NCLEX-RN Respiratory Pharmacology
Practice Questions with Detailed
Rationales
20 Original NGN Nursing Exam MCQs
Question 1
Clinical Scenario
A 22-year-old client with persistent asthma reports using an
albuterol inhaler 5 to 6 times daily for the past month. The
client reports nighttime awakenings due to coughing twice
weekly.
Question Stem
Which medication should the nurse anticipate the provider
prescribing for long-term control?
A. Ipratropium inhaler
B. Prednisone as needed
C. Fluticasone inhaler
D. Albuterol nebulizer before bedtime
Correct Answer
C. Fluticasone inhaler
,Detailed Rationale
Fluticasone is an inhaled corticosteroid (ICS) and is considered
first-line therapy for persistent asthma because it decreases
airway inflammation and reduces exacerbations. Frequent use
of albuterol indicates poor asthma control and the need for a
controller medication.
Option A is incorrect because ipratropium is primarily used as
adjunctive therapy during acute exacerbations and in COPD.
Option B is incorrect because systemic corticosteroids are
generally reserved for acute exacerbations due to significant
adverse effects with long-term use. Option D is incorrect
because increasing short-acting beta2-agonist (SABA) use treats
symptoms but does not address underlying inflammation.
Nurses should educate patients that inhaled corticosteroids are
preventive medications and may require several days to weeks
for maximum benefit. Patients should rinse the mouth after use
to reduce the risk of oral candidiasis.
Learning Objectives
• Differentiate rescue and controller medications.
• Identify indications for inhaled corticosteroids.
• Recognize signs of poorly controlled asthma.
Medication Safety Focus
, Patient education
Question 2
Clinical Scenario
A 67-year-old client with COPD is prescribed tiotropium. The
nurse is providing discharge teaching.
Question Stem
Which statement by the client indicates a need for further
teaching?
A. "I will use this medication every day."
B. "This medication may cause dry mouth."
C. "I will use this inhaler when I have sudden shortness of
breath."
D. "I should increase fluid intake if my mouth feels dry."
Correct Answer
C. "I will use this inhaler when I have sudden shortness of
breath."
Detailed Rationale
Tiotropium is a long-acting muscarinic antagonist (LAMA) used
for maintenance treatment of COPD. It is not intended for acute
bronchospasm.
Practice Questions with Detailed
Rationales
20 Original NGN Nursing Exam MCQs
Question 1
Clinical Scenario
A 22-year-old client with persistent asthma reports using an
albuterol inhaler 5 to 6 times daily for the past month. The
client reports nighttime awakenings due to coughing twice
weekly.
Question Stem
Which medication should the nurse anticipate the provider
prescribing for long-term control?
A. Ipratropium inhaler
B. Prednisone as needed
C. Fluticasone inhaler
D. Albuterol nebulizer before bedtime
Correct Answer
C. Fluticasone inhaler
,Detailed Rationale
Fluticasone is an inhaled corticosteroid (ICS) and is considered
first-line therapy for persistent asthma because it decreases
airway inflammation and reduces exacerbations. Frequent use
of albuterol indicates poor asthma control and the need for a
controller medication.
Option A is incorrect because ipratropium is primarily used as
adjunctive therapy during acute exacerbations and in COPD.
Option B is incorrect because systemic corticosteroids are
generally reserved for acute exacerbations due to significant
adverse effects with long-term use. Option D is incorrect
because increasing short-acting beta2-agonist (SABA) use treats
symptoms but does not address underlying inflammation.
Nurses should educate patients that inhaled corticosteroids are
preventive medications and may require several days to weeks
for maximum benefit. Patients should rinse the mouth after use
to reduce the risk of oral candidiasis.
Learning Objectives
• Differentiate rescue and controller medications.
• Identify indications for inhaled corticosteroids.
• Recognize signs of poorly controlled asthma.
Medication Safety Focus
, Patient education
Question 2
Clinical Scenario
A 67-year-old client with COPD is prescribed tiotropium. The
nurse is providing discharge teaching.
Question Stem
Which statement by the client indicates a need for further
teaching?
A. "I will use this medication every day."
B. "This medication may cause dry mouth."
C. "I will use this inhaler when I have sudden shortness of
breath."
D. "I should increase fluid intake if my mouth feels dry."
Correct Answer
C. "I will use this inhaler when I have sudden shortness of
breath."
Detailed Rationale
Tiotropium is a long-acting muscarinic antagonist (LAMA) used
for maintenance treatment of COPD. It is not intended for acute
bronchospasm.
