Pedi Hesi Pharmacology | PHARM 1301 Pharmacology

1. The school nurse is presenting a class on smoking cessation at the local high school. A participant in the class asks the nurse about the risk of lung cancer in those who smoke. What response related to risk for lung cancer in smokers is most accurate? A. “The younger you are when you start smoking, the higher your risk of lung cancer.” B. “The risk for lung cancer never decreases once you have smoked, which is why smokers need annual chest x-rays.” C. “The risk for lung cancer is determined mostly by what type of cigarettes you smoke.” D. “The risk for lung cancer depends primarily on the other risk factors for cancer that you have.” Ans: A Feedback: Risk is determined by the pack-year history (number of packs of cigarettes used each day, multiplied by the number of years smoked), the age of initiation of smoking, the depth of inhalation, and the tar and nicotine levels in the cigarettes smoked. The younger a person is when he or she starts smoking, the greater the risk of developing lung cancer. Risk declines after smoking cessation. The type of cigarettes is a significant variable, but this is not the most important factor. 2. A nurse is creating a health promotion intervention focused on chronic obstructive pulmonary disease (COPD). What should the nurse identify as a complication of COPD? A. Lung cancer B. Cystic fibrosis C. Respiratory failure D. Hemothorax Ans: C Feedback: Complications of COPD include respiratory failure, pneumothorax, atelectasis, pneumonia, and pulmonary hypertension (Cor Pulmonale). Lung cancer, cystic fibrosis, and hemothorax are not common complications. 3. A school nurse is caring for a 10-year-old girl who is having an asthma attack. What is the preferred intervention to alleviate this client’s airflow obstruction? A. Administer corticosteroids by metered dose inhaler B. Administer inhaled anticholinergics C. Administer an inhaled beta-adrenergic agonist D. Utilize a peak flow monitoring device Ans: C Feedback: Asthma exacerbations are best managed by early treatment and education of the patient. Quick-acting beta-adrenergic medications are the first used for prompt relief of airflow obstruction. Systemic corticosteroids may be necessary to decrease airway inflammation in patients who fail to respond to inhaled beta-adrenergic medication. A peak flow device will not resolve short-term shortness of breath. 4. A student nurse is developing a teaching plan for an adult patient with asthma. Which teaching point should have the highest priority in the plan of care that the student is developing? A. Gradually increase levels of physical exertion. B. Change filters on heaters and air conditioners frequently. C. Take prescribed medications as scheduled. D. Avoid goose-down pillows. Ans: C Feedback: Although all of the measures are appropriate for a client with asthma, taking prescribed medications on time is the most important measure in preventing asthma attacks. 5. A patient is having pulmonary-function studies performed. The patient performs a spirometry test, revealing an FEV1/FVC ratio of 60%. How should the nurse interpret this assessment finding? A. Strong exercise tolerance B. Exhalation volume is normal C. Respiratory infection D. Obstructive lung disease Ans: D Feedback: Spirometry is used to evaluate airflow obstruction, which is determined by the ratio of forced expiration volume in 1 second to forced vital capacity. Obstructive lung disease is apparent when an FEV1/FVC ratio is less than 70%. 6. A nurse is reviewing the pathophysiology of cystic fibrosis (CF) in anticipation of a new admission. The nurse should identify what characteristic aspects of CF? A. Alveolar mucus plugging, infection, and eventual bronchiectasis B. Bronchial mucus plugging, inflammation, and eventual bronchiectasis C. Atelectasis, infection, and eventual COPD D. Bronchial mucus plugging, infection, and eventual COPD Ans: B Feedback: The hallmark pathology of CF is bronchial mucus plugging, inflammation, and eventual bronchiectasis. Commonly, the bronchiectasis begins in the upper lobes and progresses to involve all lobes. Infection, atelectasis, and COPD are not hallmark pathologies of CF. 7. The nurse is taking a health history of a new patient. The patient reports experiencing pain in his left lower leg and foot when walking. This pain is relieved with rest. The nurse notes that the left lower leg is slightly edematous and is hairless. When planning this patient’s subsequent care, the nurse should most likely address what health problem? A. Coronary artery disease (CAD) B. Intermittent claudication C. Arterial embolus D. Raynaud’s disease .............................................................continued