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drug & lab quiz

Total questions: 131

Worksheet time: 1hrs 15mins

Name
Class
Date
1.

A patient calls the clinic because he is concerned about his pulse rate.  The patient is taking digoxin.  The nurse would tell the patient to hold the medication if he reports a pulse rate of which of the following?

a)

66 beats/minute

b)

78 beats/minute

c)

52 beats/minute

d)

84 beats/minute

2.

Which of the following would a nurse expect to administer for a heparin overdose?

a)

Protamine sulfate

b)

Thrombin

c)

Urokinase

3.

A patient receiving heparin has a baseline aPTT of 28 seconds.  Which result would the nurse interpret as suggesting too much heparin?

a)

70 sec

b)

42 sec

c)

38 sec

d)

98 sec

4.

A patient is receiving warfarin.  Which of the following would the nurse monitor to determine the effectiveness of therapy?  Select all that apply.

a)

International normalized ratio

b)

Vitamin K levels

c)

Whole blood clotting time

d)

Prothrombin time

e)

Partial thromboplastin time

5.

An instructor describes the action of some anticoagulants as blocking the formation of thrombin from prothrombin.  Which drug would the instructor use as an example for this action?

a)

Bivalirudin

b)

Heparin

c)

Warfarin

d)

Fondaparinux

6.

Warfarin typically takes 3 days to achieve its onset of action.

a)

T

b)

F

7.

A patient who is taking warfarin has an INR of 5.5.  The nurse will anticipate giving:

a)

Protamine Sulfate

b)

oral vit K

c)

fresh frozen plasma

d)

Intravenous iron

8.

The low-molecular-weight heparin of choice for preventing deep venous thrombosis after hip replacement therapy is:

a)

Tinzaparin

b)

Dalteparin

c)

Heparin

d)

Enoxaparin

9.

A group of students are reviewing the drugs used to treat heart failure.  The students demonstrate understanding of the information when they identify which agent as a phosphodiesterase inhibitor?

a)

Milrinone

b)

Captopril

c)

Digoxin

d)

Hydrochlorothiazide

10.

A patient is receiving digoxin.  The nurse monitors the patient's digoxin level.  Which finding would the nurse interpret as therapeutic?

a)

2.2ng.ml

b)

1.5 ng/ml

c)

3.1ng/ml

11.

A Patient is receiving candesartan.  The nurse understands that this drug acts in which manner?

a)

Increases the excretion of sodium water from the kidney

b)

Selective binds with angiotensin II receptors in the vascular smooth muscle

c)

Prevents angiotensin converting enzyme from converting angiotensin I to angiotensin II

12.

The nurse would anticipate the need for an increased dosage of digoxin if the patient is taking which of the following?

a)

Thyroid hormones

b)

Amiodarone

c)

Erythomycin

d)

Verapamil

13.

To maximize absorption of digoxin, the nurse would instruct the patient to take the drug for which of the following?

a)

On an empty stomach

b)

with a glass of water

c)

with an antiacid

14.

To maximize absorption of digoxin, the nurse would instruct the patient to take the drug for which of the following?

a)

digoxin

b)

Ace Inhibitors

c)

Hydrocholrithiazide

15.

Which of the following instructions would be appropriate to include in the teaching plan for a patient taking digoxin at home?  Select all that apply.

a)

"Weigh yourself each day at the same time and wearing the same amount of clothing."

b)

"Call your doctor if you notice an irregular heart rhythm or you feel nauseated."

c)

"Notify your doctor if your pulse is below 60 beats per minute."

d)

"Check your pulse every day before taking the medication."

16.

A group of students are reviewing the various classes of diuretics.  The students demonstrated understanding of the information when they identify which of the following as a loop diuretic?

a)

furosemide

b)

Mannitol

c)

Indapamide

17.

The risk for (a)   increases if the loop diuretics are combined with aminoglycosides.

18.

After teaching a patient about the action of spironolactone, the nurse determines that the teaching was successful when the patient states which of the following?

a)

"I should take the medicine around dinnertime for the best eff

b)

"I need to make sure I don't eat too many high potassium foods."

c)

"I need to take the drug on an empty stomach."

d)

"I can still use my salt substitute if I want to."

19.

After reviewing information about thiazide diuretics, a group of students demonstrate the need for additional teaching when they identify which of the following as a possible adverse effect?

a)

Hypocalcemia

b)

Hypokalemia

c)

Hyperglycemia

20.

When describing the action of chlorothiazide, which of the following would a nurse include?

a)

Blocking of the chloride pump

b)

Blocking the action of carbonic anhydrase

c)

Blocking of potassium secretion through the tubule

21.

A patient is receiving verapamil.  Which of the following would be important for the nurse to stress that the patients avoid?

a)

Graprefruit Juice

b)

Milk

c)

Juice

22.

The nurse is teaching a patient with angina who is prescribed sublingual tablets.  The nurse would instruct the patient to use a tablet at which frequency when experiencing an acute attack?

a)

Every 15 minutes

b)

Every 5 minutes

c)

Every 2 minutes

23.

When describing the possible adverse effects associated with nitroglycerin, which of the following would the nurse include?

a)

Hypertension

b)

Constipation

c)

Dizziness

24.

After teaching a group of students about beta-1 selective blockers, the instructor determines that the teaching was successful when the students identify which of the following as a contradiction for using this group of drugs?

a)

Thyroid disease

b)

Diabetes

c)

Sinus bradycardia

d)

COPD

25.

A patient is to receive metoprolol.  Which of the following would the nurse include in the teaching plan for this patient?

a)

"You should notice an increase in your energy level with this drug."

b)

"Take this drug with food to help promote its absorption."

c)

"This drug causes less dizziness that other similar drugs."

26.

Which of the following would be contraindication to the use of non-selective adrenergic blocker?

a)

Bronchospasm

b)

Diabetes

c)

Heart block

27.

A patient receives a beta-specific agonist.  Which of the following would lead the nurse to determine that the drug is effective?

a)

Bronchodilation

b)

Slowed cardiac conductivity

c)

Tremor

28.

Which of the following would the nurse expect to be given to a patient experiencing acute bronchospasm?

a)

Metaraminol

b)

Epinephrine

c)

Norepinephrine

29.

Which agent would the nurse expect to find when reviewing over-the-counter allergy products?

a)

Phenylephrine

b)

Dopamine

c)

Midodrine

d)

Clonidine

30.

A nurse would instruct a patient to apply a clonidine patch at which frequency?

a)

Every day

b)

Every 7 days

c)

Every other day

31.

Which of the following would be the nurse need to keep in mind about the use of dobutamine for treating heart failure?

a)

Has a slight preference for beta-2 receptors

b)

Does not raise myocardial oxygen demand

c)

Does not interact with over the counter therapies

32.

A patient is to receive atropine prior to surgery.  The nurse would teach the patient about which would of the following as possible adverse effects?  Select all that apply

a)

Dizziness

b)

Irritability

c)

Sensitivity to light

33.

When describing the possible adverse effects associated with nitroglycerin, which of the following would the nurse include?

a)

Hypertension

b)

Constipation

c)

Dizziness

34.

A patient is receiving verapamil.  Which of the following would be important for the nurse to stress that the patients avoid?

a)

Graprefruit Juice

b)

Milk

c)

Juice

35.

Which agent would be used as part of a treatment plan for narcotic detoxification?  Multiple choice

a)

Oxycodone

b)

Methadone

c)

Oxymorphine

d)

Tranmadol

36.

Which if the following would a nurse have readily available should a patient who is receiving morphine experience significant respiratory depression?  

a)

Nalbuphine

b)

Ergotamine

c)

Naloxone

d)

Buprenorphine

37.

The nurse is preparing a class on narcotic agonists and their use during pregnancy and lactation.  The nurse would include which agent as being classified as pregnancy category B?

a)

Sufentanil

b)

Propoxyphene

c)

Oxycodone

d)

Fentanyl

38.

Which agent would a nurse expect to be prescribed with migraine headaches?

a)

Naloxone

b)

Pentazocine

c)

Sumatriptan

d)

Hydrocodone

39.

 

Morphine when administered orally, has a duration of action of 5 to 7 hours.

a)

True

b)

False

40.

A patient has received a narcotic agonist for pain relief.  The nurse would monitor the patient for which of the following?

a)

Pupil constriction

b)

Tachypnea

c)

Hypertension

d)

Diarrhea

41.

The nurse administers morphine intravenously.  The nurse would expect the drug to exert its peak effects within which time frame?

a)

40 min

b)

20 min

c)

50 min

d)

30 min

42.

Which of the following most likely would be a component of a narcotic cough syrup?

a)

Levorphanol

b)

Methadone

c)

Hydrocodone

d)

Meperidine

43.

Which of the following would a nurse have readily available should a patient who is receiving morphine experience significant respiratory depression?

a)

Ergotamine

b)

Buprenorphine

c)

Nalbuphine

d)

Naloxone

44.

The nurse is assessing a patient who has just received naloxone.  Which of the following would the nurse expect to assess?  Select all that apply.

a)

Dry skin

b)

Pain

c)

Bradycardia

d)

Pulmonary edema

e)

Tremulousness

45.

A patient who is taking aspirin daily is scheduled to undergo a colonoscopy.  The patient stops taking the aspirin as ordered before the procedure.  The nurse would instruct the patient that she could resume taking aspirin after which time?

a)

7 days

b)

10 days

c)

5 days

d)

2 days

46.

A patient who is taking salicylates comes to the emergency department for evaluation.  Which of the following would lead the nurse to suspect acute salicylate toxicity?  Select all that apply

a)

Tetany

b)

Hyperpnea

c)

Diarrhea

d)

Tinnitus

e)

Excitement

47.

A patient takes ibuprofen at approximately 10:00 am.  The patient would most likely feel peak effects of the drug at which time?

a)

4:00 pm

b)

6:00 pm

c)

12:00 pm

d)

10:30am

48.

The most frequently used agent for managing pain and fever in children is (a)   .  Fill in the blank

49.

Acetaminophen acts directly on the thermoregulatory cells in the (a)   to cause sweating and vasodilatio

50.

A patient with a peptic ulcer who uses NSAIDs is at high risk for __________________  _____________. Fill in the blanks

(a)  

51.

After teaching a group of students about topical nasal steroid decongestants, the instructor determines the need for additional teaching when the students identify which of the following as an example?

a)

Triamcinolone

b)

Fluticasone

c)

Flunisolide

d)

Tetrahydrozoline

52.

A group of students demonstrate understanding of topical decongestants, identifying them as which of the following?

a)

Sympatholytics

b)

Sympathomimetics

c)

Parasympathomimetics

d)

Parasympatholytics

53.

Guaifenesin

Expectorant

Acetylcysteine

Mucolytics

Benzonatate

Antitussives

Dextromethorphan

Antitussives

Diphenhydramine

Antihistamine

a)

no answer

b)

no answer

c)

no answer

d)

no answer

54.

After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state which of the following?

a)

The drugs action leads to suppression of beta adrenergic receptor activity.

b)

The drugs are slowly absorbed from the respiratory tract.

c)

The drugs are not for use during an acute attack.

d)

The drugs are systemically absorbed when inhaled.

55.

Isoproterenol is an anticholinergic agent.

a)

True

b)

False

56.

A patient who is prescribed ipratroprium administers the drug at 9:15 am.  The patient should begin to notice the drug beginning to act at which time?

a)

9:45 am

b)

10:15 am

c)

10:00 am

d)

9:30 am

57.

A therapeutic theophylline level ranges from 10 to 20 mcg/mL.

a)

True

b)

False

58.

A group of students are reviewing the various drugs that affect inflammation.  The students demonstrate understanding when they identify which agent as a mast cell stabilizer?

a)

Calfactant

b)

Montelukast

c)

Triamcinolone

d)

Cromolyn

59.

Which of the following would the nurse include as possible adverse effects when teaching a patient about albuterol?  Select all that apply

a)

Chills

b)

Hypotension

c)

Bronchospasm

d)

Nervousness

e)

Sweating

60.

The nurse instructs a patient who is using albuterol for exercise induced bronchospasm to use the inhaler at which time?

a)

In the morning of the day when exercise is planned

b)

Immediately on beginning to exercise

c)

15 minutes prior to exercising

d)

Immediately on beginning to exercise

61.

Theophylline

Xanthine

Epinephrine

Sympathomimetic

Albuterol

Sympathomimetic

Cromolyn

Mast cell stabilizer

Budesonide

Inhaled steroid

a)

no answer

b)

no answer

62.

If a patient is receiving sucralfate and omeprazole, the doses can be taken together.

a)

True

b)

False

63.

Which of the following H-2 antagonists would the nurse identify as most potent?

a)

Nizatidine

b)

Cimetidine

 

c)

Ranitidine

d)

Famotidine

64.

A group of students are reviewing the signs and symptoms of systemic alkalosis that can occur as a result of using sodium bicarbonate.  The students demonstrate a need for additional teaching when they identify which of the following as a possible manifestation?

a)

Tetany

b)

Confusion

c)

Constipation

d)

Muscle twitching

65.

Which of the following would a nurse expect to administer if the goal of therapy is to block the release of hydrochloric acid in the stomach?

a)

Antacid

b)

Histamine-2 receptor antagonist

c)

Prostaglandin

d)

Proton pump inhibitor

66.

A patient is diagnosed with peptic ulcer due to H. pylori.  The nurse would anticipate administering which agent in conjunction with an antibiotic?

a)

Magaldrate

b)

Omeprazole

c)

Sucralfate

d)

Cimetidine

67.

The nurse is preparing a teaching plan for a patient who is receiving sucralfate.  Which of the following would the nurse need to address?  Select all that apply.

a)

Eating a high fiber diet

b)

Ensuring safety precautions

c)

Taking the drug on an empty stomach

d)

Using an antidiarrheal agent

e)

Encouraging frequent mouth care

68.

___________________________  _________________________ an antidiarrheal agent has been found helpful in treating traveler's diarrhea and preventing cramping and distention associated with dietary excess.

(a)  

69.

A physician prescribes a chemical stimulant laxative.  Which of the following would be appropriate?

a)

Polycarbophil

b)

Docusate

c)

Lactulose

d)

Bisacodyl

70.

Which of the following would be most important to include when teaching a patient using psyllium?

a)

Taking the agent at bedtime

b)

Taking other prescribed drugs along with the psyllium

c)

Taking the agent with a large amount of water

d)

Limiting the use of high fiber foods

71.

The 5-HTreceptor blockers, including ondansetron (Zofran) and granisetron (Kytril), are particularly effective in decreasing the nausea and vomiting associated with:

a)

Vestibular problems

b)

Cancer chemotherapy

c)

Pregnancy

d)

Severe pain

72.

Which if the following would a nurse expect a health care provider to prescribe as treatment for motion sickness?

a)

Phenothiazine

b)

Substance P/Neurokinin 1 receptor antagonist

c)

Anticholinergic/antihistamines

d)

5-HTreceptor blocker

73.

Which of the following drug indicates for relief of symptoms of GERD and prevention of nausea and vomiting?

a)

Loperamide (Imodium)

b)

Metoclopramide (Reglan)

c)

Sodium bicarbonate (Alka-seltzer)

d)

Omeprazole (Prilosec)

74.

When explaining the action of terazosin to a patient, which of the following would the nurse include?

a)

Inhibits testosterone production

 

b)

 

Adheres to the mucosal membrane acting as a buffer

c)

Interferes with DNA replication

d)

Blocks alpha-1 adrenergic receptors

75.

Which of the following would a nurse expect to be prescribed for a patient experiencing bladder spasms?

a)

Alfuzosin

b)

Nitrofurantoin

c)

Oxybutynin

d)

Phenazopyridine

76.

Which drug would the nurse identify as turning a patient's urine reddish brown?

a)

Solifenacin

b)

Norfloxacin

c)

Phenazopyridine

d)

Oxybutynin

77.

An instructor is teaching a group of students about appropriate interventions for patients with cystitis who is receiving norfloxacin.  The instructor determines that the students need additional teaching when they identify which intervention as appropriate?

a)

Providing citrus juices

b)

Encouraging increased fluid intake

c)

Instructing the patient to complete the full course of therapy

d)

Administering the drug with food if the patient experiences GI upset

78.

A patient has hypocalcemia secondary to hypoparathyroidism.  Which of the following would the nurse expect to be ordered?

a)

Propylthiouracil

b)

Calcitriol

c)

Methimazole

d)

Levothyroxine

79.

When describing the thyroid function, the nurse would emphasize the need for intake of which of the following?

a)

Vitamin B6

b)

Calcium

c)

Sodium

d)

Iodine

80.

A patient is receiving a thyroid hormone to treat hypothyroidism.  Which of the following would indicate to the nurse that the patient needs a reduced dosage of the drug?

a)

Tachycardia

b)

Pale dry skin

c)

Pale dry skin

d)

Slowed reflexes

81.

Select antithyroid agents to treat hyperthyroidism.  Select all that apply

a)

Liothyronine (Cytomel)

b)

Levothyroxine (Synthroid)

c)

Methimazole (Tapazole)

d)

Liotrix (Thyrolar)

e)

Propylthiouracil (PTU)

82.

 

Desmopressin is a synthetic form of antidiuretic hormone.

a)

True

b)

False

83.

A patient is ordered to receive insulin lispro at mealtimes.  The nurse will instruct this patient to administer the medication at which time?

a)

5 min before eating

b)

10 min before eating

c)

30 min before eating

d)

15 min before eating

84.

The pancreas releases (a)   , a hormone that counteracts the effects of insulin and work to increase glucose levels.

85.

Which of the following insulin does not have peak time?

a)

Detemir (Levemir)

b)

Regular Insulin

c)

Glargine (Lantus)

d)

Lispro (Humalog)

86.

A patient receives a dose of insulin lispro at 8am.  The nurse would be alert for signs and symptoms of hypoglycemia at which time?

a)

Between 2pm and 4pm

b)

Between 12 noon  and 8pm

c)

Between 8:30am and 9:30am

d)

Between 10am and 12 noon

87.

The nurse is administering an antidiabetic agent by subcutaneous injection within 60 minutes of the patient's breakfast.  Which agent would the nurse most likely be administering?

a)

Miglitol

b)

Rosiglitazone

c)

Exenatide

d)

Repag;inide

88.

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies which of the following as biguanide?

a)

Miglitol

b)

Tolbutamide

c)

Metformin

d)

Glipizide

89.

After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class?  Multiple choice

a)

Tobramycin

b)

Gentamicin

c)

Neomycin

d)

Kanamycin

90.

A student demonstrates understanding of benzodiazepines, identifying which of the following as the prototype?  

a)

Lorazepam

b)

Triazolam

c)

Flurazepam

d)

Diazepam

91.

The nurse is describing an anxiolytic that has no sedative, anticonvulsant, or muscle relaxant properties, but effective in reducing the signs and symptoms of anxiety.  Which would the nurse most likely be describing?

a)

Zaleplon

b)

Busprione

c)

Diphenhydramine

d)

Meprobamate

92.

After teaching a group of students about the signs and symptoms of benzodiazepine withdrawal, the instructor determines that additional teaching is needed when the students identify which of the following as manifestation?

a)

Nausea

 

b)

Urinary retention

c)

Headache

d)

Nightmares  

93.

When describing the action of barbiturates as anxiolytics, which of the following would the nurse need to keep in mind?  

a)

Depression of the cerebral cortex

b)

Effect on action potentials

c)

Enhancement of action of GABA

d)

Enhancement of motor output

94.

After teaching a patient who is receiving zolpidem, the patient demonstrates understanding of the information when he states that he will take the drug at which time?

a)

2 hours before bedtime

b)

Before going to bed

c)

1 hour before bed time

d)

After dinner

95.

The nurse would be most alert for which of the following in a patient who is receiving an intravenous barbiturate

a)

Bleeding

b)

Tachycardia

c)

Hypotension

d)

Hyperventilation

96.

A patient receives an intravenous dose of diazepam at 6 pm.  The nurse would expect this drug to exert its peak effects at which time?

a)

7:30 pm

b)

7:00 pm

c)

6:30 pm

d)

8:00 pm

97.

After teaching a group of students about the drugs used to treat HIV and AIDS, the instructor determines that the teaching was successful when the students identify which group as being the newest class of drugs?

a)

Fusion inhibitors

b)

Nucleoside reverse transcriptase inhibitors

c)

CCR5 co-receptor antagonist

d)

Protease inhibitors

98.

The nurse is caring for a child with respiratory syncytial virus (RSV).  Which drug would the nurse expect the pediatrician to order?

a)

Zanamivir

b)

Oseltamivir

c)

Rimantadine

d)

Ribavirin

99.

Candida is a fungus that is responsible for (a)   of the gastrointestinal tract.  Fill in the blank

100.

Which of the following would the nurse expect the health care provider to prescribe as treatment for a tinea infection?

a)

Griseofulvin

b)

Nystatin

c)

Amphotericin B

d)

Flucytosine

101.

Infections of the genitourinary tract are commonly the result of gram-positive bacteria.  True or false

a)

True

b)

False

102.

After teaching a patient about the adverse effects of iron therapy, the patient demonstrated understanding of the information when he identifies which of the following as an adverse effect? Select all that apply.

a)

Constipation

b)

Fatigue

c)

Dark stools

d)

Dizziness

e)

Anorexia

103.

A patient is receiving a cephalosporin and an aminoglycoside as combination therapy.  Which of the following would be most important for the nurse to access?

a)

Complete blood count

b)

Coagulation studies

c)

Signs of disulfiram-like reattion

d)

Serum BUN levels

104.

After teaching a group of students about cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as a cephalosporin?

a)

Ciprofloxacin

b)

Cefaclor

c)

Imipenem-cilastin

d)

Neomycin

105.

A patient is to receive rifampin.  Which of the following would be most important for the nurse to include in the teaching plan for the patient?

a)

"The drug can cause an allergic reaction."

b)

"Your urine or sweat may become orange in color."

c)

"Call your doctor if you experience headache or dizziness."

d)

"You might experience some nausea or stomach upset."

106.

After teaching a patient who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the patient states which of the following?

a)

"I should limit the amount of fluids that I drink."

b)

"I should chew gum and hard candies if my mouth gets sore."

c)

"

"I will tke the drug with an antacid to prevent an upset stomach."

d)

"I need to wear protective clothing when I'm out in the sun.

107.

Aminoglycosides due to their low risk of toxicity are replacing many of the other antibiotics today

a)

True

b)

False

108.

Which group of drugs should be avoided in children under the age of 8 years?

a)

Cephalosporins

b)

Fluroquinolones

c)

Penicillians

d)

Tetracyclines

109.

An instructor is teaching a group of students about possible drug interactions with iron preparations.  The instructor states that which drug should be separated from the administration of iron at least 2 hours?  Select all that apply.

a)

Chloramphenicol

b)

Antacids

c)

Tetracycline

d)

Ranitidine

e)

Norfloxacin

110.

A patient receives a ferrous sulfate.  The nurse would expect this drug to begin acting within which time frame?A patient receives a ferrous sulfate.  The nurse would expect this drug to begin acting within which time frame?

a)

2 days `

b)

8 days

c)

4 days

d)

6 days

111.

The nurse suspects that a client's body is attempting to correct an acid–base imbalance. How will this imbalance be corrected?

a)

Primary regulation is through GI system losses.

b)

Slow but efficient respiratory regulation will occur.

c)

Kidney regulation is powerfully effective.

d)

The cardiovascular system is the major buffer.

112.

The physician prescribes Salmeterol for Ted Black, age 39, as part of step-3 treatment for asthma. When teaching Mr. Black about Salmeterol, you should instruct him to:

a)

take this drug with a full glass of water.

b)

use this drug as needed for acute symptoms.

c)

avoid taking this drug more than twice a day.

d)

limit his intake of leafy green vegetables when taking this drug.

113.

Laboratory test results indicate that Mrs. Leahy has a subtherapeutic theophylline level. Which factor is most likely to increase her dosage requirement for theophylline?

a)

Smoking two packs of cigarettes a day

b)

Drinking eight glasses of water each day

c)

Concomitant use of albuterol by metered-dose inhaler

d)

Taking erythromycin as prescribed to treat a respiratory infection

114.

The physician also prescribes theophylline to treat Mrs. Leahy’s condition because this drug:

a)

stimulates alpha-adrenergic receptors and improves pulmonary blood flow.

b)

inhibits cholinergic stimulation to prevent bronchoconstriction.

c)

inhibits phosphodiesterase enzymes and relaxes bronchial smooth muscles.

d)

stimulates leukocyte migration to the bronchial mucosa and reduces airway edema.

115.

Mrs. Leahy was admitted with an acute exacerbation of emphysema. Which drug should you expect to give her initially?

a)

500 milligrams of erythromycin by I.V.

b)

Two puffs of cromolyn by metered-dose inhaler

c)

.

0.2 to 0.3 millilters of metaproterenol by nebulizer

d)

Two puffs of salmeterol by dry powder inhaler

116.

Mrs. Leahy also has chronic bronchitis. This disorder commonly produces which finding?

a)

Night sweats

b)

Slurred speech

c)

thick mucus

d)

Late systolic murmur

117.

 

In emphysema, the alveoli become hyperinflated and form bullae. Then what happens?

a)

Oxygen can’t be released from the hemoglobin.

b)

Th

The alveoli stimulate the production of alpha1-antitrypsin.

c)

The alveoli become filled with fluid.

d)

Oxygen can’t be exchanged across the alveolar-capillary membrane.

118.

Mary Leahy, age 72, has a history of emphysema. In this disorder, a decreased level of the plasma protein alpha1-antitrypsin results in:

a)

a decrease in the anterior-posterior diameter of the chest.

b)

constriction of blood vessels that supply the lungs.

c)

destruction of elastin and collagen fibers in the lung tissue.

d)

an increase in histamine release from mast cells.

119.

Which adverse reaction may occur if Mr. Black suddenly stops taking oral prednisone after long-term use?

a)

Diabetic ketoacidosis (DKA)

b)

Thyroid storm

c)

Hepatic failure

d)

Adrenal insufficiency

120.

Neither of these drugs helps to control Mr. Black’s asthma symptoms. So the physician moves him to step 4 which is severe persistent asthma and prescribes the oral corticosteroid prednisone. This drug helps treat asthma by:

a)

increasing the immune system’s production of granulocytes and neutrophils.

b)

decreasing the release of histamine and leukotrienes from smooth-muscle cells.

c)

blocking the migration of eosinophils and macrophages to the bronchial mucosa.

d)

blocking beta1-adrenergic impulses to the sympathetic nervous system.

121.

Salmeterol is ineffective in controlling Mr. Black’s asthma symptoms. The physician prescribes the drug, omalizumab. What type of drug is omalizumab?

a)

Corticosteroid

b)

Mast cell stabilizer

c)

Monoclonal antibody

d)

Antileukotriene

122.

You’re caring for Gary Linder, age 38, who is having an acute asthma exacerbation. For this patient, which of these is not a goal of therapy?

a)

To promote bronchodilation

b)

To decrease airway inflammation

c)

To increase mucus secretion

d)

To increase air flow

123.

After 6 months, Ms. Brooks reports that she needs to use her prescribed rescue inhaler daily besides taking fluticasone as prescribed. Her physician decides to step up her drug therapy. Which drug typically is prescribed to treat moderate persistent asthma?

a)

Prednisone

b)

Ipratropium

c)

Salmeterol

d)

Anhydrous theophyllin

124.

If fluticasone is not prescribed, which drug may the physician prescribe for step-2 treatment?

a)

Omalizumab

b)

Theophylline

c)

Cromolyn

d)

Salmeterol

125.

What advantage does fluticasone have over other corticosteroids?

a)

It can be used to treat acute asthma symptoms at home.

b)

It has a longer half-life than other corticosteroids.

c)

It acts directly on lung tissue and causes fewer systemic adverse reactions.

d)

It doesn’t need to be taken at bedtime.

126.

Because Ms. Brooks’s condition has worsened, her physician prescribes step-2 treatment, consisting of fluticasone by metered-dose inhaler. When teaching Ms. Brooks how to administer fluticasone, you should instruct her to:

a)

add 3 ml of saline solution to the inhaler.

b)

avoid eating or drinking within 2 hours of taking the drug.

c)

attach a spacer to the inhaler’s mouthpiece.

d)

avoid using a spacer.

127.

You know that Ms. Brooks’s condition is worsening when she reports that:

a)

her most recent asthma exacerbation took 30 minutes to subside.

b)

the use of a nonsteroidal anti-inflammatory drug (NSAID) causes her to experience wheezing and chest tightness.

c)

she has been using her albuterol inhaler three times a week for the past several weeks to treat dyspnea.

d)

she has identified animal dander as a trigger, along with pollen, mold, and grass.

128.

Alicia Brooks, age 29, has just been diagnosed with mild intermittent asthma. Her physician has placed her on step-1 treatment, which typically requires which drug?

a)

Oral prednisone

b)

Salmeterol by dry powder inhaler

c)

Albuterol by metered-dose inhaler

d)

Zafirlukast

129.

According to the National Asthma Education and Prevention Program, the stepwise approach to asthma treatment recommends that:

a)

physicians order pulmonary function tests for their patients every 2 months.

b)

physicians evaluate their patients every 3 to 6 months.

c)

patients keep a diary of potential asthma triggers and the response to each trigger.

d)

patients keep a diary of potential asthma triggers and the response to each trigger.

130.

The physician also prescribes methylprednisolone, a corticosteroid, to help treat Mr. Linder’s acute symptoms. Which dosage of this drug should you expect to give?

a)

Two puffs by metered-dose inhaler

.

b)

2.5 milligrams by nebulizer

c)

1 to 2 milligrams per kilogram I.V. over several minutes.

d)

60 milligrams by mouth

131.

To treat Mr. Linder’s symptoms, which drugs should you expect to give initially

a)

Salmeterol by metered-dose inhaler

b)

Fluticasone by dry powder inhaler

c)

Albuterol by nebulizer

d)

I.V. aminophylline