Chapter 17. Drugs Affecting the Respiratory System
____ 1. Digoxin levels need to be monitored closely when the following medication is started:
1. Loratadine
2. Diphenhydramine
3. Ipratropium
4. Albuterol
____ 2. Patients with pheochromocytoma should avoid which of the following classes of drugs because of
the possibility of developing hypertensive crisis?
1. Expectorants
2. Beta-2-agonists
3. Antitussives
4. Antihistamines
____ 3. Harold, a 42-year-old African American, has moderate persistent asthma. Which of the following
asthma medications should be used cautiously, if at all?
1. Betamethasone, an inhaled corticosteroid
2. Salmeterol, an inhaled long-acting beta-agonist
3. Albuterol, a short-acting beta-agonist
4. Montelukast, a leukotriene modifier
____ 4. Long-acting beta-agonists (LTBAs) received a Black Box Warning from the U.S. Food and Drug
Administration due to the:
1. Risk of life-threatening dermatological reactions
2. Increased incidence of cardiac events when LTBAs are used
3. Increased risk of asthma-related deaths when LTBAs are used
4. Risk for life-threatening alterations in electrolytes
____ 5. The bronchodilator of choice for patients taking propranolol is:
1. Albuterol
2. Pirbuterol
3. Formoterol
4. Ipratropium
____ 6. James is a 52-year-old overweight smoker taking theophylline for his persistent asthma. He tells his
provider he is going to start the Atkin’s diet for weight loss. The appropriate response would be:
1. Congratulate him on making a positive change in his life.
2. Recommend he try stopping smoking instead of the Atkin’s diet.
3. Schedule him for regular testing of serum theophylline levels during his diet due to
increased excretion of theophylline.
4. Decrease his theophylline dose because a high-protein diet may lead to elevated
theophylline levels.
, ____ 7. Li takes theophylline for his persistent asthma and calls the office with a complaint of nausea,
vomiting, and headache. The best advice for him would be to:
1. Reassure him this is probably a viral infection and should be better soon
2. Have him seen the same day for an assessment and theophylline level
3. Schedule him for an appointment in 2 to 3 days, which he can cancel if he is better
4. Order a theophylline level at the laboratory for him
____ 8. Tiotropium bromide (Spiriva) is an inhaled anticholinergic:
1. Used for the treatment of chronic obstructive pulmonary disease (COPD)
2. Used in the treatment of asthma
3. Combined with albuterol for treatment of asthma exacerbations
4. Combined with fluticasone for the treatment of persistent asthma
____ 9. Christy has exercise-induced and mild persistent asthma and is prescribed two puffs of albuterol 15
minutes before exercise and as needed for wheezing. One puff per day of beclomethasone (QVAR)
is also prescribed. Teaching regarding her inhalers includes:
1. Use one to two puffs of albuterol per day to prevent an attack with no more than
eight puffs per day
2. Beclomethasone needs to be used every day to treat her asthma
3. Report any systemic side effects she is experiencing, such as weight gain
4. Use the albuterol metered-dose inhaler (MDI) immediately after her corticosteroid
MDI to facilitate bronchodilation
____ 10. When prescribing montelukast (Singulair) for asthma, patients or parents of patients should be
instructed:
1. Montelukast twice a day is started when there is an asthma exacerbation.
2. Patients may experience weight gain on montelukast.
3. Aggression, anxiety, depression, and/or suicidal thoughts may occur when taking
montelukast.
4. Lethargy and hypersomnia may occur when taking montelukast.
____ 11. Montelukast (Singulair) may be prescribed for:
1. A 6-year-old child with exercise-induced asthma
2. A 2-year-old child with moderate persistent asthma
3. An 18-month-old child with seasonal allergic rhinitis
4. None of the above; montelukast is not approved for use in children
____ 12. The known drug interactions with the inhaled corticosteroid beclomethasone (QVAR) include:
1. Albuterol
2. MMR vaccine
3. Insulin
4. None of the above
____ 13. When educating patients who are starting on inhaled corticosteroids, the provider should tell them
that:
1. They need to get any live vaccines before starting the medication.
2. Inhaled corticosteroids need to be used daily during asthma exacerbations to be
effective.
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