NUR 545 Exam 2 with Complete
Solutions
A nurse is caring for a patient who has been prescribed Ellipta (umeclidinium) for
COPD. This may cause a hypersensitivity reaction in a patient with an allergy to:
A) Eggs
B) Milk
C) Horses
D) Peanuts - ANS-B) Milk
A nurse is caring for an adolescent patient with asthma who is well controlled on her
medications which include theophylline. Which new behavior should be of concern and
the greatest priority to report to the HCP?
A) Joining the soccer team
B) Occasionally skipping school when not ill
C) Becoming sexually active
D) Smoking marijuana - ANS-D) Smoking marijuana
A patient has received instructions from a nurse to take 2 puffs and a B2 agonist drug
(albuterol) via MDI (metered dose inhaler). Which statement would indicate the need for
further teaching?
A) I need to inhale slowly and deeply so the drug goes deep into my lungs
B) I may need to count the MDI doses that I use so that I know when it is empty
C) I should start to inhale after activating the inhaler
D) It is best to wait 1 full minute before I take the second puff - ANS-D) It is best to wait
1 full minute before I take the second puff
Mechanism of action for fluticasone (Flovent HFA)? - ANS-Anti-inflammatory, reduces
the number of cells in the airway
Mechanism of action for guaifenesin (Mucinex)? - ANS-Reduction of surface tension of
secretions; thins mucus
Mechanism of action for montelukast (Singular)? - ANS-Suppress the effect of
leukotrienes, decreasing inflammation
Mechanism of action for prednisone (Deltasone)? - ANS-Suppress inflammation
Mechanism of action for theophylline (Theolair)? - ANS-Relax smooth muscles of the
bronchi
, Mechanism of action for warfarin (Coumadin)? - ANS-Suppresses coagulation by
decreasing production of four clotting factors, namely, factors VII, IX, X, and
prothrombin.
Nursing implications for albuterol (Proventil)? - ANS--Caution with over-use; if using
more than twice a week- notify provider
-Monitor VS
-Report palpitations or chest pain
-Patient education on how to use inhaler - wait 1-2 minutes between puffs
-Keep a log with known triggers to lessen attacks
-Need to prime the inhaler MDI
Nursing implications for enoxaparin (Lovenox)/Heparin? - ANS--Bleeding risks; less risk
than with heparin
-Bruising; rotate injections sites
-Monitor blood counts
Nursing implications for ferrous sulfate? - ANS--Vitamin C enhances absorption (must
take at least 200mg), and food reduces absorption
-Foods especially rich in iron include egg yolk, brewer's yeast, and wheat germ c.
-Other foods with high iron content include muscle meats, fish, fowl, cereal grains,
beans, and green leafy vegetables.
-Educate on dark stools- this is not a GI bleed
Nursing implications for filgrastim (Neupogen)? - ANS-Education on bone pain
Nursing implications for fluticasone (Flovent HFA)? - ANS--Report signs of infection
-Increase calcium in diet
-Yearly optometrist appointment
-Stress or surgery causes a decrease in cortisol
-Never stop steroids suddenly
Nursing implications for guaifenesin (Mucinex)? - ANS--Increase PO fluids to help
liquefy secretions
-Use in caution with patients taking for longer than a week
Nursing implications for prednisone (Deltasone)? - ANS--Pt education: rinse mouth after
using inhaled steroids to lower risk or oral candidiasis
-Monitor for s/s of infection
-Education on early detection of infection
-Monitor electrolytes
-Use the lowest dose for the shortest duration- must taper to avoid adrenal crisis.
-Administer bronchodilator first, then steroid
-Nasal administration- full effect takes 2-3 weeks
-Extreme caution in diabetic patients
Solutions
A nurse is caring for a patient who has been prescribed Ellipta (umeclidinium) for
COPD. This may cause a hypersensitivity reaction in a patient with an allergy to:
A) Eggs
B) Milk
C) Horses
D) Peanuts - ANS-B) Milk
A nurse is caring for an adolescent patient with asthma who is well controlled on her
medications which include theophylline. Which new behavior should be of concern and
the greatest priority to report to the HCP?
A) Joining the soccer team
B) Occasionally skipping school when not ill
C) Becoming sexually active
D) Smoking marijuana - ANS-D) Smoking marijuana
A patient has received instructions from a nurse to take 2 puffs and a B2 agonist drug
(albuterol) via MDI (metered dose inhaler). Which statement would indicate the need for
further teaching?
A) I need to inhale slowly and deeply so the drug goes deep into my lungs
B) I may need to count the MDI doses that I use so that I know when it is empty
C) I should start to inhale after activating the inhaler
D) It is best to wait 1 full minute before I take the second puff - ANS-D) It is best to wait
1 full minute before I take the second puff
Mechanism of action for fluticasone (Flovent HFA)? - ANS-Anti-inflammatory, reduces
the number of cells in the airway
Mechanism of action for guaifenesin (Mucinex)? - ANS-Reduction of surface tension of
secretions; thins mucus
Mechanism of action for montelukast (Singular)? - ANS-Suppress the effect of
leukotrienes, decreasing inflammation
Mechanism of action for prednisone (Deltasone)? - ANS-Suppress inflammation
Mechanism of action for theophylline (Theolair)? - ANS-Relax smooth muscles of the
bronchi
, Mechanism of action for warfarin (Coumadin)? - ANS-Suppresses coagulation by
decreasing production of four clotting factors, namely, factors VII, IX, X, and
prothrombin.
Nursing implications for albuterol (Proventil)? - ANS--Caution with over-use; if using
more than twice a week- notify provider
-Monitor VS
-Report palpitations or chest pain
-Patient education on how to use inhaler - wait 1-2 minutes between puffs
-Keep a log with known triggers to lessen attacks
-Need to prime the inhaler MDI
Nursing implications for enoxaparin (Lovenox)/Heparin? - ANS--Bleeding risks; less risk
than with heparin
-Bruising; rotate injections sites
-Monitor blood counts
Nursing implications for ferrous sulfate? - ANS--Vitamin C enhances absorption (must
take at least 200mg), and food reduces absorption
-Foods especially rich in iron include egg yolk, brewer's yeast, and wheat germ c.
-Other foods with high iron content include muscle meats, fish, fowl, cereal grains,
beans, and green leafy vegetables.
-Educate on dark stools- this is not a GI bleed
Nursing implications for filgrastim (Neupogen)? - ANS-Education on bone pain
Nursing implications for fluticasone (Flovent HFA)? - ANS--Report signs of infection
-Increase calcium in diet
-Yearly optometrist appointment
-Stress or surgery causes a decrease in cortisol
-Never stop steroids suddenly
Nursing implications for guaifenesin (Mucinex)? - ANS--Increase PO fluids to help
liquefy secretions
-Use in caution with patients taking for longer than a week
Nursing implications for prednisone (Deltasone)? - ANS--Pt education: rinse mouth after
using inhaled steroids to lower risk or oral candidiasis
-Monitor for s/s of infection
-Education on early detection of infection
-Monitor electrolytes
-Use the lowest dose for the shortest duration- must taper to avoid adrenal crisis.
-Administer bronchodilator first, then steroid
-Nasal administration- full effect takes 2-3 weeks
-Extreme caution in diabetic patients
