West Coast University NURS 180 Week 5 Quiz (pdf) |
2026/2027 | Respiratory Pharmacology Q&A | Nursing
1. Which of the following best describes the primary mechanism of action of beta-2 adrenergic
agonists in the treatment of asthma?
A) Blocking histamine receptors to reduce bronchial inflammation
B) Stimulating beta-2 receptors to cause bronchodilation
C) Inhibiting leukotriene synthesis to prevent bronchoconstriction
D) Suppressing the cough reflex centrally in the medulla
Correct Answer: Stimulating beta-2 receptors to cause bronchodilation
Rationale: Beta-2 adrenergic agonists work by stimulating beta-2 receptors located on bronchial
smooth muscle, which leads to relaxation and bronchodilation. This class includes drugs such as
albuterol and salmeterol, which are mainstays of asthma rescue and maintenance therapy. The other
options describe mechanisms of antihistamines, leukotriene modifiers, and antitussives, respectively.
2. A researcher is studying the effects of antihistamine medications. Which of the following
symptoms would most likely be relieved by first-generation antihistamines such as
diphenhydramine?
A) Bronchoconstriction during an acute asthma attack
B) Nasal congestion from sinus infection
C) Allergic rhinitis symptoms including sneezing and itching
D) Productive cough with thick sputum
Correct Answer: Allergic rhinitis symptoms including sneezing and itching
Rationale: First-generation antihistamines block H1 receptors, making them effective for allergic
rhinitis symptoms such as sneezing, itching, and rhinorrhea. They are not effective for
bronchoconstriction in asthma, sinus congestion, or productive cough. Diphenhydramine is a classic
prototype in this class.
3. What is the primary function of an expectorant such as guaifenesin?
A) Suppressing the cough reflex in the central nervous system
B) Reducing inflammation in the bronchial passages
C) Loosening mucus to facilitate its removal from the airways
D) Dilating the bronchioles to improve airflow
Correct Answer: Loosening mucus to facilitate its removal from the airways
Rationale: Expectorants work by thinning bronchial secretions, making mucus easier to cough up and
expel. Guaifenesin is the most commonly used expectorant in clinical practice. This action differs from
antitussives, which suppress cough, and bronchodilators, which dilate airways.
,4. According to the mechanism of action of anticholinergic bronchodilators such as ipratropium,
which of the following effects would the nurse anticipate?
A) Direct stimulation of beta-2 receptors in the lungs
B) Blocking muscarinic receptors to reduce bronchoconstriction
C) Inhibiting histamine release from mast cells
D) Suppressing the cough center in the brainstem
Correct Answer: Blocking muscarinic receptors to reduce bronchoconstriction
Rationale: Ipratropium is an anticholinergic bronchodilator that works by blocking muscarinic
receptors in the airways. This action reduces vagal-mediated bronchoconstriction and decreases
mucus secretion. It is commonly used in chronic obstructive pulmonary disease and asthma, often in
combination with beta-2 agonists.
5. Which term refers to the class of medications that includes montelukast and zafirlukast, used for
prophylaxis of asthma?
A) Corticosteroids
B) Leukotriene receptor antagonists
C) Xanthine derivatives
D) Mast cell stabilizers
Correct Answer: Leukotriene receptor antagonists
Rationale: Montelukast and zafirlukast belong to the leukotriene receptor antagonist class, which
blocks the action of leukotrienes that cause bronchoconstriction and inflammation. These agents are
used for long-term asthma prophylaxis rather than acute symptom relief. They are particularly useful
in exercise-induced bronchoconstriction.
6. What is the most likely outcome if a patient takes an antitussive medication containing
dextromethorphan for a productive cough?
A) The mucus will be expelled more effectively
B) The cough reflex will be suppressed, potentially retaining secretions
C) The airways will dilate and breathing will improve
D) The infection causing the cough will be eradicated
Correct Answer: The cough reflex will be suppressed, potentially retaining secretions
Rationale: Dextromethorphan is a centrally acting antitussive that suppresses the cough reflex. Using
it for a productive cough can be counterproductive because retained secretions may lead to airway
obstruction or infection. Antitussives are best reserved for nonproductive, irritating coughs.
7. Which principle explains why systemic corticosteroids such as prednisone are effective in
treating asthma exacerbations?
A) They directly relax bronchial smooth muscle within minutes
,B) They suppress the inflammatory response underlying airway obstruction
C) They stimulate beta-2 receptors to enhance bronchodilation
D) They thin bronchial secretions to promote expectoration
Correct Answer: They suppress the inflammatory response underlying airway obstruction
Rationale: Corticosteroids work by suppressing the inflammatory cascade that contributes to
bronchial hyperresponsiveness and obstruction in asthma. Their effects are not immediate, often
taking hours to days, which is why they are used for exacerbations and long-term control rather than
acute rescue. They do not directly relax smooth muscle or stimulate beta receptors.
8. In the context of respiratory pharmacology, which statement best explains the difference
between a rescue inhaler and a maintenance inhaler?
A) Rescue inhalers contain corticosteroids, while maintenance inhalers contain beta-2 agonists
B) Rescue inhalers provide rapid symptom relief, while maintenance inhalers provide long-term
control
C) Rescue inhalers are taken orally, while maintenance inhalers are inhaled
D) Rescue inhalers are used only at night, while maintenance inhalers are used during the day
Correct Answer: Rescue inhalers provide rapid symptom relief, while maintenance inhalers provide
long-term control
Rationale: Rescue inhalers, such as albuterol, provide quick bronchodilation for acute symptoms.
Maintenance inhalers, such as inhaled corticosteroids or long-acting beta-2 agonists, are used
regularly to control underlying inflammation and prevent symptoms. This distinction is critical for
patient education and safe medication use.
9. A researcher is investigating the side effects of first-generation antihistamines. Which of the
following adverse effects is most commonly associated with this class?
A) Hypertension
B) Sedation and drowsiness
C) Hyperglycemia
D) Bradycardia
Correct Answer: Sedation and drowsiness
Rationale: First-generation antihistamines such as diphenhydramine cross the blood-brain barrier and
cause significant sedation due to central H1 receptor blockade. This is why patients are cautioned
about driving or operating machinery. Second-generation antihistamines were developed to minimize
this effect.
10. What would most appropriately be recommended for a patient experiencing acute
bronchospasm during an asthma attack?
A) A leukotriene receptor antagonist taken orally
B) A short-acting beta-2 agonist inhaler
, C) An inhaled corticosteroid
D) An expectorant syrup
Correct Answer: A short-acting beta-2 agonist inhaler
Rationale: Short-acting beta-2 agonists such as albuterol are the treatment of choice for acute
bronchospasm because they provide rapid bronchodilation within minutes. Inhaled corticosteroids
and leukotriene antagonists are used for long-term control, not acute rescue. Expectorants do not
address bronchospasm.
11. Which factor is most important when teaching a patient about proper use of a metered-dose
inhaler?
A) The color of the inhaler device
B) Coordination between actuation and inhalation
C) The brand name of the medication
D) The time of day the medication is taken
Correct Answer: Coordination between actuation and inhalation
Rationale: Proper coordination between pressing the inhaler and inhaling the medication is essential
for effective drug delivery to the lungs. Poor technique is a common reason for treatment failure in
asthma and COPD. Using a spacer device can help patients who have difficulty with coordination.
12. How does a xanthine derivative such as theophylline affect the respiratory system?
A) It blocks histamine receptors to reduce allergy symptoms
B) It relaxes bronchial smooth muscle and improves contractility of the diaphragm
C) It suppresses the cough center in the medulla
D) It thins mucus to facilitate expectoration
Correct Answer: It relaxes bronchial smooth muscle and improves contractility of the diaphragm
Rationale: Theophylline, a xanthine derivative, produces bronchodilation by relaxing smooth muscle
and also improves diaphragmatic contractility. It has a narrow therapeutic index requiring serum
level monitoring. It is used less commonly now due to safer alternatives but remains relevant in some
COPD and asthma regimens.
13. What distinguishes second-generation antihistamines from first-generation antihistamines?
A) Second-generation agents are more sedating
B) Second-generation agents have fewer central nervous system effects
C) Second-generation agents are only available by prescription
D) Second-generation agents work by a different receptor mechanism
Correct Answer: Second-generation agents have fewer central nervous system effects
2026/2027 | Respiratory Pharmacology Q&A | Nursing
1. Which of the following best describes the primary mechanism of action of beta-2 adrenergic
agonists in the treatment of asthma?
A) Blocking histamine receptors to reduce bronchial inflammation
B) Stimulating beta-2 receptors to cause bronchodilation
C) Inhibiting leukotriene synthesis to prevent bronchoconstriction
D) Suppressing the cough reflex centrally in the medulla
Correct Answer: Stimulating beta-2 receptors to cause bronchodilation
Rationale: Beta-2 adrenergic agonists work by stimulating beta-2 receptors located on bronchial
smooth muscle, which leads to relaxation and bronchodilation. This class includes drugs such as
albuterol and salmeterol, which are mainstays of asthma rescue and maintenance therapy. The other
options describe mechanisms of antihistamines, leukotriene modifiers, and antitussives, respectively.
2. A researcher is studying the effects of antihistamine medications. Which of the following
symptoms would most likely be relieved by first-generation antihistamines such as
diphenhydramine?
A) Bronchoconstriction during an acute asthma attack
B) Nasal congestion from sinus infection
C) Allergic rhinitis symptoms including sneezing and itching
D) Productive cough with thick sputum
Correct Answer: Allergic rhinitis symptoms including sneezing and itching
Rationale: First-generation antihistamines block H1 receptors, making them effective for allergic
rhinitis symptoms such as sneezing, itching, and rhinorrhea. They are not effective for
bronchoconstriction in asthma, sinus congestion, or productive cough. Diphenhydramine is a classic
prototype in this class.
3. What is the primary function of an expectorant such as guaifenesin?
A) Suppressing the cough reflex in the central nervous system
B) Reducing inflammation in the bronchial passages
C) Loosening mucus to facilitate its removal from the airways
D) Dilating the bronchioles to improve airflow
Correct Answer: Loosening mucus to facilitate its removal from the airways
Rationale: Expectorants work by thinning bronchial secretions, making mucus easier to cough up and
expel. Guaifenesin is the most commonly used expectorant in clinical practice. This action differs from
antitussives, which suppress cough, and bronchodilators, which dilate airways.
,4. According to the mechanism of action of anticholinergic bronchodilators such as ipratropium,
which of the following effects would the nurse anticipate?
A) Direct stimulation of beta-2 receptors in the lungs
B) Blocking muscarinic receptors to reduce bronchoconstriction
C) Inhibiting histamine release from mast cells
D) Suppressing the cough center in the brainstem
Correct Answer: Blocking muscarinic receptors to reduce bronchoconstriction
Rationale: Ipratropium is an anticholinergic bronchodilator that works by blocking muscarinic
receptors in the airways. This action reduces vagal-mediated bronchoconstriction and decreases
mucus secretion. It is commonly used in chronic obstructive pulmonary disease and asthma, often in
combination with beta-2 agonists.
5. Which term refers to the class of medications that includes montelukast and zafirlukast, used for
prophylaxis of asthma?
A) Corticosteroids
B) Leukotriene receptor antagonists
C) Xanthine derivatives
D) Mast cell stabilizers
Correct Answer: Leukotriene receptor antagonists
Rationale: Montelukast and zafirlukast belong to the leukotriene receptor antagonist class, which
blocks the action of leukotrienes that cause bronchoconstriction and inflammation. These agents are
used for long-term asthma prophylaxis rather than acute symptom relief. They are particularly useful
in exercise-induced bronchoconstriction.
6. What is the most likely outcome if a patient takes an antitussive medication containing
dextromethorphan for a productive cough?
A) The mucus will be expelled more effectively
B) The cough reflex will be suppressed, potentially retaining secretions
C) The airways will dilate and breathing will improve
D) The infection causing the cough will be eradicated
Correct Answer: The cough reflex will be suppressed, potentially retaining secretions
Rationale: Dextromethorphan is a centrally acting antitussive that suppresses the cough reflex. Using
it for a productive cough can be counterproductive because retained secretions may lead to airway
obstruction or infection. Antitussives are best reserved for nonproductive, irritating coughs.
7. Which principle explains why systemic corticosteroids such as prednisone are effective in
treating asthma exacerbations?
A) They directly relax bronchial smooth muscle within minutes
,B) They suppress the inflammatory response underlying airway obstruction
C) They stimulate beta-2 receptors to enhance bronchodilation
D) They thin bronchial secretions to promote expectoration
Correct Answer: They suppress the inflammatory response underlying airway obstruction
Rationale: Corticosteroids work by suppressing the inflammatory cascade that contributes to
bronchial hyperresponsiveness and obstruction in asthma. Their effects are not immediate, often
taking hours to days, which is why they are used for exacerbations and long-term control rather than
acute rescue. They do not directly relax smooth muscle or stimulate beta receptors.
8. In the context of respiratory pharmacology, which statement best explains the difference
between a rescue inhaler and a maintenance inhaler?
A) Rescue inhalers contain corticosteroids, while maintenance inhalers contain beta-2 agonists
B) Rescue inhalers provide rapid symptom relief, while maintenance inhalers provide long-term
control
C) Rescue inhalers are taken orally, while maintenance inhalers are inhaled
D) Rescue inhalers are used only at night, while maintenance inhalers are used during the day
Correct Answer: Rescue inhalers provide rapid symptom relief, while maintenance inhalers provide
long-term control
Rationale: Rescue inhalers, such as albuterol, provide quick bronchodilation for acute symptoms.
Maintenance inhalers, such as inhaled corticosteroids or long-acting beta-2 agonists, are used
regularly to control underlying inflammation and prevent symptoms. This distinction is critical for
patient education and safe medication use.
9. A researcher is investigating the side effects of first-generation antihistamines. Which of the
following adverse effects is most commonly associated with this class?
A) Hypertension
B) Sedation and drowsiness
C) Hyperglycemia
D) Bradycardia
Correct Answer: Sedation and drowsiness
Rationale: First-generation antihistamines such as diphenhydramine cross the blood-brain barrier and
cause significant sedation due to central H1 receptor blockade. This is why patients are cautioned
about driving or operating machinery. Second-generation antihistamines were developed to minimize
this effect.
10. What would most appropriately be recommended for a patient experiencing acute
bronchospasm during an asthma attack?
A) A leukotriene receptor antagonist taken orally
B) A short-acting beta-2 agonist inhaler
, C) An inhaled corticosteroid
D) An expectorant syrup
Correct Answer: A short-acting beta-2 agonist inhaler
Rationale: Short-acting beta-2 agonists such as albuterol are the treatment of choice for acute
bronchospasm because they provide rapid bronchodilation within minutes. Inhaled corticosteroids
and leukotriene antagonists are used for long-term control, not acute rescue. Expectorants do not
address bronchospasm.
11. Which factor is most important when teaching a patient about proper use of a metered-dose
inhaler?
A) The color of the inhaler device
B) Coordination between actuation and inhalation
C) The brand name of the medication
D) The time of day the medication is taken
Correct Answer: Coordination between actuation and inhalation
Rationale: Proper coordination between pressing the inhaler and inhaling the medication is essential
for effective drug delivery to the lungs. Poor technique is a common reason for treatment failure in
asthma and COPD. Using a spacer device can help patients who have difficulty with coordination.
12. How does a xanthine derivative such as theophylline affect the respiratory system?
A) It blocks histamine receptors to reduce allergy symptoms
B) It relaxes bronchial smooth muscle and improves contractility of the diaphragm
C) It suppresses the cough center in the medulla
D) It thins mucus to facilitate expectoration
Correct Answer: It relaxes bronchial smooth muscle and improves contractility of the diaphragm
Rationale: Theophylline, a xanthine derivative, produces bronchodilation by relaxing smooth muscle
and also improves diaphragmatic contractility. It has a narrow therapeutic index requiring serum
level monitoring. It is used less commonly now due to safer alternatives but remains relevant in some
COPD and asthma regimens.
13. What distinguishes second-generation antihistamines from first-generation antihistamines?
A) Second-generation agents are more sedating
B) Second-generation agents have fewer central nervous system effects
C) Second-generation agents are only available by prescription
D) Second-generation agents work by a different receptor mechanism
Correct Answer: Second-generation agents have fewer central nervous system effects
