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OVERVIEW:
NUR 170 Med Surg Exam 3 – 2026/2027 covers respiratory pharmacology
including bronchodilators, corticosteroids, leukotriene modifiers, antitussives,
expectorants, antihistamines, decongestants and antitubercular agents, plus
hypertension management with diuretics, ACE inhibitors, ARBs, alpha-blockers
and electrolyte monitoring, and endocrine disorders focusing on insulin types,
oral hypoglycemics, corticosteroid tapering, thyroid replacement and calcium
regulation for diabetes, adrenal insufficiency, hypothyroidism and
hypoparathyroidism management essentials.
Answers are in bold Green, with rationales after.
1) A patient is ordered the following inhalers, a bronchodilator (ipratropium) and a
glucocorticoid (Beclamethasone). The nurse will
A. administer the bronchodilator 5 minutes before the glucocorticoid.
B. mix the drugs and administer them together.
C. administer the glucocorticoid 10 minutes before the bronchodilator.
D. administer the glucocorticoid immediately after the bronchodilator.
Rationale: CORRECT: Bronchodilator first opens airways, allowing deeper
penetration of steroid. Wait 5 minutes between. Never mix unless formulated as
combination.
, 2) A patient has just received a nebulizer treatment of albuterol. It is most important
for the nurse to assess the patient for the development of which side effect/adverse
effect?
A. Tremors
B. Bradycardia
C. Hypotension
D. Hypoglycemia
Rationale: CORRECT: Beta-2 stimulation causes tremors, anxiety, tachycardia,
hypertension, hyperglycemia. Tremors most common.
3) A patient with chronic obstructive pulmonary disease asks the nurse what the
albuterol (Proventil) he is taking does. The nurse should inform the patient that
albuterol is used to
A. mobilize respiratory secretions.
B. decrease the cough response.
C. increase the work of breathing.
D. dilate the larger airways.
Rationale: CORRECT: Short-acting beta-2 agonist bronchodilator - relaxes bronchial
smooth muscle, dilates large airways, decreases airway resistance.
4) The nurse is preparing a class for patients with asthma. The nurse will inform the
patients that leukotriene modifiers are used in the treatment of asthma to
A. assist in opening narrowed airways.
B. suppress the release of histamine and other mediators from the mast cells.
C. loosen mucus from the airways.
D. prevent serious complications from bacterial infections.
Rationale: CORRECT: Montelukast blocks leukotrienes and suppresses histamine
release from mast cells, decreasing inflammation and bronchoconstriction.
Maintenance, not rescue.
5) A patient’s blood pressure (BP) is 142/82 mm Hg. The health care provider
prescribed a diuretic to lower this BP. The nurse knows that this BP is
A. within the prehypertensive range.
B. indicating stage 1 hypertension.
C. indicating stage 1 hypertension according to the diastolic pressure.