Chapter 55 Drugs Acting on the Lower Respiratory Tract

Chapter 55  Drugs Acting on the Lower Respiratory Tract

Complete Chapter Questions And Answers
 

Sample Questions

1.
A 70-year-old man is being treated for chronic obstructive pulmonary disease (COPD) with theophylline (Theo-Dur). What will be a priority assessment by the nurse?
A)
Ingestion of fatty foods
B)
Weight
C)
Activity level
D)
Use of nicotine
Ans:
D

Feedback:

Nutritional status, weight, and activity level would be important for a nurse to know about a COPD patient. However, it would be most important for the nurse to know whether the patient smokes or uses tobacco in other ways or smoking cessation methods that involve nicotine. Nicotine increases the metabolism of theophyllines; the dosage may need to be increased to produce a therapeutic effect.

2.
A 6-year-old child weighing 52 pounds has had a loading dose of aminophylline (Truphylline). The nurse is ready to administer the regular prescribed dose of 4 mg/kg every 4 hours for three doses. How many milligram will the patient receive in 12 hours?
A)
44 mg
B)
94 mg
C)
284 mg
D)
344 mg
Ans:
C

Feedback:

First, using the formula: 2.2 pounds and 52 pounds: times kg, determine the child’s weight in kg (52/2.2 = 23.64). Next, using the formula of amount of drug prescribed times weight in kg, determine the amount the child will receive in one dose (4 times 23.64 = 94.56). To determine the mg in a 12-hour period multiply 94.56 times 3 = 283.68. Round to 284 mg. Options A, B, and D are not correct.

3.
A patient is in the clinic to have blood drawn to assess his or her theophylline level. The patient is taking theophylline (Theo-Dur) and appears to being doing well on the drug. He or she reports no problems. What serum level will the nurse expect the patient to have?
A)
Between 0.5 to 5 mcg/mL
B)
Between 10 to 20 mcg/mL
C)
Between 25 to 35 mcg/mL
D)
Between 40 to 50 mcg/mL
Ans:
B

Feedback:

Therapeutic theophylline levels should be between 10 and 20 mcg/mL. A level between 0.5 and 5 mcg/mL would be low and would not produce a therapeutic effect. Levels between 25 and 50 mcg/mL would be too high and could cause serious adverse effects.

4.
A patient presents to the emergency department (ED) having an acute asthma attack. An ED physician has ordered a sympathomimetic (epinephrine). The nurse expects what as the therapeutic effect of this drug?
A)
Decrease the inflammatory response in the airways
B)
Reduce the surface tension within the alveoli allowing for gas exchange
C)
Inhibit the release of histamine and slow-reacting substance of anaphylaxis (SRSA) to prevent the allergic asthmatic response
D)
Cause dilation of the bronchi with increased rate and depth of respiration
Ans:
D

Feedback:

Epinephrine will cause the bronchi to dilate and also cause the rate and depth of respiration to increase. Inhaled steroids decrease the inflammatory response and lung surfactants reduce the surface tension within the alveoli. Mast cell stabilizers inhibit the release of histamine and SRSA to prevent the allergic response. Options A, B, and C are not correct.

5.
An inhaled sympathomimetic drug has been ordered for a teenage athlete who has exercise-induced asthma. What should the patient be instructed to do?
A)
Use the inhaler every day at the same time each day.
B)
Use the inhaler as soon as the symptoms start.
C)
Use the inhaler 30 to 60 minutes before exercising to ensure peak therapeutic levels when needed.
D)
Use the inhaler 2 to 3 hours before exercising to ensure peak effectiveness.
Ans:
C

Feedback:

Teaching a patient about using an inhaled sympathomimetic for management of exercise-induced asthma should include instructions to use the inhaler 30 to 60 minutes before exercising to ensure therapeutic levels when needed. The inhaler would not be used daily and waiting until symptoms occur will be too late for prevention. Options B and D are not correct.