Lewis - Chapter 31: Nursing Management: Obstructive Pulmonary Diseases
Exam Questions and Answers With Verified Solutions 2025
The nurse is caring for a client with chronic bronchitis who has a new prescription for a
combined fluticasone and salmeterol inhaler and the client asks the nurse the purpose of
using two drugs. Which of the following information is the basis for the nurse's response?
a. One drug decreases inflammation, and the other is a bronchodilator.
b. It is a combination of long-acting and slow-acting bronchodilators.
c. The combination of two drugs works more quickly in an acute asthma attack.
d. The two drugs work together to block the effects of histamine on the bronchioles. - ✔✔ANS: A
Salmeterol is a long-acting bronchodilator, and fluticasone is a corticosteroid. They work
together to prevent asthma attacks. Neither medication is an antihistamine. The two-drug
combination of salmeterol and fluticasone is not used during an acute attack because the
medications do not work rapidly.
The nurse has completed client teaching about the administration of salmeterol using a
metered-dose inhaler (MDI). Which of the following actions by the client indicates good
understanding of the teaching?
a. The client attaches a spacer before using the MDI.
b. The client coughs vigorously after using the inhaler.
c. The client floats the MDI in water to see if it is empty.
d. The client activates the inhaler at the onset of expiration. - ✔✔ANS: A
Spacers can improve the delivery of medication to the lower airways. The other client
actions indicate a need for further teaching.
The nurse is preparing a client with possible asthma for pulmonary function testing. Which
of the following instructions should the nurse include in the teaching plan?
,a. Avoid eating or drinking for several hours before the testing.
b. Use rescue medications immediately before the tests are done.
c. Take oral corticosteroids at least 2 hours before the examination.
d. Withhold bronchodilators for 6-12 hours before the examination. - ✔✔ANS: D
Bronchodilators are held before pulmonary function testing so that a baseline assessment
of airway function can be determined. Testing is repeated after bronchodilator use to
determine whether the decrease in lung function is reversible. There is no need for the
client to be NPO. Oral corticosteroids also should be held before the examination and
corticosteroids given 2 hours before the examination would be at a high level. Rescue
medications (which are bronchodilators) would not be given until after the baseline
pulmonary function was assessed.
Which of the following information should the nurse include when teaching the client with
asthma about the prescribed medications?
a. Utilize the inhaled corticosteroid when shortness of breath occurs.
b. Inhale slowly and deeply when using the dry-powder inhaler (DPI).
c. Hold your breath for 5 seconds after using the bronchodilator inhaler.
d. Tremors are an expected adverse effect of rapidly acting bronchodilators. - ✔✔ANS: D
Tremors are a common adverse effect of short-acting b2-adrenergic (SABA) medications
and not a reason to avoid using the SABA inhaler. Inhaled corticosteroids do not act
rapidly to reduce dyspnea. Rapid inhalation is needed when using a DPI. The client should
hold the breath for 10 seconds after using inhalers.
The nurse is evaluating the effectiveness of therapy for a client who has received treatment
during an asthma attack. Which of the following findings is the best indicator that the
therapy has been effective?
, a. No wheezes are audible.
b. Oxygen saturation is >92%.
c. Accessory muscle use has decreased.
d. Respiratory rate is 16 breaths/minute. - ✔✔ANS: B
The goal for treatment of an asthma attack is to keep the oxygen saturation >92%. The
other client data may occur when the client is too fatigued to continue with the increased
work of breathing required in an asthma attack.
The nurse is assessing a client in the asthma clinic who has recorded daily peak flows that
are 85% of the baseline. Which of the following actions should the nurse plan to take?
a. Teach the client about the use of oral corticosteroids.
b. Administer a bronchodilator and recheck the peak flow.
c. Instruct the client to continue to use current medications.
d. Evaluate whether the peak flowmeter is being used correctly. - ✔✔ANS: C
The client's peak flow readings indicate good asthma control (values over 80%), and no
changes are needed. The other actions would be used for clients in the yellow or red zones
for peak flow.
Which of the following actions by a client who has asthma indicates a good understanding
of the nurse's teaching about peak flowmeter use?
a. The client records an average of three peak flow readings every day.
b. The client inhales rapidly through the peak flowmeter mouthpiece.
c. The client uses the albuterol metered-dose inhaler (MDI) for peak flows in the
yellow zone.
d. The client calls the health care provider when the peak flow is in the green zone. - ✔✔ANS: C
Readings in the yellow zone indicate a decrease in peak flow; the client should use
short-acting b2-adrenergic (SABA) medications. The best of three peak flow readings
Exam Questions and Answers With Verified Solutions 2025
The nurse is caring for a client with chronic bronchitis who has a new prescription for a
combined fluticasone and salmeterol inhaler and the client asks the nurse the purpose of
using two drugs. Which of the following information is the basis for the nurse's response?
a. One drug decreases inflammation, and the other is a bronchodilator.
b. It is a combination of long-acting and slow-acting bronchodilators.
c. The combination of two drugs works more quickly in an acute asthma attack.
d. The two drugs work together to block the effects of histamine on the bronchioles. - ✔✔ANS: A
Salmeterol is a long-acting bronchodilator, and fluticasone is a corticosteroid. They work
together to prevent asthma attacks. Neither medication is an antihistamine. The two-drug
combination of salmeterol and fluticasone is not used during an acute attack because the
medications do not work rapidly.
The nurse has completed client teaching about the administration of salmeterol using a
metered-dose inhaler (MDI). Which of the following actions by the client indicates good
understanding of the teaching?
a. The client attaches a spacer before using the MDI.
b. The client coughs vigorously after using the inhaler.
c. The client floats the MDI in water to see if it is empty.
d. The client activates the inhaler at the onset of expiration. - ✔✔ANS: A
Spacers can improve the delivery of medication to the lower airways. The other client
actions indicate a need for further teaching.
The nurse is preparing a client with possible asthma for pulmonary function testing. Which
of the following instructions should the nurse include in the teaching plan?
,a. Avoid eating or drinking for several hours before the testing.
b. Use rescue medications immediately before the tests are done.
c. Take oral corticosteroids at least 2 hours before the examination.
d. Withhold bronchodilators for 6-12 hours before the examination. - ✔✔ANS: D
Bronchodilators are held before pulmonary function testing so that a baseline assessment
of airway function can be determined. Testing is repeated after bronchodilator use to
determine whether the decrease in lung function is reversible. There is no need for the
client to be NPO. Oral corticosteroids also should be held before the examination and
corticosteroids given 2 hours before the examination would be at a high level. Rescue
medications (which are bronchodilators) would not be given until after the baseline
pulmonary function was assessed.
Which of the following information should the nurse include when teaching the client with
asthma about the prescribed medications?
a. Utilize the inhaled corticosteroid when shortness of breath occurs.
b. Inhale slowly and deeply when using the dry-powder inhaler (DPI).
c. Hold your breath for 5 seconds after using the bronchodilator inhaler.
d. Tremors are an expected adverse effect of rapidly acting bronchodilators. - ✔✔ANS: D
Tremors are a common adverse effect of short-acting b2-adrenergic (SABA) medications
and not a reason to avoid using the SABA inhaler. Inhaled corticosteroids do not act
rapidly to reduce dyspnea. Rapid inhalation is needed when using a DPI. The client should
hold the breath for 10 seconds after using inhalers.
The nurse is evaluating the effectiveness of therapy for a client who has received treatment
during an asthma attack. Which of the following findings is the best indicator that the
therapy has been effective?
, a. No wheezes are audible.
b. Oxygen saturation is >92%.
c. Accessory muscle use has decreased.
d. Respiratory rate is 16 breaths/minute. - ✔✔ANS: B
The goal for treatment of an asthma attack is to keep the oxygen saturation >92%. The
other client data may occur when the client is too fatigued to continue with the increased
work of breathing required in an asthma attack.
The nurse is assessing a client in the asthma clinic who has recorded daily peak flows that
are 85% of the baseline. Which of the following actions should the nurse plan to take?
a. Teach the client about the use of oral corticosteroids.
b. Administer a bronchodilator and recheck the peak flow.
c. Instruct the client to continue to use current medications.
d. Evaluate whether the peak flowmeter is being used correctly. - ✔✔ANS: C
The client's peak flow readings indicate good asthma control (values over 80%), and no
changes are needed. The other actions would be used for clients in the yellow or red zones
for peak flow.
Which of the following actions by a client who has asthma indicates a good understanding
of the nurse's teaching about peak flowmeter use?
a. The client records an average of three peak flow readings every day.
b. The client inhales rapidly through the peak flowmeter mouthpiece.
c. The client uses the albuterol metered-dose inhaler (MDI) for peak flows in the
yellow zone.
d. The client calls the health care provider when the peak flow is in the green zone. - ✔✔ANS: C
Readings in the yellow zone indicate a decrease in peak flow; the client should use
short-acting b2-adrenergic (SABA) medications. The best of three peak flow readings
