NCLEX-RN Pharmacology Respiratory
System Exam Questions & Answers
20 Original ATI & NGN-Style MCQs with
Rationales
Asthma, COPD, Inhalers,
Corticosteroids, Bronchodilators
Nursing Study Guide
Question 1
Clinical Scenario
A 68-year-old man with moderate chronic obstructive
pulmonary disease (COPD) presents to the clinic with increasing
shortness of breath during activity. His medical history includes
hypertension and type 2 diabetes mellitus. Current medications
include tiotropium, metformin, and lisinopril. The provider
prescribes an albuterol metered-dose inhaler (MDI) for rescue
therapy. During the teaching session, the nurse evaluates the
client's understanding of proper inhaler use.
,Question Stem
Which statement by the client indicates correct understanding
of albuterol therapy?
A. "I will use this inhaler every morning to prevent breathing
problems."
B. "I should wait until my breathing becomes severe before
using the inhaler."
C. "I will carry this inhaler with me and use it when I suddenly
become short of breath."
D. "I should stop taking my tiotropium once I begin using this
inhaler."
Correct Answer
Correct Answer: C. "I will carry this inhaler with me and use it
when I suddenly become short of breath."
Detailed Rationale
Albuterol is a short-acting beta₂-adrenergic agonist (SABA) that
rapidly relaxes bronchial smooth muscle, producing
bronchodilation within minutes. It is considered a rescue
medication and should be readily available for immediate relief
of acute bronchospasm or sudden dyspnea. Patients should
understand that albuterol treats symptoms when they occur
,rather than preventing chronic airway inflammation or
replacing maintenance medications.
Option A is incorrect because scheduled daily use of albuterol
suggests poor asthma or COPD control and may indicate the
need to reassess maintenance therapy. Option B is incorrect
because delaying treatment until symptoms become severe
may worsen respiratory distress and increase the risk of
hospitalization. Option D is incorrect because tiotropium is a
long-acting muscarinic antagonist (LAMA) used for maintenance
therapy and should continue as prescribed. Rescue and
maintenance inhalers serve different therapeutic purposes.
The nurse should also teach the client to monitor for common
adverse effects such as tremor, palpitations, nervousness, and
transient tachycardia. Frequent need for rescue inhaler use
(more than recommended) should prompt reevaluation by the
healthcare provider because it may indicate worsening disease
control.
Learning Objectives
After completing this question, the learner should be able to:
• Differentiate rescue medications from maintenance
inhalers.
• Identify the therapeutic role of albuterol.
, • Reinforce appropriate patient education regarding inhaler
use.
• Recognize signs of inadequate respiratory disease control.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 24-year-old woman with persistent asthma arrives at the
outpatient clinic for a follow-up visit. She reports using her
prescribed fluticasone inhaler twice daily and rarely needing her
rescue inhaler. During assessment, the nurse observes white
patches on the client's tongue and inner cheeks. The client
denies fever or sore throat.
Question Stem
Which nursing intervention is most appropriate?
A. Instruct the client to rinse her mouth with water after each
corticosteroid inhalation.
B. Advise the client to discontinue the inhaler immediately.
C. Recommend doubling the corticosteroid dose for improved
asthma control.
System Exam Questions & Answers
20 Original ATI & NGN-Style MCQs with
Rationales
Asthma, COPD, Inhalers,
Corticosteroids, Bronchodilators
Nursing Study Guide
Question 1
Clinical Scenario
A 68-year-old man with moderate chronic obstructive
pulmonary disease (COPD) presents to the clinic with increasing
shortness of breath during activity. His medical history includes
hypertension and type 2 diabetes mellitus. Current medications
include tiotropium, metformin, and lisinopril. The provider
prescribes an albuterol metered-dose inhaler (MDI) for rescue
therapy. During the teaching session, the nurse evaluates the
client's understanding of proper inhaler use.
,Question Stem
Which statement by the client indicates correct understanding
of albuterol therapy?
A. "I will use this inhaler every morning to prevent breathing
problems."
B. "I should wait until my breathing becomes severe before
using the inhaler."
C. "I will carry this inhaler with me and use it when I suddenly
become short of breath."
D. "I should stop taking my tiotropium once I begin using this
inhaler."
Correct Answer
Correct Answer: C. "I will carry this inhaler with me and use it
when I suddenly become short of breath."
Detailed Rationale
Albuterol is a short-acting beta₂-adrenergic agonist (SABA) that
rapidly relaxes bronchial smooth muscle, producing
bronchodilation within minutes. It is considered a rescue
medication and should be readily available for immediate relief
of acute bronchospasm or sudden dyspnea. Patients should
understand that albuterol treats symptoms when they occur
,rather than preventing chronic airway inflammation or
replacing maintenance medications.
Option A is incorrect because scheduled daily use of albuterol
suggests poor asthma or COPD control and may indicate the
need to reassess maintenance therapy. Option B is incorrect
because delaying treatment until symptoms become severe
may worsen respiratory distress and increase the risk of
hospitalization. Option D is incorrect because tiotropium is a
long-acting muscarinic antagonist (LAMA) used for maintenance
therapy and should continue as prescribed. Rescue and
maintenance inhalers serve different therapeutic purposes.
The nurse should also teach the client to monitor for common
adverse effects such as tremor, palpitations, nervousness, and
transient tachycardia. Frequent need for rescue inhaler use
(more than recommended) should prompt reevaluation by the
healthcare provider because it may indicate worsening disease
control.
Learning Objectives
After completing this question, the learner should be able to:
• Differentiate rescue medications from maintenance
inhalers.
• Identify the therapeutic role of albuterol.
, • Reinforce appropriate patient education regarding inhaler
use.
• Recognize signs of inadequate respiratory disease control.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A 24-year-old woman with persistent asthma arrives at the
outpatient clinic for a follow-up visit. She reports using her
prescribed fluticasone inhaler twice daily and rarely needing her
rescue inhaler. During assessment, the nurse observes white
patches on the client's tongue and inner cheeks. The client
denies fever or sore throat.
Question Stem
Which nursing intervention is most appropriate?
A. Instruct the client to rinse her mouth with water after each
corticosteroid inhalation.
B. Advise the client to discontinue the inhaler immediately.
C. Recommend doubling the corticosteroid dose for improved
asthma control.
