NR 566 WEEK 4 MIDTERM STUDY
GUIDE PLUS REVIEW QUESTIONS
RESPIRATORY, EYES, EARS
QUESTIONS
1.
When used in the treatment of chronic obstructive pulmonary inhibit bacterial protein disease (COPD),
macrolides: synthesis.
Macrolides such as erythromycin (Erytab) and azithromycin (Zithromax) inhibit bacterial protein synthesis and
growth by blocking dissociation of peptidyl trna from ribosomes, causing RNA-dependent protein synthesis to
arrest. Macrolides exert several immune-modulatory and anti-inflammatory outcomes. Penicillin inhibit
bacterial cell wall synthesis while fluoroquinolones prevent bacterial DNA from replicating.
2.
Theophylline (Theo-24) may have an outcome on the serum total cholesterol and uric acid
concentrations of: levels.
As a result of its pharmacological outcomes, theophylline at serum concentrations within the 10 to 20 mcg/ml
range modestly increases plasma glucose, uric acid, free fatty acids, total cholesterol, HDL, HDL/LDL ratio, and
urinary free cortisol excretion.
3.
Doxycycline (Doryx), for the treatment of may cause esophageal irritation and pneumonia,
ulceration.
Doxycycline (Doryx) may cause esophageal irritation and ulceration. The client should be instructed to drink
fluids liberally. The client should avoid excessive sunlight or artificial ultraviolet light while receiving
doxycycline and to discontinue therapy if photo toxicity occurs. The use of doxycycline might increase the
incidence of vaginal candidiasis.
4.
Which of the following medications, when combined with pulmonary Tiotropium (Spiriva rehabilitation,
enhances exercise performance? Handihaler).
Medboost stuvia.com
,Tiotropium (Spiriva handihaler), a long-acting ant muscarinic antagonist, enhances the outcome iveness of
pulmonary rehabilitation in increasing exercise performance.
5. The initial recommended treatment for uncomplicated acute bronchitis in adults is: antitussives.
Most cases of acute bronchitis are viral and resolve without treatment within a couple of weeks.
Management of cough is recommended with antitussives. Because of the risk of antibiotic resistance and
Clostridium difficile infection, antibiotics should not be routinely used in the treatment of acute bronchitis.
Decongestants and antihistamines are in out comeive unless there is confirmed sinusitis or underlying allergy.
The FDA has recommended that cough and cold preparations not be used in children younger than 6 years.
6.
Robitussin DM is a combination of dextromethorphan and: guaifenesin.
Robitussin DM is a combination of dextromethorphan and guaifenesin for the treatment of cough. It can be
purchased over the counter. It is not recommended for children younger than 6 years.
7.
Dextromethorphan, a cough suppressant, is safe to administer to clients who have: hypertension.
The use of dextromethorphan, a cough suppressant, is contraindicated in clients with difficulty clearing
secretions or with Parkinson's disease. Dextromethorphan decreases the sensitivity of cough receptors and
interrupts cough impulse transmission by depressing the medullary cough center through sigma receptor
stimulation. Also, due to serotonergic outcomes, caution should be used when administering to clients who
are taking certain selective serotonin reuptake inhibitors (ssris) or serotonin norepinephrine reuptake
inhibitors (snris) (i.e. Venlafaxine [Effexor]).
8.
The main side outcome related to the use of long-acting ant muscarinic antagonists is: dry mouth.
The main side outcome is dryness of mouth. Inhaled anticholinergic drugs are poorly absorbed, which limits
the troublesome systemic outcomes observed with atropine. Extensive use of this class of agents in a wide
range of doses and clinical settings has shown them to be very safe.
9.
Treatment of Bordetella pertussis in a client with a sulfamethoxazole/trimethoprim hypersensitivity to
macrolides is: (Bactrim).
Sulfamethoxazole/trimethoprim (Bactrim) is an alternative choice for clients in whom a macrolide is
contraindicated.
10.
, A client who is receiving warfarin (Coumadin) requires the initiation the warfarin (Coumadin) of
doxycycline (Doryx) for the treatment of pneumonia. The nurse dose may need to be practitioner
knows that: decreased.
Because tetracyclines depress plasma prothrombin activity, clients who are on anticoagulant therapy may
require downward adjustment of their anticoagulant dosage. The combination of warfarin (Coumadin) and
doxycycline (Doryx) may cause an increase in the INR and subsequent risk of bleeding. Hepatic metabolism is
inhibited and alteration of vitamin K-producing gut flora may occur.
11.
Amoxicillin/clavulanate (Augmentin), a beta-lactam is primarily excreted unchanged in the antibiotic,
urine.
Approximately 50% to 70% of the amoxicillin and approximately 25% to 40% of the clavulanic acid are
excreted unchanged in urine. Neither component in amoxicillin/clavulanate (Augmentin) is highly
proteinbound. Amoxicillin diffuses readily into most body tissues and fluids, with the exception of the brain
and spinal fluid. The half-life of amoxicillin after the oral administration of Augmentin is 1.3 hours and that of
clavulanic acid is 1 hour.
12.
An example of an inhaled glucocorticoid used in the treatment of asthma is: budesonide (Pulmicort)
Budesonide (Pulmicort) is an inhaled corticosteroid used in the treatment of asthma. The mechanism of
action of inhaled glucocorticoids is to decrease the activity of inflammatory cells and mediators.
13.
For complaints of dysphonia related to the use of mometasone (Asmanex utilize a spacer for
Twist haler), the client should be advised to: administration.
For complaints of dysphonia related to the use of mometasone (Asmanex Twisthaler), the nurse practitioner
should advise the client to use a spacer when taking the medication. Using a spacer causes less deposition of
the droplets in the mouth, which can cause dysphonia. If the asthma is well controlled, stopping the
medication is not appropriate. The use of an oropharyngeal analgesic (i.e., Chloraseptic spray) would not help
with inhibit dysphonia.
14.
Montelukast (Singular) blocks or inhibits the action of: leukotrienes.
Montelukast (Singular) blocks or inhibits the action of leukotrienes. In asthma, leukotriene-mediated
outcomes include airway edema, smooth muscle contraction, and altered cellular activity associated with the
inflammatory process. In allergic rhinitis, cysteinyl leukotriene receptors are released from the nasal mucosa
after allergen exposure during both early- and late-phase reactions and are associated with symptoms of
allergic rhinitis.
Medboost stuvia.com
, 15.
Which statement is NOT true about Long-acting beta2-agonists have no outcome on reduction of beta2-
agonists? Exacerbations.
The principal action of beta2-agonists is to relax airway smooth muscle by stimulating beta2-adrenergic
receptors, which increase cyclic AMP and produce functional antagonism to bronchoconstriction. There are
short-acting (SABA) and long-acting (LABA) beta2-agonists. Twice-daily labas significantly improve FEV1 and
lung volumes, dyspnea, health status, exacerbation rate and number of hospitalizations, but they have no
outcome on mortality or rate of decline of lung function. Stimulation of beta2-adrenergic receptors can
produce resting sinus tachycardia, cardiac rhythm disturbances, and exaggerate somatic tremor, regardless of
route of administration.
16.
Caution is advised when theophylline (Theo-24) is prescribed for clients with a atrial history of:
fibrillation.
Theophylline should be used with extreme caution in clients with active peptic ulcer disease, seizure disorder
or cardiac arrhythmias (not including bradyarrhythmias) due to the increased risk of exacerbation of these
conditions.
17.
Inhaled antimuscarinic agents, such as ipratropium reduce exacerbation rates better than bromide
(Atrovent HFA),: beta2-agonists.
Inhaled ant muscarinic agents block the bronchoconstrictor outcomes of acetylcholine on M3 muscarinic
receptors expressed in airway smooth muscle. There are short-acting antimuscarinics (samas) and long acting
antimuscarinic antagonists (lamas). A greater outcome on exacerbation rates for LAMA treatment
(tiotropium) versus LABA treatment has been shown. Inhaled anticholinergic drugs are poorly absorbed,
which limits the troublesome systemic outcomes observed with atropine. Labas have proven to be very safe.
18.
The beta2 adrenergic receptor agonist most commonly used to prevent bronchospasm albuterol.
Associated with exercise-induced asthma is:
Short-acting beta-2 agonists (sabas) are the most commonly used preexercise medications for
exerciseinduced asthma. Sabas include albuterol, levalbuterol (Xopenex FHA) and pirbuterol (Maxair).
Fluticasone (Flovent) is an inhaled steroid. Salmeterol (Serevent) is a long-acting beta-2 agonist (LABA).
Budesonide (Pulmicort) is an inhaled steroid.
19.
The most common symptom of theophylline toxicity (acute or chronic) is severe and protracted vomiting.
GUIDE PLUS REVIEW QUESTIONS
RESPIRATORY, EYES, EARS
QUESTIONS
1.
When used in the treatment of chronic obstructive pulmonary inhibit bacterial protein disease (COPD),
macrolides: synthesis.
Macrolides such as erythromycin (Erytab) and azithromycin (Zithromax) inhibit bacterial protein synthesis and
growth by blocking dissociation of peptidyl trna from ribosomes, causing RNA-dependent protein synthesis to
arrest. Macrolides exert several immune-modulatory and anti-inflammatory outcomes. Penicillin inhibit
bacterial cell wall synthesis while fluoroquinolones prevent bacterial DNA from replicating.
2.
Theophylline (Theo-24) may have an outcome on the serum total cholesterol and uric acid
concentrations of: levels.
As a result of its pharmacological outcomes, theophylline at serum concentrations within the 10 to 20 mcg/ml
range modestly increases plasma glucose, uric acid, free fatty acids, total cholesterol, HDL, HDL/LDL ratio, and
urinary free cortisol excretion.
3.
Doxycycline (Doryx), for the treatment of may cause esophageal irritation and pneumonia,
ulceration.
Doxycycline (Doryx) may cause esophageal irritation and ulceration. The client should be instructed to drink
fluids liberally. The client should avoid excessive sunlight or artificial ultraviolet light while receiving
doxycycline and to discontinue therapy if photo toxicity occurs. The use of doxycycline might increase the
incidence of vaginal candidiasis.
4.
Which of the following medications, when combined with pulmonary Tiotropium (Spiriva rehabilitation,
enhances exercise performance? Handihaler).
Medboost stuvia.com
,Tiotropium (Spiriva handihaler), a long-acting ant muscarinic antagonist, enhances the outcome iveness of
pulmonary rehabilitation in increasing exercise performance.
5. The initial recommended treatment for uncomplicated acute bronchitis in adults is: antitussives.
Most cases of acute bronchitis are viral and resolve without treatment within a couple of weeks.
Management of cough is recommended with antitussives. Because of the risk of antibiotic resistance and
Clostridium difficile infection, antibiotics should not be routinely used in the treatment of acute bronchitis.
Decongestants and antihistamines are in out comeive unless there is confirmed sinusitis or underlying allergy.
The FDA has recommended that cough and cold preparations not be used in children younger than 6 years.
6.
Robitussin DM is a combination of dextromethorphan and: guaifenesin.
Robitussin DM is a combination of dextromethorphan and guaifenesin for the treatment of cough. It can be
purchased over the counter. It is not recommended for children younger than 6 years.
7.
Dextromethorphan, a cough suppressant, is safe to administer to clients who have: hypertension.
The use of dextromethorphan, a cough suppressant, is contraindicated in clients with difficulty clearing
secretions or with Parkinson's disease. Dextromethorphan decreases the sensitivity of cough receptors and
interrupts cough impulse transmission by depressing the medullary cough center through sigma receptor
stimulation. Also, due to serotonergic outcomes, caution should be used when administering to clients who
are taking certain selective serotonin reuptake inhibitors (ssris) or serotonin norepinephrine reuptake
inhibitors (snris) (i.e. Venlafaxine [Effexor]).
8.
The main side outcome related to the use of long-acting ant muscarinic antagonists is: dry mouth.
The main side outcome is dryness of mouth. Inhaled anticholinergic drugs are poorly absorbed, which limits
the troublesome systemic outcomes observed with atropine. Extensive use of this class of agents in a wide
range of doses and clinical settings has shown them to be very safe.
9.
Treatment of Bordetella pertussis in a client with a sulfamethoxazole/trimethoprim hypersensitivity to
macrolides is: (Bactrim).
Sulfamethoxazole/trimethoprim (Bactrim) is an alternative choice for clients in whom a macrolide is
contraindicated.
10.
, A client who is receiving warfarin (Coumadin) requires the initiation the warfarin (Coumadin) of
doxycycline (Doryx) for the treatment of pneumonia. The nurse dose may need to be practitioner
knows that: decreased.
Because tetracyclines depress plasma prothrombin activity, clients who are on anticoagulant therapy may
require downward adjustment of their anticoagulant dosage. The combination of warfarin (Coumadin) and
doxycycline (Doryx) may cause an increase in the INR and subsequent risk of bleeding. Hepatic metabolism is
inhibited and alteration of vitamin K-producing gut flora may occur.
11.
Amoxicillin/clavulanate (Augmentin), a beta-lactam is primarily excreted unchanged in the antibiotic,
urine.
Approximately 50% to 70% of the amoxicillin and approximately 25% to 40% of the clavulanic acid are
excreted unchanged in urine. Neither component in amoxicillin/clavulanate (Augmentin) is highly
proteinbound. Amoxicillin diffuses readily into most body tissues and fluids, with the exception of the brain
and spinal fluid. The half-life of amoxicillin after the oral administration of Augmentin is 1.3 hours and that of
clavulanic acid is 1 hour.
12.
An example of an inhaled glucocorticoid used in the treatment of asthma is: budesonide (Pulmicort)
Budesonide (Pulmicort) is an inhaled corticosteroid used in the treatment of asthma. The mechanism of
action of inhaled glucocorticoids is to decrease the activity of inflammatory cells and mediators.
13.
For complaints of dysphonia related to the use of mometasone (Asmanex utilize a spacer for
Twist haler), the client should be advised to: administration.
For complaints of dysphonia related to the use of mometasone (Asmanex Twisthaler), the nurse practitioner
should advise the client to use a spacer when taking the medication. Using a spacer causes less deposition of
the droplets in the mouth, which can cause dysphonia. If the asthma is well controlled, stopping the
medication is not appropriate. The use of an oropharyngeal analgesic (i.e., Chloraseptic spray) would not help
with inhibit dysphonia.
14.
Montelukast (Singular) blocks or inhibits the action of: leukotrienes.
Montelukast (Singular) blocks or inhibits the action of leukotrienes. In asthma, leukotriene-mediated
outcomes include airway edema, smooth muscle contraction, and altered cellular activity associated with the
inflammatory process. In allergic rhinitis, cysteinyl leukotriene receptors are released from the nasal mucosa
after allergen exposure during both early- and late-phase reactions and are associated with symptoms of
allergic rhinitis.
Medboost stuvia.com
, 15.
Which statement is NOT true about Long-acting beta2-agonists have no outcome on reduction of beta2-
agonists? Exacerbations.
The principal action of beta2-agonists is to relax airway smooth muscle by stimulating beta2-adrenergic
receptors, which increase cyclic AMP and produce functional antagonism to bronchoconstriction. There are
short-acting (SABA) and long-acting (LABA) beta2-agonists. Twice-daily labas significantly improve FEV1 and
lung volumes, dyspnea, health status, exacerbation rate and number of hospitalizations, but they have no
outcome on mortality or rate of decline of lung function. Stimulation of beta2-adrenergic receptors can
produce resting sinus tachycardia, cardiac rhythm disturbances, and exaggerate somatic tremor, regardless of
route of administration.
16.
Caution is advised when theophylline (Theo-24) is prescribed for clients with a atrial history of:
fibrillation.
Theophylline should be used with extreme caution in clients with active peptic ulcer disease, seizure disorder
or cardiac arrhythmias (not including bradyarrhythmias) due to the increased risk of exacerbation of these
conditions.
17.
Inhaled antimuscarinic agents, such as ipratropium reduce exacerbation rates better than bromide
(Atrovent HFA),: beta2-agonists.
Inhaled ant muscarinic agents block the bronchoconstrictor outcomes of acetylcholine on M3 muscarinic
receptors expressed in airway smooth muscle. There are short-acting antimuscarinics (samas) and long acting
antimuscarinic antagonists (lamas). A greater outcome on exacerbation rates for LAMA treatment
(tiotropium) versus LABA treatment has been shown. Inhaled anticholinergic drugs are poorly absorbed,
which limits the troublesome systemic outcomes observed with atropine. Labas have proven to be very safe.
18.
The beta2 adrenergic receptor agonist most commonly used to prevent bronchospasm albuterol.
Associated with exercise-induced asthma is:
Short-acting beta-2 agonists (sabas) are the most commonly used preexercise medications for
exerciseinduced asthma. Sabas include albuterol, levalbuterol (Xopenex FHA) and pirbuterol (Maxair).
Fluticasone (Flovent) is an inhaled steroid. Salmeterol (Serevent) is a long-acting beta-2 agonist (LABA).
Budesonide (Pulmicort) is an inhaled steroid.
19.
The most common symptom of theophylline toxicity (acute or chronic) is severe and protracted vomiting.
