NCLEX-RN Respiratory Pharmacology
Practice Questions & Rationales
20 Original NGN-Style MCQs
Asthma, COPD, Inhalers,
Corticosteroids, Bronchodilators
|Nursing Exam Study Guide
Question 1
Clinical Scenario
A 24-year-old woman with a history of persistent asthma arrives
at the emergency department complaining of wheezing, chest
tightness, and shortness of breath after exposure to cat dander.
Assessment findings include respiratory rate 30/min, heart rate
116/min, oxygen saturation 90% on room air, and diffuse
bilateral expiratory wheezes. The provider prescribes albuterol
via nebulizer.
Question Stem
Which assessment finding best indicates that the albuterol
treatment has been effective?
,A. Heart rate decreases from 116/min to 72/min
B. Oxygen saturation increases to 96% with decreased wheezing
C. Blood pressure decreases from 132/80 mm Hg to 110/68 mm
Hg
D. Productive cough with thick yellow sputum develops
Correct Answer
Correct Answer: B. Oxygen saturation increases to 96% with
decreased wheezing
Detailed Rationale
Albuterol is a short-acting beta2-adrenergic agonist (SABA) that
rapidly relaxes bronchial smooth muscle, producing
bronchodilation and improving airflow. A rise in oxygen
saturation accompanied by decreased wheezing and reduced
work of breathing demonstrates that ventilation has improved
and the medication has achieved its intended therapeutic
effect.
Option A is incorrect because although tachycardia related to
respiratory distress may improve as oxygenation improves,
albuterol commonly causes transient tachycardia rather than an
immediate decrease in heart rate. Heart rate alone is not the
best indicator of therapeutic success.
,Option C is incorrect because blood pressure changes are not
the primary measure of bronchodilator effectiveness.
Option D is incorrect because thick yellow sputum suggests
infection rather than successful bronchodilation. While
coughing may increase after treatment as airways open,
development of purulent sputum is not an expected
therapeutic response.
The nurse should assess breath sounds, respiratory effort,
oxygen saturation, peak expiratory flow (if available), and
symptom relief before and after administration. Patients should
also be taught that increasing reliance on albuterol may indicate
worsening asthma control requiring reassessment of long-term
therapy.
Learning Objectives
After completing this question, the learner should be able to:
• Identify the expected therapeutic response to albuterol.
• Evaluate treatment effectiveness using respiratory
assessment findings.
• Prioritize oxygenation when assessing bronchodilator
therapy.
• Recognize common adverse effects associated with beta2-
agonists.
, Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 67-year-old man with moderate chronic obstructive
pulmonary disease (COPD) is prescribed tiotropium via a dry
powder inhaler once daily. During discharge teaching, the nurse
assesses the patient's understanding of medication
administration.
Question Stem
Which statement by the patient indicates a need for further
teaching?
A. "I will take this medication every day even when I feel well."
B. "I will rinse my mouth after using this medication."
C. "I will use this inhaler if I suddenly become very short of
breath."
D. "I should keep using my rescue inhaler for acute breathing
attacks."
Correct Answer
Practice Questions & Rationales
20 Original NGN-Style MCQs
Asthma, COPD, Inhalers,
Corticosteroids, Bronchodilators
|Nursing Exam Study Guide
Question 1
Clinical Scenario
A 24-year-old woman with a history of persistent asthma arrives
at the emergency department complaining of wheezing, chest
tightness, and shortness of breath after exposure to cat dander.
Assessment findings include respiratory rate 30/min, heart rate
116/min, oxygen saturation 90% on room air, and diffuse
bilateral expiratory wheezes. The provider prescribes albuterol
via nebulizer.
Question Stem
Which assessment finding best indicates that the albuterol
treatment has been effective?
,A. Heart rate decreases from 116/min to 72/min
B. Oxygen saturation increases to 96% with decreased wheezing
C. Blood pressure decreases from 132/80 mm Hg to 110/68 mm
Hg
D. Productive cough with thick yellow sputum develops
Correct Answer
Correct Answer: B. Oxygen saturation increases to 96% with
decreased wheezing
Detailed Rationale
Albuterol is a short-acting beta2-adrenergic agonist (SABA) that
rapidly relaxes bronchial smooth muscle, producing
bronchodilation and improving airflow. A rise in oxygen
saturation accompanied by decreased wheezing and reduced
work of breathing demonstrates that ventilation has improved
and the medication has achieved its intended therapeutic
effect.
Option A is incorrect because although tachycardia related to
respiratory distress may improve as oxygenation improves,
albuterol commonly causes transient tachycardia rather than an
immediate decrease in heart rate. Heart rate alone is not the
best indicator of therapeutic success.
,Option C is incorrect because blood pressure changes are not
the primary measure of bronchodilator effectiveness.
Option D is incorrect because thick yellow sputum suggests
infection rather than successful bronchodilation. While
coughing may increase after treatment as airways open,
development of purulent sputum is not an expected
therapeutic response.
The nurse should assess breath sounds, respiratory effort,
oxygen saturation, peak expiratory flow (if available), and
symptom relief before and after administration. Patients should
also be taught that increasing reliance on albuterol may indicate
worsening asthma control requiring reassessment of long-term
therapy.
Learning Objectives
After completing this question, the learner should be able to:
• Identify the expected therapeutic response to albuterol.
• Evaluate treatment effectiveness using respiratory
assessment findings.
• Prioritize oxygenation when assessing bronchodilator
therapy.
• Recognize common adverse effects associated with beta2-
agonists.
, Medication Safety Focus
Monitoring
Question 2
Clinical Scenario
A 67-year-old man with moderate chronic obstructive
pulmonary disease (COPD) is prescribed tiotropium via a dry
powder inhaler once daily. During discharge teaching, the nurse
assesses the patient's understanding of medication
administration.
Question Stem
Which statement by the patient indicates a need for further
teaching?
A. "I will take this medication every day even when I feel well."
B. "I will rinse my mouth after using this medication."
C. "I will use this inhaler if I suddenly become very short of
breath."
D. "I should keep using my rescue inhaler for acute breathing
attacks."
Correct Answer
