1 || |P |a |g
|e
Nurs 640 Exam 1 2026 Newest
Comprehensive Questions And
Perfect Answers
Airway Responsiveness asthma - correct-answer -The increased AHR is normally
| | | | | | | | |
measured by methacholine or histamine challenge w/ calculation of the
| | | | | | | | | |
provocative concentration that reduces FEV1 by 20% (PC20).
| | | | | | |
Rarely used in clinical practice, but can be used in differential diagnosis of chronic
| | | | | | | | | | | | |
cough & when the diagnosis is in doubt in the setting of normal PFT.
| | | | | | | | | | | | | |
Imagings-asthma - correct-answer -Chest roentgenography - usually normal but in
| | | | | | | | |
|more severe patients may show hyperinflated lungs.
| | | | | |
In exacerbations, there may be evidence of pneumothorax.
| | | | | | |
Lung shadowing usually indicates pneumonia or eosinophilic infiltrates in pts w/
| | | | | | | | | |
bronchopulmonary aspergillosis.
| |
CT - areas of bronchiectasis in pts w/ severe asthma, & thickening of the bronchial
| | | | | | | | | | | | | |
walls, but these changes are not diagnostic of asthma.
| | | | | | | | |
Bronchodilator Therapies - correct-answer -act primarily on airway smooth
| | | | | | | |
muscle to reverse bronchoconstriction of asthma. Rapid relief of symptoms, but
| | | | | | | | | | |
has little or no effect on the underlying inflammatory process.
| | | | | | | | | |
,2 || |P |a |g
|e
B2- Agonists - correct-answer -Relaxes airway smooth muscle cells of the airways,
| | | | | | | | | | |
where they act as functional antagonists, reversing & preventing contraction of
| | | | | | | | | | |
airway smooth muscle cells by all known bronchoconstrictors.
| | | | | | |
Given by inhalation to reduce side effects.
| | | | | | |
SABAs such as albuterol & terbutaline have a duration of action of 3-6 hrs. They
| | | | | | | | | | | | | |
have rapid onset of bronchodilation, therefore used as needed for symptom relief.
| | | | | | | | | | | |
Increased use of SABAs indicates that asthma is not controlled.
| | | | | | | | | |
LABAs include salmeterol & formoterol, have duration of action over 12 hrs & are
| | | | | | | | | | | | |
given 2x daily. Indacaterol is given once daily. LABAs have replaced the regular use
| | | | | | | | | | | | | |
of SABAs, but LABAs should not be given in the absence of ICS therapy because
| | | | | | | | | | | | | | |
they don't control the underlying inflammation. They improve asthma control and
| | | | | | | | | | |
reduce exacerbations when given w/ ICS, which allows asthma to be controlled
| | | | | | | | | | | |
at lower doses of corticosteroids.
| | | | |
Most common side effects are tremors and palpitations.
| | | | | | |
Anticholinergics - correct-answer -Muscarinic receptor antagonists such as | | | | | | |
ipratropium bromide prevent cholinergic nerve-induced bronchoconstriction &
| | | | | |
|mucus secretion. |
Less effective than B2 agonists.
| | | |
May be used as an additional bronchodilator in pts w/ asthma that is not
| | | | | | | | | | | | |
controlled by ICS & LABA combinations.
| | | | | |
High doses may be given by nebulizer in treating acute severe asthma, but should
| | | | | | | | | | | | |
only be given following B2-agonists, because they have slower onset of
| | | | | | | | | | |
bronchodilation.
,3 || |P |a |g
|e
Theophylline - correct-answer -It has now fallen out of favor because side effects
| | | | | | | | | | | |
are common & inhaled B2-agonists are much more effective bronchodilators.
| | | | | | | | | |
Nausea, vomiting & headaches are the most common side effects due to
| | | | | | | | | | |
phosphodiesterase inhibition. Diuresis & palpitations may also occur, at high
| | | | | | | | | |
concentrations, cardiac arrhythmias, epileptic seizures, & death may occur due to
| | | | | | | | | |
adenosine A1-receptor antagonism.
| | |
Inhaled Corticosteroids - correct-answer -Most effective anti-inflammatory agents
| | | | | | |
|used in asthma therapy and are beneficial in treating asthma of any severity and
| | | | | | | | | | | | |
|age.
Usually given 2x daily, but some may be effective once daily in mildly symptomatic
| | | | | | | | | | | | |
pts.
|
Now given as first-line therapy for patients with persistent asthma, but if they
| | | | | | | | | | | |
don't control symptoms at low doses, it is usual to add a LABA as the next step.
| | | | | | | | | | | | | | | | |
Side effects include hoarseness (dysphonia) and oral candidiasis, which may be
| | | | | | | | | |
reduced with the use of large-volume spacer device.
| | | | | | | |
Systemic Corticosteroids - correct-answer -Used IV for the treatment of acute
| | | | | | | | | |
severe asthma, although several studies now show that OCS (usually prednisone
| | | | | | | | | |
or prednisolone 30-45 mg once daily for 5-10 days) is used to treat acute
| | | | | | | | | | | | | |
exacerbations of asthma. No tapering of the dose is needed.
| | | | | | | | |
, 4 || |P |a |g
|e
Antileukotrienes - correct-answer -E.g. Montelukast - provide modest clinical | | | | | | | |
benefit in asthma.
| | |
Less effective than ICS in controlling asthma and have less effect on airway
| | | | | | | | | | | |
inflammation, but are useful as an add-on therapy in some pts not controlled w/
| | | | | | | | | | | | |
|low doses of ICS, although less effective than LABA.
| | | | | | | |
Given once or twice daily
| | | |
Anti-IgE - correct-answer -Omalizumab
| | |
Reduce number of exacerbations in pts w/ severe asthma and may improve
| | | | | | | | | | |
asthma control.
| |
Very expensive and is only suitable for highly selected pts who are not controlled
| | | | | | | | | | | | |
on maximal doses of inhaler therapy and have circulating IgE within a specified
| | | | | | | | | | | | |
range.
|
Given a 3-4 month trial of therapy.
| | | | | |
Given subq every 3-4 weeks and appears not to have significant side effects.
| | | | | | | | | | | |
Acute Severe Asthma Management - correct-answer -High concentration of
| | | | | | | |
oxygen by face mask yo achieve O2sat >90%.
| | | | | | | |
Mainstay of treatment are high doses of SABA given either by nebulizer or
| | | | | | | | | | | |
metered-dose inhaler w/ a spacer.
| | | | |
In severely ill patients with impending respiratory failure, IV B2-agonists may be
| | | | | | | | | | |
|given.
A nebulized anticholinergic may be added if there is not a satisfactory response to
| | | | | | | | | | | | |
B2-agonists alone, as there are additive effects.
| | | | | | |
|e
Nurs 640 Exam 1 2026 Newest
Comprehensive Questions And
Perfect Answers
Airway Responsiveness asthma - correct-answer -The increased AHR is normally
| | | | | | | | |
measured by methacholine or histamine challenge w/ calculation of the
| | | | | | | | | |
provocative concentration that reduces FEV1 by 20% (PC20).
| | | | | | |
Rarely used in clinical practice, but can be used in differential diagnosis of chronic
| | | | | | | | | | | | |
cough & when the diagnosis is in doubt in the setting of normal PFT.
| | | | | | | | | | | | | |
Imagings-asthma - correct-answer -Chest roentgenography - usually normal but in
| | | | | | | | |
|more severe patients may show hyperinflated lungs.
| | | | | |
In exacerbations, there may be evidence of pneumothorax.
| | | | | | |
Lung shadowing usually indicates pneumonia or eosinophilic infiltrates in pts w/
| | | | | | | | | |
bronchopulmonary aspergillosis.
| |
CT - areas of bronchiectasis in pts w/ severe asthma, & thickening of the bronchial
| | | | | | | | | | | | | |
walls, but these changes are not diagnostic of asthma.
| | | | | | | | |
Bronchodilator Therapies - correct-answer -act primarily on airway smooth
| | | | | | | |
muscle to reverse bronchoconstriction of asthma. Rapid relief of symptoms, but
| | | | | | | | | | |
has little or no effect on the underlying inflammatory process.
| | | | | | | | | |
,2 || |P |a |g
|e
B2- Agonists - correct-answer -Relaxes airway smooth muscle cells of the airways,
| | | | | | | | | | |
where they act as functional antagonists, reversing & preventing contraction of
| | | | | | | | | | |
airway smooth muscle cells by all known bronchoconstrictors.
| | | | | | |
Given by inhalation to reduce side effects.
| | | | | | |
SABAs such as albuterol & terbutaline have a duration of action of 3-6 hrs. They
| | | | | | | | | | | | | |
have rapid onset of bronchodilation, therefore used as needed for symptom relief.
| | | | | | | | | | | |
Increased use of SABAs indicates that asthma is not controlled.
| | | | | | | | | |
LABAs include salmeterol & formoterol, have duration of action over 12 hrs & are
| | | | | | | | | | | | |
given 2x daily. Indacaterol is given once daily. LABAs have replaced the regular use
| | | | | | | | | | | | | |
of SABAs, but LABAs should not be given in the absence of ICS therapy because
| | | | | | | | | | | | | | |
they don't control the underlying inflammation. They improve asthma control and
| | | | | | | | | | |
reduce exacerbations when given w/ ICS, which allows asthma to be controlled
| | | | | | | | | | | |
at lower doses of corticosteroids.
| | | | |
Most common side effects are tremors and palpitations.
| | | | | | |
Anticholinergics - correct-answer -Muscarinic receptor antagonists such as | | | | | | |
ipratropium bromide prevent cholinergic nerve-induced bronchoconstriction &
| | | | | |
|mucus secretion. |
Less effective than B2 agonists.
| | | |
May be used as an additional bronchodilator in pts w/ asthma that is not
| | | | | | | | | | | | |
controlled by ICS & LABA combinations.
| | | | | |
High doses may be given by nebulizer in treating acute severe asthma, but should
| | | | | | | | | | | | |
only be given following B2-agonists, because they have slower onset of
| | | | | | | | | | |
bronchodilation.
,3 || |P |a |g
|e
Theophylline - correct-answer -It has now fallen out of favor because side effects
| | | | | | | | | | | |
are common & inhaled B2-agonists are much more effective bronchodilators.
| | | | | | | | | |
Nausea, vomiting & headaches are the most common side effects due to
| | | | | | | | | | |
phosphodiesterase inhibition. Diuresis & palpitations may also occur, at high
| | | | | | | | | |
concentrations, cardiac arrhythmias, epileptic seizures, & death may occur due to
| | | | | | | | | |
adenosine A1-receptor antagonism.
| | |
Inhaled Corticosteroids - correct-answer -Most effective anti-inflammatory agents
| | | | | | |
|used in asthma therapy and are beneficial in treating asthma of any severity and
| | | | | | | | | | | | |
|age.
Usually given 2x daily, but some may be effective once daily in mildly symptomatic
| | | | | | | | | | | | |
pts.
|
Now given as first-line therapy for patients with persistent asthma, but if they
| | | | | | | | | | | |
don't control symptoms at low doses, it is usual to add a LABA as the next step.
| | | | | | | | | | | | | | | | |
Side effects include hoarseness (dysphonia) and oral candidiasis, which may be
| | | | | | | | | |
reduced with the use of large-volume spacer device.
| | | | | | | |
Systemic Corticosteroids - correct-answer -Used IV for the treatment of acute
| | | | | | | | | |
severe asthma, although several studies now show that OCS (usually prednisone
| | | | | | | | | |
or prednisolone 30-45 mg once daily for 5-10 days) is used to treat acute
| | | | | | | | | | | | | |
exacerbations of asthma. No tapering of the dose is needed.
| | | | | | | | |
, 4 || |P |a |g
|e
Antileukotrienes - correct-answer -E.g. Montelukast - provide modest clinical | | | | | | | |
benefit in asthma.
| | |
Less effective than ICS in controlling asthma and have less effect on airway
| | | | | | | | | | | |
inflammation, but are useful as an add-on therapy in some pts not controlled w/
| | | | | | | | | | | | |
|low doses of ICS, although less effective than LABA.
| | | | | | | |
Given once or twice daily
| | | |
Anti-IgE - correct-answer -Omalizumab
| | |
Reduce number of exacerbations in pts w/ severe asthma and may improve
| | | | | | | | | | |
asthma control.
| |
Very expensive and is only suitable for highly selected pts who are not controlled
| | | | | | | | | | | | |
on maximal doses of inhaler therapy and have circulating IgE within a specified
| | | | | | | | | | | | |
range.
|
Given a 3-4 month trial of therapy.
| | | | | |
Given subq every 3-4 weeks and appears not to have significant side effects.
| | | | | | | | | | | |
Acute Severe Asthma Management - correct-answer -High concentration of
| | | | | | | |
oxygen by face mask yo achieve O2sat >90%.
| | | | | | | |
Mainstay of treatment are high doses of SABA given either by nebulizer or
| | | | | | | | | | | |
metered-dose inhaler w/ a spacer.
| | | | |
In severely ill patients with impending respiratory failure, IV B2-agonists may be
| | | | | | | | | | |
|given.
A nebulized anticholinergic may be added if there is not a satisfactory response to
| | | | | | | | | | | | |
B2-agonists alone, as there are additive effects.
| | | | | | |
