Test bank pharmacology: a patient-centered nursing process approach
The nurse is caring for a patient who is receiving intravenous theophylline. The
patient complains of
headache and nausea. The nurse will contact the provider to
a. change the medication to an oral theophylline.
b. obtain an order for a serum theophylline level.
c. request an order for an analgesic medication.
d. suggest an alternative methylxanthine medication. - -ANS: B
Theophylline has a narrow therapeutic index and a risk for severe symptoms
with toxic levels. When patients
report symptoms of theophylline adverse effects, a serum drug level should be
obtained. Giving an oral
Test Bank - Pharmacology: A Patient-Centered Nursing Process Approach (9th
Edition, 2017) 201
theophylline would only compound the problem if the patient has a toxic drug
level. Analgesics may be used,
but only after toxicity is ruled out. Adding a different methylxanthine will
compound the symptoms and will
likely result in drug interaction or unwanted synergism.
--1. The nurse is caring for a patient recently diagnosed with mild emphysema
and provides teaching about the
disease and medications for treatment. Which statement by the patient
indicates understanding of the
medication regimen?
a. I should use albuterol when my symptoms worsen.
b. I will need to take oral prednisone on a daily basis.
c. My provider will prescribe prophylactic antibiotics.
d. My symptoms are reversible with proper medications. - -ANS: A
,Albuterol is used to treat bronchospasm during symptom flares. Oral
prednisone is given for acute flares but
not generally on a daily basis until symptoms are chronic and severe because
of the risk of adrenal suppression.
Prophylactic antibiotics are not given regularly because of the risk of antibiotic
resistance. Symptoms of
emphysema are not reversible.
--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?
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 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?
Test Bank - Pharmacology: A Patient-Centered Nursing Process Approach (9th
Edition, 2017) 200
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.
--The nurse is teaching a patient who will begin taking oral theophylline (Theo-
Dur) when discharged home
from the hospital. What information will the nurse include when teaching the
patient about this drug?
a. An extra dose should be taken when symptoms worsen.
b. Anorexia and gastrointestinal upset are unexpected side effects.
c. Avoid caffeine while taking this medication.
d. Food will decrease the amount of drug absorbed. - -ANS: C
Caffeine and theophylline are both xanthine derivatives and should not be
taken together because of the
increased risk of toxicity and severe adverse effects. Theophylline has a narrow
therapeutic range and must be
dosed carefully; patients should never increase or decrease the dose without
consulting their provider.
The nurse is caring for a patient who is receiving intravenous theophylline. The
patient complains of
headache and nausea. The nurse will contact the provider to
a. change the medication to an oral theophylline.
b. obtain an order for a serum theophylline level.
c. request an order for an analgesic medication.
d. suggest an alternative methylxanthine medication. - -ANS: B
Theophylline has a narrow therapeutic index and a risk for severe symptoms
with toxic levels. When patients
report symptoms of theophylline adverse effects, a serum drug level should be
obtained. Giving an oral
Test Bank - Pharmacology: A Patient-Centered Nursing Process Approach (9th
Edition, 2017) 201
theophylline would only compound the problem if the patient has a toxic drug
level. Analgesics may be used,
but only after toxicity is ruled out. Adding a different methylxanthine will
compound the symptoms and will
likely result in drug interaction or unwanted synergism.
--1. The nurse is caring for a patient recently diagnosed with mild emphysema
and provides teaching about the
disease and medications for treatment. Which statement by the patient
indicates understanding of the
medication regimen?
a. I should use albuterol when my symptoms worsen.
b. I will need to take oral prednisone on a daily basis.
c. My provider will prescribe prophylactic antibiotics.
d. My symptoms are reversible with proper medications. - -ANS: A
,Albuterol is used to treat bronchospasm during symptom flares. Oral
prednisone is given for acute flares but
not generally on a daily basis until symptoms are chronic and severe because
of the risk of adrenal suppression.
Prophylactic antibiotics are not given regularly because of the risk of antibiotic
resistance. Symptoms of
emphysema are not reversible.
--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?
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 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?
Test Bank - Pharmacology: A Patient-Centered Nursing Process Approach (9th
Edition, 2017) 200
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.
--The nurse is teaching a patient who will begin taking oral theophylline (Theo-
Dur) when discharged home
from the hospital. What information will the nurse include when teaching the
patient about this drug?
a. An extra dose should be taken when symptoms worsen.
b. Anorexia and gastrointestinal upset are unexpected side effects.
c. Avoid caffeine while taking this medication.
d. Food will decrease the amount of drug absorbed. - -ANS: C
Caffeine and theophylline are both xanthine derivatives and should not be
taken together because of the
increased risk of toxicity and severe adverse effects. Theophylline has a narrow
therapeutic range and must be
dosed carefully; patients should never increase or decrease the dose without
consulting their provider.
