NUR 378 Exam 2 V1 | NUR 378
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 2) |
Concordia
1. A patient with acute asthma exacerbation is prescribed albuterol via a metered-dose
inhaler. Which physiological response should the nurse monitor for after administration?
A. Tachycardia
B. Hypoglycemia
C. Bradycardia
D. Hypoventilation
Correct Answer: A
Albuterol is a sympathomimetic agent that stimulates beta2-adrenergic receptors to cause
bronchodilation. However, it also has some beta1 activity, which can lead to cardiovascular
stimulation including tachycardia and palpitations. The nurse must assess the patient’s
heart rate and rhythm frequently during treatment to ensure safety.
2. When teaching a patient about the proper use of a corticosteroid inhaler like fluticasone,
which instruction is most critical for preventing local side effects?
A. Use the inhaler only when feeling short of breath.
B. Take a deep breath and hold it for at least 30 seconds.
,C. Rinse the mouth with water and spit after each use.
D. Avoid drinking water for one hour after administration.
Correct Answer: C
Rinsing the mouth helps to remove residual medication from the oral mucosa, which
significantly reduces the risk of developing oral candidiasis or thrush. Corticosteroids
suppress the local immune response in the mouth, allowing fungal overgrowth if not
cleared. This step is a standard part of patient education for all inhaled glucocorticoids.
3. A patient is being treated with theophylline for chronic obstructive pulmonary disease
(COPD). The nurse notes a serum theophylline level of 24 mcg/mL. What is the priority
nursing action?
A. Administer the next dose as scheduled.
B. Assess the patient for signs of toxicity and notify the provider.
C. Increase the dosage to achieve a higher therapeutic effect.
D. Document the findings as within the normal therapeutic range.
Correct Answer: B
The therapeutic range for theophylline is typically between 10 and 20 mcg/mL, meaning a
level of 24 mcg/mL is toxic. Toxicity can lead to severe adverse effects such as cardiac
arrhythmias and seizures. The nurse must hold the medication and contact the healthcare
provider immediately for further instructions.
,4. A nurse is providing discharge teaching for a patient prescribed montelukast. When should
the nurse advise the patient to take this medication?
A. At the first sign of an acute asthma attack.
B. Once daily in the evening.
C. Thirty minutes before strenuous exercise only.
D. Twice daily, once in the morning and once at night.
Correct Answer: B
Montelukast is a leukotriene receptor antagonist used for the long-term prophylaxis and
treatment of asthma. It is most effective when taken once daily in the evening because
leukotriene levels tend to peak during the night. It is not intended for the treatment of
acute bronchospasm or status asthmaticus.
5. A patient is prescribed multiple medications for respiratory management. Which of the
following drugs are classified as bronchodilators? (Select all that apply)
A. Albuterol
B. Ipratropium
C. Theophylline
D. Fluticasone
E. Salmeterol
Correct Answer: A
, Albuterol, Ipratropium, Theophylline, and Salmeterol all function to open the airways
through various mechanisms such as beta-agonism or anticholinergic effects. Fluticasone is
a corticosteroid, which reduces inflammation rather than providing direct bronchodilation.
Identifying the specific class of respiratory drugs is essential for understanding their onset
and role in therapy.
6. The nurse is caring for a patient receiving ipratropium via nebulizer. Which condition in the
patient’s medical history would require cautious use of this medication?
A. Hypertension
B. Diabetes Mellitus
C. Hypothyroidism
D. Glaucoma
Correct Answer: D
Ipratropium is an anticholinergic medication that can increase intraocular pressure,
making it potentially dangerous for patients with glaucoma. Anticholinergic effects can also
cause urinary retention, which is a concern for patients with prostatic hypertrophy. The
nurse must assess for these conditions before initiating therapy to prevent exacerbations.
7. What instruction should the nurse provide to a patient taking guaifenesin for a productive
cough?
A. Restrict fluid intake to concentrate the medication.
B. Expect the cough to stop completely within two doses.
Pharmacology in Nursing | Actual Q&A
with Rationale (NUR378 Exam 2) |
Concordia
1. A patient with acute asthma exacerbation is prescribed albuterol via a metered-dose
inhaler. Which physiological response should the nurse monitor for after administration?
A. Tachycardia
B. Hypoglycemia
C. Bradycardia
D. Hypoventilation
Correct Answer: A
Albuterol is a sympathomimetic agent that stimulates beta2-adrenergic receptors to cause
bronchodilation. However, it also has some beta1 activity, which can lead to cardiovascular
stimulation including tachycardia and palpitations. The nurse must assess the patient’s
heart rate and rhythm frequently during treatment to ensure safety.
2. When teaching a patient about the proper use of a corticosteroid inhaler like fluticasone,
which instruction is most critical for preventing local side effects?
A. Use the inhaler only when feeling short of breath.
B. Take a deep breath and hold it for at least 30 seconds.
,C. Rinse the mouth with water and spit after each use.
D. Avoid drinking water for one hour after administration.
Correct Answer: C
Rinsing the mouth helps to remove residual medication from the oral mucosa, which
significantly reduces the risk of developing oral candidiasis or thrush. Corticosteroids
suppress the local immune response in the mouth, allowing fungal overgrowth if not
cleared. This step is a standard part of patient education for all inhaled glucocorticoids.
3. A patient is being treated with theophylline for chronic obstructive pulmonary disease
(COPD). The nurse notes a serum theophylline level of 24 mcg/mL. What is the priority
nursing action?
A. Administer the next dose as scheduled.
B. Assess the patient for signs of toxicity and notify the provider.
C. Increase the dosage to achieve a higher therapeutic effect.
D. Document the findings as within the normal therapeutic range.
Correct Answer: B
The therapeutic range for theophylline is typically between 10 and 20 mcg/mL, meaning a
level of 24 mcg/mL is toxic. Toxicity can lead to severe adverse effects such as cardiac
arrhythmias and seizures. The nurse must hold the medication and contact the healthcare
provider immediately for further instructions.
,4. A nurse is providing discharge teaching for a patient prescribed montelukast. When should
the nurse advise the patient to take this medication?
A. At the first sign of an acute asthma attack.
B. Once daily in the evening.
C. Thirty minutes before strenuous exercise only.
D. Twice daily, once in the morning and once at night.
Correct Answer: B
Montelukast is a leukotriene receptor antagonist used for the long-term prophylaxis and
treatment of asthma. It is most effective when taken once daily in the evening because
leukotriene levels tend to peak during the night. It is not intended for the treatment of
acute bronchospasm or status asthmaticus.
5. A patient is prescribed multiple medications for respiratory management. Which of the
following drugs are classified as bronchodilators? (Select all that apply)
A. Albuterol
B. Ipratropium
C. Theophylline
D. Fluticasone
E. Salmeterol
Correct Answer: A
, Albuterol, Ipratropium, Theophylline, and Salmeterol all function to open the airways
through various mechanisms such as beta-agonism or anticholinergic effects. Fluticasone is
a corticosteroid, which reduces inflammation rather than providing direct bronchodilation.
Identifying the specific class of respiratory drugs is essential for understanding their onset
and role in therapy.
6. The nurse is caring for a patient receiving ipratropium via nebulizer. Which condition in the
patient’s medical history would require cautious use of this medication?
A. Hypertension
B. Diabetes Mellitus
C. Hypothyroidism
D. Glaucoma
Correct Answer: D
Ipratropium is an anticholinergic medication that can increase intraocular pressure,
making it potentially dangerous for patients with glaucoma. Anticholinergic effects can also
cause urinary retention, which is a concern for patients with prostatic hypertrophy. The
nurse must assess for these conditions before initiating therapy to prevent exacerbations.
7. What instruction should the nurse provide to a patient taking guaifenesin for a productive
cough?
A. Restrict fluid intake to concentrate the medication.
B. Expect the cough to stop completely within two doses.
