STUVIA 2024/2025
Chapter 36: Lower Respiratory Disorders
A patient who has been taking theophylline at home reports having palpitations and jitteriness. Which
of the following could interact with theophylline to increase side effects such as these?
a. Ephedra.
b. Acetaminophen.
c. Ibuprofen.
d. Diphenhydramine. - ✔✔ANS: A
Ephedra is a stimulant that potentiates theophylline and may increase side effects. Patients should be
questioned about use of herbal medications. To determine toxicity, serum drug levels must be drawn;
at this point, the patient reports symptoms of theophylline side effects.
A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to report experiencing
cough and a bad taste. The nurse will instruct the patient to perform which action?
a. Drink water before and after using the inhaler.
b. Schedule an appointment to discuss these effects with the provider.
c. Stop taking the medication immediately.
d. Use the inhaler only as needed for acute bronchospasms. - ✔✔ANS: A
%
Cough and a bad taste are the most common side effects associated with cromolyn sodium, and
these effects can be decreased by drinking water before and after using the drug. The effects are not
serious and do not warrant discussion with the provider. Stopping the medication abruptly can cause
a rebound bronchospasm. This medication is not useful in acute bronchospasm.
A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse
notes white spots on the patient's tongue and oral mucous membranes. After notifying the provider,
the nurse will remind the patient to perform which action?
a. Avoid using a spacer with the inhaled glucocorticoid medication.
b. Clean the inhaler with hot, soapy water after each use.
c. Consume yogurt daily while using this medication.
d. Rinse the mouth thoroughly with water after each use. - ✔✔ANS: D
When using inhaled glucocorticoid medications, Candida albicans oropharyngeal infections may be
prevented by rinsing the mouth and throat with water after each dose. Patients should also use a
spacer to reduce deposits of the drug in the oral cavity. The inhaler should be washed with warm
water daily, but not after each use. There is no indication that yogurt is effective.
A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What
information will the nurse include when teaching this patient about this medication?
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, STUVIA 2024/2025
a. Failure to respond to the medication indicates a need for a higher dose.
b. Monitor for hypoglycemia symptoms when using this medication.
c. Palpitations are common with this drug even at normal, therapeutic doses.
d. Overuse of this medication can result in airway narrowing and bronchospasm. - ✔✔ANS: D
Excessive use of an aerosol drug can occasionally cause severe paradoxical airway resistance, so
patients should be cautioned against overuse. Excessive use can also lead to tolerance and loss of
drug effectiveness, but patients should not increase the dose because of the risk of bronchospasm
and the increased incidence of adverse effects such as tremors and tachycardia. Hyperglycemia can
occur. Palpitations are common with increased doses but not at therapeutic doses.
A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient
asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The
nurse will explain that the inhaled form of albuterol:
a. has a more immediate onset than the oral form.
b. may cause more side effects than the oral preparation.
c. requires an increased dose in order to have therapeutic effects.
d. will not lead to tolerance with increased doses. - ✔✔ANS: A
Inhaled medications have more immediate effects than oral preparations. As long as they are used
%
correctly, systemic side effects are less common. Less drug is needed for therapeutic effects since
the drug is delivered directly to target tissues. Increased doses will lead to drug tolerance.
A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled
glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about
disease and medication management, the nurse will instruct the patient to administer these
medications in which order?
a. Albuterol, ipratropium bromide, steroid
b. Albuterol, steroid, ipratropium bromide
c. Ipratropium bromide, albuterol, steroid
d. Steroid, ipratropium bromide, albuterol - ✔✔ANS: A
Patients who use a beta agonist should be taught to use it 5 minutes before administering ipratropium
bromide, and ipratropium bromide should be given 5 minutes prior to an inhaled glucocorticoid. This
helps the bronchioles to dilate so the subsequent medication can be deposited in the bronchioles for
improved effect.
A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has
chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is
prescribed primarily for which reason?
stuvia
Chapter 36: Lower Respiratory Disorders
A patient who has been taking theophylline at home reports having palpitations and jitteriness. Which
of the following could interact with theophylline to increase side effects such as these?
a. Ephedra.
b. Acetaminophen.
c. Ibuprofen.
d. Diphenhydramine. - ✔✔ANS: A
Ephedra is a stimulant that potentiates theophylline and may increase side effects. Patients should be
questioned about use of herbal medications. To determine toxicity, serum drug levels must be drawn;
at this point, the patient reports symptoms of theophylline side effects.
A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to report experiencing
cough and a bad taste. The nurse will instruct the patient to perform which action?
a. Drink water before and after using the inhaler.
b. Schedule an appointment to discuss these effects with the provider.
c. Stop taking the medication immediately.
d. Use the inhaler only as needed for acute bronchospasms. - ✔✔ANS: A
%
Cough and a bad taste are the most common side effects associated with cromolyn sodium, and
these effects can be decreased by drinking water before and after using the drug. The effects are not
serious and do not warrant discussion with the provider. Stopping the medication abruptly can cause
a rebound bronchospasm. This medication is not useful in acute bronchospasm.
A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse
notes white spots on the patient's tongue and oral mucous membranes. After notifying the provider,
the nurse will remind the patient to perform which action?
a. Avoid using a spacer with the inhaled glucocorticoid medication.
b. Clean the inhaler with hot, soapy water after each use.
c. Consume yogurt daily while using this medication.
d. Rinse the mouth thoroughly with water after each use. - ✔✔ANS: D
When using inhaled glucocorticoid medications, Candida albicans oropharyngeal infections may be
prevented by rinsing the mouth and throat with water after each dose. Patients should also use a
spacer to reduce deposits of the drug in the oral cavity. The inhaler should be washed with warm
water daily, but not after each use. There is no indication that yogurt is effective.
A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What
information will the nurse include when teaching this patient about this medication?
stuvia
, STUVIA 2024/2025
a. Failure to respond to the medication indicates a need for a higher dose.
b. Monitor for hypoglycemia symptoms when using this medication.
c. Palpitations are common with this drug even at normal, therapeutic doses.
d. Overuse of this medication can result in airway narrowing and bronchospasm. - ✔✔ANS: D
Excessive use of an aerosol drug can occasionally cause severe paradoxical airway resistance, so
patients should be cautioned against overuse. Excessive use can also lead to tolerance and loss of
drug effectiveness, but patients should not increase the dose because of the risk of bronchospasm
and the increased incidence of adverse effects such as tremors and tachycardia. Hyperglycemia can
occur. Palpitations are common with increased doses but not at therapeutic doses.
A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient
asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The
nurse will explain that the inhaled form of albuterol:
a. has a more immediate onset than the oral form.
b. may cause more side effects than the oral preparation.
c. requires an increased dose in order to have therapeutic effects.
d. will not lead to tolerance with increased doses. - ✔✔ANS: A
Inhaled medications have more immediate effects than oral preparations. As long as they are used
%
correctly, systemic side effects are less common. Less drug is needed for therapeutic effects since
the drug is delivered directly to target tissues. Increased doses will lead to drug tolerance.
A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled
glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about
disease and medication management, the nurse will instruct the patient to administer these
medications in which order?
a. Albuterol, ipratropium bromide, steroid
b. Albuterol, steroid, ipratropium bromide
c. Ipratropium bromide, albuterol, steroid
d. Steroid, ipratropium bromide, albuterol - ✔✔ANS: A
Patients who use a beta agonist should be taught to use it 5 minutes before administering ipratropium
bromide, and ipratropium bromide should be given 5 minutes prior to an inhaled glucocorticoid. This
helps the bronchioles to dilate so the subsequent medication can be deposited in the bronchioles for
improved effect.
A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has
chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is
prescribed primarily for which reason?
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