Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 30

Question 1

Type: MCSA

The nurse is caring for a client with asthma. The client asks the nurse what structures make up the upper respiratory tract. Which response by the nurse is the most appropriate?

1. The nose, nasal cavity, pharynx, and paranasal sinuses
2. The lungs and associated structures
3. The nose and paranasal sinuses
4. The nose, nasal cavity, pharynx, and the lungs

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 492

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-1 Identify major structures and functions associated with the respiratory system.

Question 2

Type: MCSA

What is the correct term for blood flow through the lung?

1. Perfusion
2. Inspiration
3. Respiration
4. Expiration

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page number: 492

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-1 Identify major structures and functions associated with the respiratory system.

Question 3

Type: MCSA

A client asks the nurse what ventilation is. What is the most appropriate response by the nurse?

1. “Ventilation is the process by which gases are exchanged.”
2. “Ventilation is the process of moving air into and out of the lungs.”
3. “Ventilation is the blood flow through the lung.”
4. “Ventilation is taking a breath in.”

Cognitive Level: Remembering

Client Need: Health Promotion and Maintenance

Page Number: 492

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-1 Identify major structures and functions associated with the respiratory system.

Question 4

Type: MCMA

The nurse explains to the client why inhalation medications work rapidly. What should the nurse include in the teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. There is a rich blood supply to the lungs.
2. The inside surface of the lungs is small, and the dose is concentrated in that area.
3. There is a large surface area inside the lungs.
4. Inhaled medications are given at very high doses.
5. Inhaled medications are given with food.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 493

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-2 Explain why inhalation is an effective route of drug administration for respiratory medicines.

Question 5

Type: MCSA

The nurse explains to the client the different ways to administer inhalation medications. Which administration technique should not be included in the teaching session?

1. Dry powder inhaler
2. Hypodermic syringe
3. Nebulizer
4. Metered-dose inhaler

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 493

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-2 Explain why inhalation is an effective route of drug administration for respiratory medicines.

Question 6

Type: MCMA

A client has been diagnosed with allergic rhinitis. Which symptoms would the nurse expect to observe? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Nasal congestion
2. Wheezing
3. Watery eyes
4. Sneezing
5. Urticaria

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 495

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-3 Describe common causes and symptoms of allergic rhinitis.

Question 7

Type: MCMA

The client asks the nurse to identify possible causes of allergic rhinitis. Which causes should the nurse include in the client education? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Asthma
2. Dust mites
3. Mold
4. Pollen
5. Tobacco smoke

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 495

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-3 Describe common causes and symptoms of allergic rhinitis.

Question 8

Type: MCMA

The nurse explains common triggers for asthma attacks to a client who was recently diagnosed. Which triggers should the nurse include in the teaching session? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Household dust
2. Aspirin (ASA)
3. Exercise in dry, warm climates
4. Tobacco smoke
5. Acetaminophen (Tylenol)

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Page Number: 503

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-8 Describe the inflammatory and bronchospasm components of asthma.

Question 9

Type: MCSA

During an asthma attack, the bronchioles become swollen and contracted with excessive mucous secretion. How is this manifested in the client?

1. Having fits of coughing
2. Being able to inhale but not exhale
3. Requiring oxygen
4. Going into respiratory arrest

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 502

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-8 Describe the inflammatory and bronchospasm components of asthma.

Question 10

Type: MCSA

Classmates of a hospitalized child want to bring a gift for their friend. Which gift is the most appropriate for this child based on the known causes of asthma?

1. Flowers
2. A stuffed animal
3. A book
4. A plant

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 503

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 30-8 Describe the inflammatory and bronchospasm components of asthma.

Question 11

Type: MCSA

A client asks the nurse what the goal of treatment for allergic rhinitis is. Which response by the nurse is the most appropriate?

1. “Relief of symptoms and suppression of immune system.”
2. “Prevention of symptoms and decreased immune response.”
3. “Prevention of occurrence and relief of symptoms.”
4. “Suppression of cough and immune system.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 495

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-4 Explain the role of antihistamines in the treatment of allergic rhinitis and other allergies.

Question 12

Type: MCSA

The client wants to know why the physician prescribed an inhaled form of a beta-adrenergic stimulator instead of an oral form. What is the best response by the nurse?

1. It produces fewer side effects.
2. It causes bronchodilation.
3. It works quickly to decrease inflammation.
4. It produces little systemic toxicity.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 505

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-9 Explain the role of beta-adrenergic agonists in the treatment of asthma.

Question 13

Type: MCMA

Decongestants should be used with caution in patients with which diagnoses? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Hyperthyroidism
2. Diabetes
3. Hypertension
4. Heart disease
5. Allergic rhinitis

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 501

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-6 Explain the role of decongestants in the treatment of nasal congestion.

Question 14

Type: MCMA

A healthy client asks the nurse what types of medications can be taken for the common cold. Which drug classes should the nurse include in client education? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Antitussives
2. Expectorants
3. Decongestants
4. Antihistamines
5. Antipyretics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 496, 497, and 500–502

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-7 Explain the role of antitussives and expectorants in treating symptoms of the common cold.

Question 15

Type: MCSA

A client asks the nurse what the most commonly used OTC antitussive is. Which response by the nurse is most appropriate?

1. “Dextromethorphan”
2. “Guaifenesin (Mucinex)”
3. “Benzonatate (Tessalon)”
4. “Acetylcysteine (Mucomyst)”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 502

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-7 Explain the role of antitussives and expectorants in treating symptoms of the common cold.

Question 16

Type: MCMA

The client asks the nurse which antihistamines are available as intranasal sprays. Which response by the nurse is most appropriate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Loratadine (Claritin)
2. Diphenhydramine (Benadryl)
3. Olopatadine (Patanase)
4. Azelastine (Astelin)
5. Neo-synephrine (Afrin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 497

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-4 Explain the role of antihistamines in the treatment of allergic rhinitis and other allergies.

Question 17

Type: MCSA

A client has been prescribed fexofenadine (Allegra) for allergic rhinitis. Which statement made by the client indicates the need for further teaching?

1. “This medication is available only in pill form.”
2. “I will take this medication every day to prevent symptoms of allergies.”
3. “I will take this medication only when I have seasonal allergy symptoms.”
4. “This medication does not cause drowsiness.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 497

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-4 Explain the role of antihistamines in the treatment of allergic rhinitis and other allergies.

Question 18

Type: MCSA

The client complains of numbness of the throat and tongue after taking benzonatate (Tessalon). What instruction should the nurse provide for the client?

1. Take one-half the prescribed dose.
2. Swallow the medication whole.
3. Stop taking benzonatate immediately, because this is a life-threatening emergency.
4. Take benzonatate with an antihistamine.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 502

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-7 Explain the role of antitussives and expectorants in treating symptoms of the common cold.

Question 19

Type: MCSA

A client has prescriptions for albuterol (Proventil HFA) and salmeterol (Serevent). Which instruction should the nurse provide for this client?

1. They should not be taken together.
2. The order of administration does not matter.
3. Take salmeterol first.
4. Take albuterol first.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 504

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-9 Explain the role of beta-adrenergic agonists in the treatment of asthma.

Question 20

Type: MCSA

After taking the medication guaifenesin (Mucinex), the client complains of coughing up phlegm. What is the best response by the nurse?

1. This requires further investigation.
2. This is indicative of an allergic reaction.
3. This means there is probably more pathology present.
4. This is normal.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 502

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-7 Explain the role of antitussives and expectorants in treating symptoms of the common cold.

Question 21

Type: MCSA

Xanthines are not as popular as they were 20 years ago. Why has this group of medications lost its popularity?

1. They have a slower onset.
2. They are related to caffeine.
3. They produce less effective bronchodilation.
4. They interact with a large number of other drugs.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 506

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-9 Explain the role of beta-adrenergic agonists in the treatment of asthma.

Question 22

Type: MCSA

The nurse teaches the client that they were prescribed a first-generation antihistamine to avoid alcohol and other CNS depressants. What is the rationale for this particular teaching topic?

1. The antihistamine will not work if combined with alcohol or a CNS depressant.
2. The sedating effects will be increased.
3. The combination will cause insomnia.
4. Anaphylaxis is more likely when antihistamines are taken with alcohol.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 497

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-4 Explain the role of antihistamines in the treatment of allergic rhinitis and other allergies.

Question 23

Type: MCSA

Antihistamines should be used with caution in clients with asthma or COPD. What is the rationale for this caution?

1. Anticholinergic effects of antihistamines can trigger angioedema.
2. Most people with asthma are allergic to antihistamines.
3. Antihistamines cause severe headache when given to clients with COPD or asthma.
4. Anticholinergic effects of antihistamines can trigger bronchospasm.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 498

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-4 Explain the role of antihistamines in the treatment of allergic rhinitis and other allergies.

Question 24

Type: MCSA

A client with asthma asks the nurse which type of medication will decrease inflammation associated with asthma. What is the best response by the nurse?

1. “Corticosteroids.”
2. “Expectorants.”
3. “Bronchodilators.”
4. “Antitussives.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 499

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-10 Explain the role of corticosteroids in the treatment of asthma.

Question 25

Type: MCSA

A client with asthma asks the nurse which type of medication will decrease bronchoconstriction associated with asthma. Which response by the nurse is the most correct?

1. “Bronchodilators.”
2. “Corticosteroids.”
3. “Expectorants.”
4. “Antitussives.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 504

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-9 Explain the role of beta-adrenergic agonists in the treatment of asthma.

Question 26

Type: MCSA

A client with asthma is being discharged after a short stay for an exacerbation of asthma. The nurse is reviewing the medication regimen. The client asks why they are only prescribed an oral corticosteroid for 10 days. Which is the nurse’s response?

1. “I should call the prescriber and confirm.”

2. “You can take it longer.”

3. “Treatment time is usually limited to 10 days and then a reevaluation is necessary.”

4. “Don’t worry about it.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 508

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-10 Explain the role of corticosteroids in the treatment of asthma.

Question 27

Type: MCMA

A nurse is reviewing medications with a client with asthma. The client has been prescribed an intranasal corticosteroids. Which should be included in teaching the client about intranasal corticosteroids? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. The medication will decrease secretion of inflammatory mediators.

2. It takes 2–3 weeks of therapy before optimal benefits are attained.

3. Stop taking all other medications.

4. You may experience a runny nose and sneezing.

5. Follow up with the prescriber in 4 weeks.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 499

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-5 Explain the role of intranasal corticosteroids in the treatment of allergic rhinitis.

Question 28

Type: MCMA

A nurse is reviewing medications with a client with asthma. The client has been prescribed an intranasal corticosteroid but cannot remember the name of the medication. Which medications does the nurse know as intranasal corticosteroids? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Fluticasone (Flonase Allergy Relief)

2. Budesonide (Rhinocort Allergy Spray)

3. Diphenhydramine (Benadryl)

4. Oxymetazoline (Afrin)

5. Triamcinolone (Nasacort)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 499

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-5 Explain the role of intranasal corticosteroids in the treatment of allergic rhinitis.

Question 29

Type: MCSA

A client is prescribed montelukast (Singulair), a leukotriene modifier. Which best describes why this medication was added to the treatment of the client’s asthma?

1. The medication is used for the prophylaxis of asthma.

2. The medication is important for an acute bronchospasm.

3. The medication has serious adverse effects including immunosuppression.

4. The medication should not have been added to the treatment.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 508

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-11 Explain the role of mast cell stabilizers, leukotriene modifiers, and monoclonal antibodies in the treatment of asthma.

Question 30

Type: MCSA

A nurse is teaching a client who has uncontrolled asthma about the addition of two new medications. Cromolyn and montelukast (Singulair) have been added. The client asks why these medications were added. What is the nurse’s best response?

1. They are used as second-line drugs for the treatment of asthma.

2. Both work together in a synergist approach.

3. The prescriber is discontinuing the albuterol (Proventil) and ipratropium (Atrovent).

4. The prescriber is trying something new.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 508

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-11 Explain the role of mast cell stabilizers, leukotriene modifiers, and monoclonal antibodies in the treatment of asthma.

Question 31

Type: MCMA

A nurse is reviewing medications with a client recently diagnosed with COPD. The client asks how they can prevent further exacerbations of the COPD. Which should be included in the plan of care regarding COPD? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Smoking cessation

2. Exercise

3. Healthy eating program

4. Take medications as prescribed

5. Use oxygen therapy as needed

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 509

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-12 Identify the drugs that are used to bring symptomatic relief for patients with chronic obstructive pulmonary disease.

Question 32

Type: MCMA

Which medications are used in the medication treatment plan of COPD? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Bronchodilators

2. Expectorants

3. Mucolytics

4. Antibiotics

5. Oxygen

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 509

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 30-12 Identify the drugs that are used to bring symptomatic relief for patients with chronic obstructive pulmonary disease.