1|Page
Nurs 640 Exam 1 2026|Newest
Comprehensive Questions And
Perfect Answers
Airway Responsiveness asthma - correct-answer -The increased AHR is normally
measured by methacholine or histamine challenge w/ calculation of the
provocative concentration that reduces FEV1 by 20% (PC20).
Rarely used in clinical practice, but can be used in differential diagnosis of chronic
cough & when the diagnosis is in doubt in the setting of normal PFT.
Imagings-asthma - correct-answer -Chest roentgenography - usually normal but in
more severe patients may show hyperinflated lungs.
In exacerbations, there may be evidence of pneumothorax.
Lung shadowing usually indicates pneumonia or eosinophilic infiltrates in pts w/
bronchopulmonary aspergillosis.
CT - areas of bronchiectasis in pts w/ severe asthma, & thickening of the bronchial
walls, but these changes are not diagnostic of asthma.
Bronchodilator Therapies - correct-answer -act primarily on airway smooth
muscle to reverse bronchoconstriction of asthma. Rapid relief of symptoms, but
has little or no effect on the underlying inflammatory process.
,2|Page
B2- Agonists - correct-answer -Relaxes airway smooth muscle cells of the airways,
where they act as functional antagonists, reversing & preventing contraction of
airway smooth muscle cells by all known bronchoconstrictors.
Given by inhalation to reduce side effects.
SABAs such as albuterol & terbutaline have a duration of action of 3-6 hrs. They
have rapid onset of bronchodilation, therefore used as needed for symptom relief.
Increased use of SABAs indicates that asthma is not controlled.
LABAs include salmeterol & formoterol, have duration of action over 12 hrs & are
given 2x daily. Indacaterol is given once daily. LABAs have replaced the regular use
of SABAs, but LABAs should not be given in the absence of ICS therapy because
they don't control the underlying inflammation. They improve asthma control and
reduce exacerbations when given w/ ICS, which allows asthma to be controlled at
lower doses of corticosteroids.
Most common side effects are tremors and palpitations.
Anticholinergics - correct-answer -Muscarinic receptor antagonists such as
ipratropium bromide prevent cholinergic nerve-induced bronchoconstriction &
mucus secretion.
Less effective than B2 agonists.
May be used as an additional bronchodilator in pts w/ asthma that is not
controlled by ICS & LABA combinations.
High doses may be given by nebulizer in treating acute severe asthma, but should
only be given following B2-agonists, because they have slower onset of
bronchodilation.
,3|Page
Theophylline - correct-answer -It has now fallen out of favor because side effects
are common & inhaled B2-agonists are much more effective bronchodilators.
Nausea, vomiting & headaches are the most common side effects due to
phosphodiesterase inhibition. Diuresis & palpitations may also occur, at high
concentrations, cardiac arrhythmias, epileptic seizures, & death may occur due to
adenosine A1-receptor antagonism.
Inhaled Corticosteroids - correct-answer -Most effective anti-inflammatory agents
used in asthma therapy and are beneficial in treating asthma of any severity and
age.
Usually given 2x daily, but some may be effective once daily in mildly symptomatic
pts.
Now given as first-line therapy for patients with persistent asthma, but if they
don't control symptoms at low doses, it is usual to add a LABA as the next step.
Side effects include hoarseness (dysphonia) and oral candidiasis, which may be
reduced with the use of large-volume spacer device.
Systemic Corticosteroids - correct-answer -Used IV for the treatment of acute
severe asthma, although several studies now show that OCS (usually prednisone
or prednisolone 30-45 mg once daily for 5-10 days) is used to treat acute
exacerbations of asthma. No tapering of the dose is needed.
, 4|Page
Antileukotrienes - correct-answer -E.g. Montelukast - provide modest clinical
benefit in asthma.
Less effective than ICS in controlling asthma and have less effect on airway
inflammation, but are useful as an add-on therapy in some pts not controlled w/
low doses of ICS, although less effective than LABA.
Given once or twice daily
Anti-IgE - correct-answer -Omalizumab
Reduce number of exacerbations in pts w/ severe asthma and may improve
asthma control.
Very expensive and is only suitable for highly selected pts who are not controlled
on maximal doses of inhaler therapy and have circulating IgE within a specified
range.
Given a 3-4 month trial of therapy.
Given subq every 3-4 weeks and appears not to have significant side effects.
Acute Severe Asthma Management - correct-answer -High concentration of
oxygen by face mask yo achieve O2sat >90%.
Mainstay of treatment are high doses of SABA given either by nebulizer or
metered-dose inhaler w/ a spacer.
In severely ill patients with impending respiratory failure, IV B2-agonists may be
given.
A nebulized anticholinergic may be added if there is not a satisfactory response to
B2-agonists alone, as there are additive effects.
Nurs 640 Exam 1 2026|Newest
Comprehensive Questions And
Perfect Answers
Airway Responsiveness asthma - correct-answer -The increased AHR is normally
measured by methacholine or histamine challenge w/ calculation of the
provocative concentration that reduces FEV1 by 20% (PC20).
Rarely used in clinical practice, but can be used in differential diagnosis of chronic
cough & when the diagnosis is in doubt in the setting of normal PFT.
Imagings-asthma - correct-answer -Chest roentgenography - usually normal but in
more severe patients may show hyperinflated lungs.
In exacerbations, there may be evidence of pneumothorax.
Lung shadowing usually indicates pneumonia or eosinophilic infiltrates in pts w/
bronchopulmonary aspergillosis.
CT - areas of bronchiectasis in pts w/ severe asthma, & thickening of the bronchial
walls, but these changes are not diagnostic of asthma.
Bronchodilator Therapies - correct-answer -act primarily on airway smooth
muscle to reverse bronchoconstriction of asthma. Rapid relief of symptoms, but
has little or no effect on the underlying inflammatory process.
,2|Page
B2- Agonists - correct-answer -Relaxes airway smooth muscle cells of the airways,
where they act as functional antagonists, reversing & preventing contraction of
airway smooth muscle cells by all known bronchoconstrictors.
Given by inhalation to reduce side effects.
SABAs such as albuterol & terbutaline have a duration of action of 3-6 hrs. They
have rapid onset of bronchodilation, therefore used as needed for symptom relief.
Increased use of SABAs indicates that asthma is not controlled.
LABAs include salmeterol & formoterol, have duration of action over 12 hrs & are
given 2x daily. Indacaterol is given once daily. LABAs have replaced the regular use
of SABAs, but LABAs should not be given in the absence of ICS therapy because
they don't control the underlying inflammation. They improve asthma control and
reduce exacerbations when given w/ ICS, which allows asthma to be controlled at
lower doses of corticosteroids.
Most common side effects are tremors and palpitations.
Anticholinergics - correct-answer -Muscarinic receptor antagonists such as
ipratropium bromide prevent cholinergic nerve-induced bronchoconstriction &
mucus secretion.
Less effective than B2 agonists.
May be used as an additional bronchodilator in pts w/ asthma that is not
controlled by ICS & LABA combinations.
High doses may be given by nebulizer in treating acute severe asthma, but should
only be given following B2-agonists, because they have slower onset of
bronchodilation.
,3|Page
Theophylline - correct-answer -It has now fallen out of favor because side effects
are common & inhaled B2-agonists are much more effective bronchodilators.
Nausea, vomiting & headaches are the most common side effects due to
phosphodiesterase inhibition. Diuresis & palpitations may also occur, at high
concentrations, cardiac arrhythmias, epileptic seizures, & death may occur due to
adenosine A1-receptor antagonism.
Inhaled Corticosteroids - correct-answer -Most effective anti-inflammatory agents
used in asthma therapy and are beneficial in treating asthma of any severity and
age.
Usually given 2x daily, but some may be effective once daily in mildly symptomatic
pts.
Now given as first-line therapy for patients with persistent asthma, but if they
don't control symptoms at low doses, it is usual to add a LABA as the next step.
Side effects include hoarseness (dysphonia) and oral candidiasis, which may be
reduced with the use of large-volume spacer device.
Systemic Corticosteroids - correct-answer -Used IV for the treatment of acute
severe asthma, although several studies now show that OCS (usually prednisone
or prednisolone 30-45 mg once daily for 5-10 days) is used to treat acute
exacerbations of asthma. No tapering of the dose is needed.
, 4|Page
Antileukotrienes - correct-answer -E.g. Montelukast - provide modest clinical
benefit in asthma.
Less effective than ICS in controlling asthma and have less effect on airway
inflammation, but are useful as an add-on therapy in some pts not controlled w/
low doses of ICS, although less effective than LABA.
Given once or twice daily
Anti-IgE - correct-answer -Omalizumab
Reduce number of exacerbations in pts w/ severe asthma and may improve
asthma control.
Very expensive and is only suitable for highly selected pts who are not controlled
on maximal doses of inhaler therapy and have circulating IgE within a specified
range.
Given a 3-4 month trial of therapy.
Given subq every 3-4 weeks and appears not to have significant side effects.
Acute Severe Asthma Management - correct-answer -High concentration of
oxygen by face mask yo achieve O2sat >90%.
Mainstay of treatment are high doses of SABA given either by nebulizer or
metered-dose inhaler w/ a spacer.
In severely ill patients with impending respiratory failure, IV B2-agonists may be
given.
A nebulized anticholinergic may be added if there is not a satisfactory response to
B2-agonists alone, as there are additive effects.
