NCLEX-RN Respiratory System
Pharmacology Practice Questions with
Detailed Rationales
20 Original NGN & ATI-Style Nursing
Exam MCQs
Asthma, COPD, Tuberculosis,
Pneumonia & Respiratory Medications
Study Guide
Question 1
Clinical Scenario
A 24-year-old client with a history of persistent asthma presents
to the emergency department with wheezing, chest tightness,
and shortness of breath after exposure to cat dander.
Assessment findings include respiratory rate 28/min, heart rate
118/min, SpO₂ 89% on room air, and diffuse expiratory
wheezes. The provider prescribes albuterol via nebulizer. The
nurse prepares to administer the medication.
,Question Stem
Which therapeutic response indicates that the medication is
producing its intended effect?
A. Decreased airway inflammation within several hours
B. Increased urine output and reduced peripheral edema
C. Improved airflow with decreased wheezing and easier
breathing
D. Suppression of the immune response to environmental
allergens
Correct Answer
Correct Answer: C. Improved airflow with decreased wheezing
and easier breathing
Detailed Rationale
Albuterol is a short-acting beta₂-adrenergic agonist (SABA) used
as a rescue medication for acute bronchospasm. By stimulating
beta₂ receptors in bronchial smooth muscle, it produces rapid
bronchodilation, typically within 5 minutes of inhalation. The
expected therapeutic outcome is improved airflow, reduced
wheezing, decreased work of breathing, and improved
oxygenation. The nurse should reassess respiratory status,
oxygen saturation, lung sounds, respiratory effort, and the
client's subjective improvement after administration. Mild
,tachycardia and tremors may occur due to some beta₁
stimulation, but these adverse effects are generally transient.
Option A is incorrect because reduction of airway inflammation
is primarily achieved with inhaled corticosteroids rather than
albuterol. Option B describes the therapeutic effect of diuretics
used in heart failure rather than bronchodilators. Option D is
incorrect because albuterol does not suppress immune function
or modify allergic responses. Patients requiring frequent
albuterol use (more than twice weekly outside exercise
prophylaxis) may have poorly controlled asthma and should be
evaluated for adjustment of long-term controller therapy.
Nurses should also teach patients to carry rescue inhalers,
monitor symptom frequency, and seek emergency care if
symptoms do not improve after prescribed rescue doses.
Learning Objectives
After completing this question, the learner should be able to:
• Identify the expected therapeutic effect of short-acting
beta₂ agonists.
• Evaluate clinical improvement following bronchodilator
administration.
• Differentiate rescue medications from controller
medications.
Medication Safety Focus
, Monitoring
Question 2
Clinical Scenario
A 58-year-old client with moderate persistent asthma uses
fluticasone via a metered-dose inhaler twice daily. During a
follow-up visit, the client reports a sore mouth and notices
white patches on the tongue. Lung sounds are clear, and
asthma symptoms have improved.
Question Stem
Which nursing instruction is most appropriate?
A. Stop using the inhaler until the provider is notified.
B. Rinse the mouth thoroughly with water after each inhalation.
C. Increase the number of inhalations to overcome the
symptoms.
D. Take the medication only when wheezing occurs.
Correct Answer
Correct Answer: B. Rinse the mouth thoroughly with water
after each inhalation.
Detailed Rationale
Pharmacology Practice Questions with
Detailed Rationales
20 Original NGN & ATI-Style Nursing
Exam MCQs
Asthma, COPD, Tuberculosis,
Pneumonia & Respiratory Medications
Study Guide
Question 1
Clinical Scenario
A 24-year-old client with a history of persistent asthma presents
to the emergency department with wheezing, chest tightness,
and shortness of breath after exposure to cat dander.
Assessment findings include respiratory rate 28/min, heart rate
118/min, SpO₂ 89% on room air, and diffuse expiratory
wheezes. The provider prescribes albuterol via nebulizer. The
nurse prepares to administer the medication.
,Question Stem
Which therapeutic response indicates that the medication is
producing its intended effect?
A. Decreased airway inflammation within several hours
B. Increased urine output and reduced peripheral edema
C. Improved airflow with decreased wheezing and easier
breathing
D. Suppression of the immune response to environmental
allergens
Correct Answer
Correct Answer: C. Improved airflow with decreased wheezing
and easier breathing
Detailed Rationale
Albuterol is a short-acting beta₂-adrenergic agonist (SABA) used
as a rescue medication for acute bronchospasm. By stimulating
beta₂ receptors in bronchial smooth muscle, it produces rapid
bronchodilation, typically within 5 minutes of inhalation. The
expected therapeutic outcome is improved airflow, reduced
wheezing, decreased work of breathing, and improved
oxygenation. The nurse should reassess respiratory status,
oxygen saturation, lung sounds, respiratory effort, and the
client's subjective improvement after administration. Mild
,tachycardia and tremors may occur due to some beta₁
stimulation, but these adverse effects are generally transient.
Option A is incorrect because reduction of airway inflammation
is primarily achieved with inhaled corticosteroids rather than
albuterol. Option B describes the therapeutic effect of diuretics
used in heart failure rather than bronchodilators. Option D is
incorrect because albuterol does not suppress immune function
or modify allergic responses. Patients requiring frequent
albuterol use (more than twice weekly outside exercise
prophylaxis) may have poorly controlled asthma and should be
evaluated for adjustment of long-term controller therapy.
Nurses should also teach patients to carry rescue inhalers,
monitor symptom frequency, and seek emergency care if
symptoms do not improve after prescribed rescue doses.
Learning Objectives
After completing this question, the learner should be able to:
• Identify the expected therapeutic effect of short-acting
beta₂ agonists.
• Evaluate clinical improvement following bronchodilator
administration.
• Differentiate rescue medications from controller
medications.
Medication Safety Focus
, Monitoring
Question 2
Clinical Scenario
A 58-year-old client with moderate persistent asthma uses
fluticasone via a metered-dose inhaler twice daily. During a
follow-up visit, the client reports a sore mouth and notices
white patches on the tongue. Lung sounds are clear, and
asthma symptoms have improved.
Question Stem
Which nursing instruction is most appropriate?
A. Stop using the inhaler until the provider is notified.
B. Rinse the mouth thoroughly with water after each inhalation.
C. Increase the number of inhalations to overcome the
symptoms.
D. Take the medication only when wheezing occurs.
Correct Answer
Correct Answer: B. Rinse the mouth thoroughly with water
after each inhalation.
Detailed Rationale
