NUR 378 Exam 3 V2 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 3) |
Concordia
1. A patient is prescribed albuterol via a metered-dose inhaler for the treatment of asthma.
Which side effect should the nurse instruct the patient to monitor for most closely?
A. Tachycardia
B. Bradycardia
C. Hypoglycemia
D. Drowsiness
Correct Answer: A
Albuterol is a sympathomimetic agent that primarily stimulates beta-2 receptors but also
has some beta-1 activity. This stimulation often leads to cardiovascular effects such as
increased heart rate and palpitations. The nurse must ensure the patient understands that
feeling ‘jittery’ or having a racing heart is a common, though potentially concerning,
adverse effect.
2. When educating a patient on the use of beclomethasone dipropionate, which action is
most important to prevent a common local adverse effect?
A. Limit fluid intake to 1 liter per day
,B. Use the medication only when feeling short of breath
C. Rinse the mouth with water after each use
D. Avoid sunlight for two hours after administration
Correct Answer: C
Inhaled corticosteroids like beclomethasone can cause oropharyngeal candidiasis, also
known as thrush. Rinsing the mouth and spitting after inhalation removes residual
medication from the oral mucosa, significantly reducing this risk. This is a maintenance
medication and should be used daily regardless of symptoms, unlike rescue inhalers.
3. A patient taking theophylline for chronic obstructive pulmonary disease (COPD) presents
with nausea, vomiting, and a heart rate of 120 bpm. What is the priority nursing action?
A. Request a serum theophylline level
B. Increase the dose to improve oxygenation
C. Administer an antiemetic
D. Encourage the patient to drink caffeine
Correct Answer: A
Theophylline has a very narrow therapeutic index, typically between 10 to 20 mcg/mL.
Symptoms of toxicity include gastrointestinal distress and central nervous system
stimulation like tachycardia or seizures. Obtaining a serum level is the critical first step to
confirm toxicity and guide further medical intervention.
,4. A patient is prescribed montelukast for the prophylaxis of asthma. When should the nurse
instruct the patient to take this medication?
A. Once daily in the evening
B. Immediately at the onset of an asthma attack
C. Thirty minutes before vigorous exercise
D. Once daily in the morning
Correct Answer: A
Montelukast is a leukotriene receptor antagonist used for chronic asthma management. It
is traditionally dosed in the evening because asthma symptoms often worsen at night or in
the early morning hours. Consistent daily dosing is required for therapeutic effect, and it is
not intended for acute symptom relief.
5. A nurse is teaching a student about the correct steps for using a metered-dose inhaler
(MDI). Which sequence represents the most appropriate technique?
A. Exhale, shake the inhaler, inhale quickly, then hold breath for 2 seconds
B. Inhale deeply, press the canister, exhale immediately, then shake
C. Shake the inhaler, inhale, press the canister, then exhale
D. Exhale, press the canister, wait 5 seconds, then inhale
E. Shake the inhaler, exhale fully, press the canister while inhaling slowly, and hold breath
for 10 seconds
, F. Press the canister first, then shake, then inhale
Correct Answer: E
Proper MDI technique is essential for drug delivery to the lower respiratory tract. Shaking
the canister ensures the medication is mixed, and exhaling first allows for a deeper
inhalation of the dose. Holding the breath for 10 seconds allows the medication particles to
settle on the bronchial walls for maximum efficacy.
6. The nurse provides instructions to a patient taking guaifenesin for a productive cough.
Which instruction is most effective for thinning secretions?
A. Increase fluid intake to at least 2 liters per day
B. Take the medication with milk to prevent GI upset
C. Limit physical activity to prevent coughing spells
D. Only take the medication at bedtime
Correct Answer: A
Guaifenesin is an expectorant that works by increasing the volume and reducing the
viscosity of secretions in the trachea and bronchi. Adequate hydration is the most
important factor in assisting the action of expectorants to thin mucus. The nurse should
emphasize that the medication works best when the patient is well-hydrated.
7. A patient is taking diphenhydramine for allergic rhinitis. Which statement by the patient
indicates a need for further teaching regarding side effects?
A. I should avoid driving if I feel sleepy
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 3) |
Concordia
1. A patient is prescribed albuterol via a metered-dose inhaler for the treatment of asthma.
Which side effect should the nurse instruct the patient to monitor for most closely?
A. Tachycardia
B. Bradycardia
C. Hypoglycemia
D. Drowsiness
Correct Answer: A
Albuterol is a sympathomimetic agent that primarily stimulates beta-2 receptors but also
has some beta-1 activity. This stimulation often leads to cardiovascular effects such as
increased heart rate and palpitations. The nurse must ensure the patient understands that
feeling ‘jittery’ or having a racing heart is a common, though potentially concerning,
adverse effect.
2. When educating a patient on the use of beclomethasone dipropionate, which action is
most important to prevent a common local adverse effect?
A. Limit fluid intake to 1 liter per day
,B. Use the medication only when feeling short of breath
C. Rinse the mouth with water after each use
D. Avoid sunlight for two hours after administration
Correct Answer: C
Inhaled corticosteroids like beclomethasone can cause oropharyngeal candidiasis, also
known as thrush. Rinsing the mouth and spitting after inhalation removes residual
medication from the oral mucosa, significantly reducing this risk. This is a maintenance
medication and should be used daily regardless of symptoms, unlike rescue inhalers.
3. A patient taking theophylline for chronic obstructive pulmonary disease (COPD) presents
with nausea, vomiting, and a heart rate of 120 bpm. What is the priority nursing action?
A. Request a serum theophylline level
B. Increase the dose to improve oxygenation
C. Administer an antiemetic
D. Encourage the patient to drink caffeine
Correct Answer: A
Theophylline has a very narrow therapeutic index, typically between 10 to 20 mcg/mL.
Symptoms of toxicity include gastrointestinal distress and central nervous system
stimulation like tachycardia or seizures. Obtaining a serum level is the critical first step to
confirm toxicity and guide further medical intervention.
,4. A patient is prescribed montelukast for the prophylaxis of asthma. When should the nurse
instruct the patient to take this medication?
A. Once daily in the evening
B. Immediately at the onset of an asthma attack
C. Thirty minutes before vigorous exercise
D. Once daily in the morning
Correct Answer: A
Montelukast is a leukotriene receptor antagonist used for chronic asthma management. It
is traditionally dosed in the evening because asthma symptoms often worsen at night or in
the early morning hours. Consistent daily dosing is required for therapeutic effect, and it is
not intended for acute symptom relief.
5. A nurse is teaching a student about the correct steps for using a metered-dose inhaler
(MDI). Which sequence represents the most appropriate technique?
A. Exhale, shake the inhaler, inhale quickly, then hold breath for 2 seconds
B. Inhale deeply, press the canister, exhale immediately, then shake
C. Shake the inhaler, inhale, press the canister, then exhale
D. Exhale, press the canister, wait 5 seconds, then inhale
E. Shake the inhaler, exhale fully, press the canister while inhaling slowly, and hold breath
for 10 seconds
, F. Press the canister first, then shake, then inhale
Correct Answer: E
Proper MDI technique is essential for drug delivery to the lower respiratory tract. Shaking
the canister ensures the medication is mixed, and exhaling first allows for a deeper
inhalation of the dose. Holding the breath for 10 seconds allows the medication particles to
settle on the bronchial walls for maximum efficacy.
6. The nurse provides instructions to a patient taking guaifenesin for a productive cough.
Which instruction is most effective for thinning secretions?
A. Increase fluid intake to at least 2 liters per day
B. Take the medication with milk to prevent GI upset
C. Limit physical activity to prevent coughing spells
D. Only take the medication at bedtime
Correct Answer: A
Guaifenesin is an expectorant that works by increasing the volume and reducing the
viscosity of secretions in the trachea and bronchi. Adequate hydration is the most
important factor in assisting the action of expectorants to thin mucus. The nurse should
emphasize that the medication works best when the patient is well-hydrated.
7. A patient is taking diphenhydramine for allergic rhinitis. Which statement by the patient
indicates a need for further teaching regarding side effects?
A. I should avoid driving if I feel sleepy
