NCLEX-RN Respiratory Pharmacology
Exam Questions & Rationales
20 Original NGN NCLEX Practice MCQs
Asthma, COPD, Inhalers, Oxygen
Therapy, Nursing Pharmacology Study
Guide
Question 1
Clinical Scenario
A 22-year-old client with acute asthma exacerbation arrives in
the emergency department with wheezing, shortness of breath,
and an oxygen saturation of 89% on room air. The provider
prescribes albuterol via nebulizer.
Question Stem
Which finding indicates the albuterol treatment is having the
desired therapeutic effect?
A. Heart rate decreases from 110/min to 70/min
B. Respiratory wheezing decreases and oxygen saturation
improves to 95%
,C. Blood pressure decreases from 138/84 mm Hg to 108/60 mm
Hg
D. Respiratory rate decreases from 28/min to 10/min
Correct Answer
Correct Answer: B. Respiratory wheezing decreases and
oxygen saturation improves to 95%
Detailed Rationale
Albuterol is a short-acting beta2-adrenergic agonist (SABA) that
relaxes bronchial smooth muscle and rapidly improves airflow.
The primary therapeutic goal during an asthma exacerbation is
bronchodilation, resulting in decreased wheezing, improved
oxygenation, and reduced work of breathing. Therefore,
improved oxygen saturation and reduced wheezing indicate
effective treatment.
Option A is incorrect because heart rate reduction is not the
primary indicator of therapeutic effectiveness. In fact, albuterol
commonly causes mild tachycardia.
Option C is incorrect because blood pressure changes are not
the intended therapeutic outcome of albuterol therapy.
Option D is incorrect because a respiratory rate of 10/min may
indicate respiratory depression rather than improvement.
Nurses should assess lung sounds, respiratory effort, oxygen
saturation, and symptom relief following administration.
,Common adverse effects include tremors, nervousness, and
tachycardia. Frequent use of rescue inhalers may indicate
poorly controlled asthma and should prompt provider
evaluation.
Learning Objective
After completing this question, the learner should be able to:
• Identify the therapeutic effects of albuterol.
• Evaluate response to bronchodilator therapy.
• Recognize expected adverse effects of beta2 agonists.
• Monitor respiratory status during asthma treatment.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 67-year-old client with chronic obstructive pulmonary disease
(COPD) is prescribed tiotropium inhalation daily. During
discharge teaching, the nurse evaluates the client's
understanding.
Question Stem
, Which statement by the client indicates correct understanding
of tiotropium therapy?
A. "I will use this medication whenever I have sudden shortness
of breath."
B. "I should swallow the capsule if I cannot use my inhaler."
C. "This medication helps prevent bronchospasm and should be
used every day."
D. "I can stop taking this medication when my breathing
improves."
Correct Answer
Correct Answer: C. "This medication helps prevent
bronchospasm and should be used every day."
Detailed Rationale
Tiotropium is a long-acting muscarinic antagonist (LAMA) used
for maintenance treatment of COPD. It prevents
bronchoconstriction through prolonged bronchodilation and
must be taken daily for maximum benefit. It is not a rescue
medication.
Option A is incorrect because tiotropium does not provide rapid
relief of acute bronchospasm.
Option B is incorrect because inhalation capsules should never
be swallowed. They are designed specifically for inhalation
devices.
Exam Questions & Rationales
20 Original NGN NCLEX Practice MCQs
Asthma, COPD, Inhalers, Oxygen
Therapy, Nursing Pharmacology Study
Guide
Question 1
Clinical Scenario
A 22-year-old client with acute asthma exacerbation arrives in
the emergency department with wheezing, shortness of breath,
and an oxygen saturation of 89% on room air. The provider
prescribes albuterol via nebulizer.
Question Stem
Which finding indicates the albuterol treatment is having the
desired therapeutic effect?
A. Heart rate decreases from 110/min to 70/min
B. Respiratory wheezing decreases and oxygen saturation
improves to 95%
,C. Blood pressure decreases from 138/84 mm Hg to 108/60 mm
Hg
D. Respiratory rate decreases from 28/min to 10/min
Correct Answer
Correct Answer: B. Respiratory wheezing decreases and
oxygen saturation improves to 95%
Detailed Rationale
Albuterol is a short-acting beta2-adrenergic agonist (SABA) that
relaxes bronchial smooth muscle and rapidly improves airflow.
The primary therapeutic goal during an asthma exacerbation is
bronchodilation, resulting in decreased wheezing, improved
oxygenation, and reduced work of breathing. Therefore,
improved oxygen saturation and reduced wheezing indicate
effective treatment.
Option A is incorrect because heart rate reduction is not the
primary indicator of therapeutic effectiveness. In fact, albuterol
commonly causes mild tachycardia.
Option C is incorrect because blood pressure changes are not
the intended therapeutic outcome of albuterol therapy.
Option D is incorrect because a respiratory rate of 10/min may
indicate respiratory depression rather than improvement.
Nurses should assess lung sounds, respiratory effort, oxygen
saturation, and symptom relief following administration.
,Common adverse effects include tremors, nervousness, and
tachycardia. Frequent use of rescue inhalers may indicate
poorly controlled asthma and should prompt provider
evaluation.
Learning Objective
After completing this question, the learner should be able to:
• Identify the therapeutic effects of albuterol.
• Evaluate response to bronchodilator therapy.
• Recognize expected adverse effects of beta2 agonists.
• Monitor respiratory status during asthma treatment.
Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 67-year-old client with chronic obstructive pulmonary disease
(COPD) is prescribed tiotropium inhalation daily. During
discharge teaching, the nurse evaluates the client's
understanding.
Question Stem
, Which statement by the client indicates correct understanding
of tiotropium therapy?
A. "I will use this medication whenever I have sudden shortness
of breath."
B. "I should swallow the capsule if I cannot use my inhaler."
C. "This medication helps prevent bronchospasm and should be
used every day."
D. "I can stop taking this medication when my breathing
improves."
Correct Answer
Correct Answer: C. "This medication helps prevent
bronchospasm and should be used every day."
Detailed Rationale
Tiotropium is a long-acting muscarinic antagonist (LAMA) used
for maintenance treatment of COPD. It prevents
bronchoconstriction through prolonged bronchodilation and
must be taken daily for maximum benefit. It is not a rescue
medication.
Option A is incorrect because tiotropium does not provide rapid
relief of acute bronchospasm.
Option B is incorrect because inhalation capsules should never
be swallowed. They are designed specifically for inhalation
devices.
