N316B – Child and Family Health Nursing – Pharmacology Midterm Questions and Answers

N316B – Child and Family Health Nursing – Pharmacology Midterm Questions and Answers

Question 1

A nurse is teaching an 80-year-old client how to use a metered dose inhaler. The nurse is
concerned that the client is unable to coordinate the release of the medication during the
inhalation phase. Which intervention should improve the delivery of the medication?

Question 1 Answer Choices

AAsk a family member to assist the client with the inhaler.

Ask a family member to assist the client with the inhaler.

BRequest a home health nurse to visit the client at home.

Request a home health nurse to visit the client at home.

CUse nebulized treatments at home instead.

Use nebulized treatments at home instead.

DAdd a spacer device to the inhaler canister.

Add a spacer device to the inhaler canister.



Question Explanation Rationale

Use of a spacer is especially useful with older adults because it allows more time to inhale and
requires less eye-hand coordination. If the client is not using the metered dose inhaler (MDI)
properly, the medication can get trapped in the upper airway and lead to dry mouth and throat
irritation. Using a spacer will allow more drug to be deposited in the lungs and less in the
mouth.



Question 2

The nurse is providing discharge education to a client with moderate persistent asthma. The
nurse should instruct the client to administer which medication first?

Question 2 Answer Choices

ABronchodilator

Bronchodilator

,BGlucocorticoid

Glucocorticoid

CAnticholinergic

Anticholinergic

DMast cell stabilizer

Mast cell stabilizer



Question Explanation Rationale

Bronchodilators, such as albuterol, are beta-agonist drugs that relieve bronchospasm by
relaxing the smooth muscle of the airway. These medications should be inhaled first to open
the airways, which will allow the other medications to move more deeply into the lungs and
increase their effectiveness.



Question 3

A client with a history of asthma is admitted for a minor surgical procedure. Preoperatively, the
peak flow is measured at 480 liters/minute. Postoperatively, the client reports chest tightness
and the peak flow is now 200 liters/minute. What should the nurse do first?

Question 3 Answer Choices

ANotify both the surgeon and primary care provider

Notify both the surgeon and primary care provider

BRepeat the peak flow reading in 30 minutes

Repeat the peak flow reading in 30 minutes

CAdminister the PRN dose of albuterol

Administer the PRN dose of albuterol

DApply oxygen at two liters per nasal cannula

Apply oxygen at two liters per nasal cannula

,Question Explanation Rationale

Peak flow monitoring during exacerbations of asthma is recommended for clients with
moderate-to-severe persistent asthma to determine the severity of the exacerbation and to
guide the treatment. A peak flow reading of less than 50% of the client's baseline reading is a
medical alert condition and a short-acting beta agonist must be taken immediately. Notifying
the health care provider is important, but that is not what would be done first. First, the client
needs assistance. Oxygen administration will not be effective if the airway constriction is not
relieved with the albuterol. Leaving the client and returning in 30 minutes will do nothing to
help a client in acute distress.



Question 6

The nurse is teaching the client how to properly use a dry powder capsule inhaler. How should
the nurse instruct the client to use this type of inhaler?

Question 6 Answer Choices

AShake inhaler before putting it in mouth

Shake inhaler before putting it in mouth

BSeal lips tightly around mouthpiece and inhale rapidly and deeply

Seal lips tightly around mouthpiece and inhale rapidly and deeply

CRinse mouthpiece in hot soapy water after using

Rinse mouthpiece in hot soapy water after using

DBreathe in medicine slowly and deeply for about 3-5 seconds

Breathe in medicine slowly and deeply for about 3-5 seconds



Question Explanation Rationale

The client should breathe in quickly and deeply for up to 10 seconds when using a dry powder
capsule inhaler. The client should not shake this type of inhaler. The mouthpiece can be rinsed
with warm water but without soap or detergent.



Question 7

, A client is being discharged with a prescription for warfarin. Which information is most
important to be included in the nurse's discharge teaching?

Question 7 Answer Choices

ATake acetaminophen for minor pain

Take acetaminophen for minor pain

BUse a soft toothbrush

Use a soft toothbrush

CAvoid eating leafy green vegetables

Avoid eating leafy green vegetables

DReport nose or gum bleeding

Report nose or gum bleeding



Question Explanation Rationale

The most important teaching is to make sure that the client understands to report any sign of
bleeding including nose or gum bleeding, blood noted in stools or urine, coughing up blood, or
easy bruising. Dark green leafy vegetables are high in vitamin K which can lower the
effectiveness of warfarin (Coumadin). Acetaminophen does not contain aspirin which can cause
internal bleeding so is safe to use when taking warfarin. A soft toothbrush will be less irritating
to the gums and therefore decrease the risk of bleeding gums. Although green leafy vegetables
contain Vitamin K, it is no longer recommended to avoid them but to keep their intake
consistent.



Question 9

The client has been treated with long-term glucocorticoid therapy. While completing the
physical assessment, which finding should the nurse expect?

Question 9 Answer Choices

AJaundice

Jaundice

BPeripheral edema