing for the nurse to teach a patient who is switching allergy medications
from diphenhydramine (Benadryl) to loratadine (Claritin)?
1
Loratadine can potentially cause dysrhythmias.
2
Loratadine has fewer sedative effects.
3
Loratadine has increased bronchodilating effects.
