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WorksheetsChapter 53: Intro to Respiratory Drugs - Title Page
Total questions: 149
Worksheet time: 1hrs 15mins
According to the title page shown, who is the presenter/author of "Ch. 53 Intro to Respiratory Drugs"?
Todd Robbins, MSN, APRN, FNP-C
Sarah Johnson, MD, PhD
Michael Lee, PharmD
Emily Carter, RN
According to the learning objectives shown, which topic focuses on explaining a process occurring at a specific structure with clinical examples?
Major structures of the respiratory system and their roles
Respiration at the respiratory membrane
Common respiratory tract infections
Ventilation and gas-exchange disorders
Fill in the blank: One learning objective is to (a) common respiratory tract infections.
According to the definition provided, ARDS is best described as which of the following?
Acute reversible bronchospasm with airway inflammation
Progressive loss of lung compliance with increasing hypoxia after severe insult
Air in the pleural space compressing alveoli
Chronic not fully reversible obstruction seen in long-term smokers
Fill in the blank: (a) are the smallest respiratory sacs where gas exchange occurs; they are the functional gas exchange units.
Which statement differentiates asthma from COPD as described on the page?
Asthma is chronic and not fully reversible; COPD is recurrent and reversible
Asthma involves recurrent, reversible bronchospasm with airway inflammation/hyperreactivity; COPD is chronic, not fully reversible obstruction across an emphysema + chronic bronchitis spectrum
Both asthma and COPD are acute infections of the alveoli
COPD is an incomplete expansion of alveoli after surgery
Which structure is defined as the branching conducting airways leading to alveoli?
Conducting airways
Bronchial tree
Alveoli
Pleural space
Fill in the blank: The mucociliary escalator involves (a) that move mucus and trap particulates, protecting the lower respiratory tract.
Which chain of events best describes the pathophysiology of the common cold as presented?
Bacterial infection leading to alveolar consolidation and decreased gas exchange
Viral URI causing histamine/prostaglandin release resulting in congestion, rhinorrhea, and sneezing
Air entering pleural space compressing alveoli and lungs collapsing
Thick secretions causing airway obstruction and tissue damage with mucus stasis
Which of the following correctly distinguishes conducting airways from alveoli based on the definitions given?
Conducting airways include the nose to bronchi and are for ventilation only, whereas alveoli are the functional gas exchange units
Conducting airways are the smallest respiratory sacs where gas exchange occurs, whereas alveoli handle ventilation only
Both conducting airways and alveoli are only involved in gas exchange
Conducting airways are found only after the alveoli
Fill in the blank: In cystic fibrosis, thick secretions lead to airway obstruction, infections, and tissue damage; (a) occurs in the lungs.
Which condition is defined as infectious/alveolar inflammation that leads to decreased gas exchange?
Pneumothorax
Atelectasis
Pneumonia
ARDS
Fill in the blank: (a) is defined as air in the pleural space that compresses alveoli.
According to the Respiratory System Overview, the system is split by function into two parts. Which pairing correctly matches function with the appropriate part?
Conducting: gas exchange; Respiratory: ventilation
Conducting: ventilation; Respiratory: gas exchange
Conducting: perfusion; Respiratory: filtration
Conducting: diffusion; Respiratory: perfusion
Fill in the blank: The conducting portion of the respiratory system (a) air and includes the nose, pharynx, larynx, trachea, and bronchi.
Which structures are listed as part of the respiratory zone responsible for gas exchange?
Nose, pharynx, larynx
Trachea and main bronchi only
Bronchioles, alveolar ducts/sacs, pulmonary capillaries
Epiglottis and vocal cords
The conducting airways are described as providing ventilation only. What is explicitly NOT occurring in this region?
Perfusion
Diffusion of gases (gas exchange)
Air filtration
Humidification
Fill in the blank: The mucociliary escalator involves (a) cells and cilia moving mucus to the throat for swallowing.
Which combination best describes nasal defenses highlighted in the diagram explanation?
Nasal cartilage strengthens airflow; alveolar pores equalize pressure
Nasal hair and rich blood supply filter, warm, and humidify incoming air
Surfactant reduces surface tension in the nose
Anticholinergics increase mucus production for trapping particles
A patient with chronic smoking history has impaired clearance of airway mucus. Based on the Conducting Airways & Defenses slide, which mechanism is directly affected and why would anticholinergic drugs further worsen mucus clearance?
Alveolar macrophage phagocytosis is enhanced by smoking; anticholinergics increase ciliary beat frequency
Cough reflex arc is strengthened by smoking; anticholinergics liquefy mucus
Ciliary function is paralyzed by smoking; anticholinergics can dry mucus, hindering the mucociliary escalator
Bronchial smooth muscle hypertrophy improves ventilation; anticholinergics increase mucus secretion
According to the diagram, as airways narrow from bronchi to bronchioles, there is _______ cartilage and _______ smooth muscle.
(a)
Which cell type is identified as having thin walls that maximize diffusion for gas exchange?
Type I alveolar cells
Type II alveolar cells
Goblet cells
Ciliated columnar cells
Loss of surfactant leads to which condition, as labeled in the figure?
Pulmonary edema
Atelectasis (collapse)
Pulmonary embolism
Pneumothorax
Fill in the blank: Type II cells produce (a) and have ACE activity; they also metabolize serotonin/hormones.
Gas exchange occurs across which sequence of layers of the respiratory membrane shown in the diagram?
Epithelium → surfactant → endothelium → basement membranes
Surfactant and epithelial layer → epithelial basement membrane → capillary basement membrane → capillary endothelium
Capillary endothelium → alveolar epithelium → interstitial space only
Mucous blanket → cilia → capillary endothelium
According to the figure, the direction of diffusion is: O2 diffuses _______; CO2 diffuses _______.
(a)
Which combination is essential for effective gas exchange as noted in the content?
Thick membrane, small surface area, high ventilation/perfusion mismatch
Adequate surface area, thin membrane, and matching ventilation/perfusion
Only high hemoglobin concentration
Only increased cardiac output
A patient with pulmonary fibrosis develops hypoxemia. Using the 'membrane layers walk-through,' which mechanism best explains this finding?
Reduced mucus production decreases humidification
Thickening of the respiratory membrane impairs diffusion of O2
Loss of hemoglobin binding sites reduces CO2 transport
Increased surfactant decreases alveolar surface tension
Identify the labeled airway epithelial features in image A: the surface _______ cell, the _______ blanket, and the _______.
(a)
Which brain regions compose the CNS respiratory center that drives the diaphragm and intercostal muscles?
Cerebellum and thalamus
Pons and medulla
Frontal cortex and limbic system
Hypothalamus and hippocampus
Chemoreceptors respond to increased _______ and increased _______ by increasing respiratory rate and depth; low O2 serves as a backup trigger.
(a)
A patient with COPD is a chronic CO2 retainer and relies more on hypoxic drive. Using the slide’s mechanisms, which combination best explains why a β2-agonist and an anticholinergic together improve ventilation?
β2-agonist stimulates parasympathetic vagal tone; anticholinergic enhances chemoreceptor sensitivity to CO2.
β2-agonist causes bronchodilation via sympathetic effects and increases rate/depth; anticholinergic reduces vagal bronchoconstriction.
β2-agonist suppresses the CNS respiratory center; anticholinergic stimulates the pons and medulla.
β2-agonist increases H+ production; anticholinergic converts low O2 from backup to primary trigger.
Differentiate: The slide lists red flags suggesting bacterial sinusitis or pneumonia. Which of the following is NOT one of those red flags?
High fevers
Focal lung findings
Unilateral facial pain
Watery eyes
Common cold (viral) typically presents with which combination of symptoms?
Congestion, rhinorrhea, sneezing, sore throat, watery eyes
High fever, unilateral facial pain, purulent sputum
Chest pain, hemoptysis, night sweats
Severe dyspnea, cyanosis, hypotension
Fill in the blank: Allergic (seasonal) rhinitis is described as (a) leading to nasal symptoms.
Which statement best characterizes sinusitis according to the slide?
Inflamed sinus epithelium causing pressure and pain with risk of spread if untreated
Viral laryngeal inflammation causing hoarseness and throat pain
Acute bronchial irritation always caused by bacteria
Systemic allergic reaction with rash and fever
Pharyngitis/laryngitis are often _______; hallmark features include hoarseness and throat pain, and _______ can co-present.
(a)
According to the teaching points on the slide, which action is emphasized to prevent bacterial complications after influenza?
Immediate antibiotic use for all colds
Staying still so mucus settles
Symptom control along with fluids and rest
Avoiding hydration to reduce secretions
Which combination of exam findings is linked to pneumonia pathophysiology on this slide?
Hyperresonance to percussion and wheezing only
Crackles from fluid, dullness to percussion, increased respiratory rate, and accessory muscle use
Clear breath sounds with normal percussion
Bradycardia and hypotension only
Fill in the blank: In pneumonia, alveolar exudate and membrane involvement lead to (a) .
Which symptom set is listed for pneumonia on the slide?
Cough with hemoptysis, weight loss, night sweats
Dyspnea, fatigue, fever, crackles, hypoxia, abnormal breath sounds
Rhinorrhea, sneezing, watery eyes
Hoarseness and throat pain only
Which pathogen and transmission route are identified for tuberculosis (TB) on this slide?
Streptococcus pneumoniae; droplet contact from surfaces
Mycobacterium tuberculosis; airborne droplets
Haemophilus influenzae; fecal-oral
Respiratory syncytial virus; direct skin contact
TB is described as slow-growing and resilient with which organ system involvement most common?
Gastrointestinal tract
Central nervous system
Liver
Lung
Fill in the blank: TB symptoms include cough (± (a) ), fever, weight loss, night sweats, and fatigue.
According to the diagram on atelectasis, which of the following is NOT listed as a cause?
External compression (tumor, pneumothorax, effusion)
Obstruction by a mucus plug
Low surfactant
Bacterial pneumonia
Fill in the blank from the atelectasis diagram: Post-op risk factors include anesthesia, pain, and low cough reflex leading to (a) and secretions.
Which clinical finding combination best matches the atelectasis panel?
Crackles, dyspnea, fever, hypoxia; asymmetric chest movement
Hyperresonance, hemoptysis, night sweats
Clubbing, cyanosis, barrel chest
Stridor, drooling, muffled voice
From the bronchiectasis diagram, what pathologic change leads to recurrent infections?
Hypertrophy of alveoli
Loss of cilia and mucus clearance
Increased surfactant production
Bronchial smooth muscle atrophy
Fill in the blank based on the bronchiectasis slide: Chronic dilation of bronchi/bronchioles occurs with (a) /inflammation.
Which presentation is specifically listed for bronchiectasis?
Nonproductive dry cough with wheeze
Purulent productive cough with fever, malaise, myalgia/arthralgia
Sudden pleuritic chest pain with hemoptysis
Nocturnal cough relieved by water
According to notes on the bronchiectasis slide, which population often has this condition and what are example treatments?
Common in asthma; treated with beta-blockers
Often in cystic fibrosis; treated with airway clearance techniques, antibiotics, vaccinations, and nutrition
Only in smokers; treated with surgery only
Only in immunocompetent athletes; treated with rest
In the asthma diagram, which structural changes contribute to airway obstruction on expiration?
Atrophied mucous glands and reduced smooth muscle
Bronchospasm, edema of the mucosa, and thick secretions
Alveolar rupture and pneumothorax
Loss of pulmonary surfactant
Fill in the blank from the asthma flow diagram: Reversible (a) + inflammation + hyperreactivity.
Which triggers are explicitly listed on the asthma slide?
Cold air only
Allergens, irritants, infection, exercise, emotion
Bacterial toxins and dehydration only
Altitude and sunlight
A patient reports increased need for their inhaler during cold snaps. According to the asthma notes, which management pillar should also be reinforced alongside bronchodilators?
Anti-inflammatory control with ICS and trigger avoidance
Antibiotics for 10 days
Diuretics to reduce edema
Anticoagulation therapy
According to the diagram, COPD (Emphysema + Chronic Bronchitis) develops loss of elasticity and is characterized as a progressive, not fully reversible obstruction often from smoking/noxious stimuli. Which of the following best matches the defined feature of emphysema shown: "loss of elastic recoil; alveolar wall destruction; collapse on expiration"?
Increased mucus production without airway collapse
Loss of elastic recoil with alveolar wall destruction causing collapse on expiration
Reversible bronchoconstriction with normal alveolar architecture
Pulmonary fibrosis with increased lung compliance
Fill in the blank: Chronic bronchitis is defined in the diagram as cough with mucus and inflammation lasting _______ months in _______ consecutive years.
(a)
Which diagnostic method listed in the COPD diagram directly supports the diagnosis by showing low peak expiratory flow along with symptoms?
Bronchoscopy
Spirometry
Chest X-ray
Arterial blood gas
The diagram explains V/Q mismatch as an imbalance between ventilation and perfusion. Which scenario from the options corresponds to high V/Q ratio as described?
Under-ventilated and over-perfused lung regions leading to low V/Q
Over-ventilated and under-perfused lung regions leading to high V/Q
Equal ventilation and perfusion throughout the lung
Increased perfusion with increased ventilation producing normal V/Q
DoK2: Based on the treatment guidance depicted, which combination best aligns with recommended management for COPD patients with chronic hypoxemia and risk of CO2 retention?
High-flow oxygen without monitoring and antihistamines
Smoking cessation, vaccinations, bronchodilators, ICS in select cases, pulmonary rehab, and oxygen for chronic hypoxemia while watching for CO2 retention
Antibiotics for all patients and fluid restriction
Surgical resection of alveoli and diuretics as first-line
Fill in the blank: The diagram explicitly states that cigarette smoking _______ cilia, emphasizing a key preventive message to _______.
(a)
In the Cystic Fibrosis (CF) diagram, which genetic abnormality and chromosome are identified as the cause of thick secretions?
Genetic sodium channel defect on chromosome 5
Genetic chloride transport defect on chromosome 7
Genetic potassium channel defect on chromosome 11
Mitochondrial DNA deletion affecting chloride transport
DoK2: According to the CF diagram, place the following sequence in order by selecting the option that correctly reflects the stated path: obstruction → infections → tissue damage across multiple tracts. Which outcome domains are explicitly mentioned?
Respiratory only
Respiratory and renal tracts
Respiratory, GI, and reproductive tracts
GI and urinary tracts only
DoK3: A 19-year-old with CF has recurrent lung infections and poor weight gain. Using the care recommendations shown, which integrated plan best addresses both airway and nutritional needs?
Chest PT alone
High-calorie diet only
Infection prevention/treatment, chest PT/airway clearance, pancreatic enzymes, and nutrition with psychosocial support
Empiric long-term diuretics and bed rest
According to the diagram text, Respiratory Distress Syndrome (RDS) in neonates is primarily due to _______ leading to alveolar collapse and hypoxemia, and is treated with _______.
(a)
Which statement best distinguishes ARDS in adults from neonatal RDS as described in the figure text?
ARDS is caused by low surfactant and resolves without ventilation.
ARDS follows a severe insult causing capillary leak and diffuse alveolar damage, leading to decreased compliance and refractory hypoxemia.
ARDS is limited to premature infants and is treated only with surfactant replacement.
ARDS presents with normal lung compliance but severe hypercapnia.
A patient in the ICU develops ARDS secondary to sepsis. Using the diagram, explain the pathophysiologic sequence that leads to refractory hypoxemia and the typical management approach.
(a)
According to the Key Points Summary, which pairing correctly matches the primary role of each respiratory zone?
Conducting zone: gas exchange; Respiratory zone: protection
Conducting zone: protection; Respiratory zone: gas exchange
Both zones: gas exchange only
Both zones: protection only
Fill in the blanks: _______ defenses safeguard alveoli, while _______ keeps sacs open.
(a)
According to the title page, which chapter focuses on drugs acting on the upper respiratory tract and who is credited as the author?
Chapter 45 by John Smith, MD
Chapter 54 by Todd Robbins, MSN, APRN, FNP-C
Chapter 34 by Emily Johnson, PharmD
Chapter 54 by Anonymous
According to the Chapter 54 learning objectives, which task specifically focuses on understanding how medications move through and are processed by the body?
Outline the underlying physiological events that occur with upper respiratory disorders
Discuss the use of drugs that act on the upper respiratory tract across the lifespan
Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse effects, and important drug–drug interactions associated with drugs acting on the upper respiratory tract
Outline the nursing considerations, including important teaching points, for patients receiving drugs acting on the upper respiratory tract
Fill in the blank to accurately complete the stated objective: Compare and contrast the (a) drugs with other agents in their class and with other classes of drugs that act on the upper respiratory tract.
According to the chapter overview, upper airway medications primarily (a) rather than cure or treat infection.
Which statement best reflects a key nursing consideration for antitussives presented in this section?
Use antitussives liberally in all post-operative patients to prevent pain from coughing
Antitussives can cause CNS depression leading to drowsiness and sedation; use caution when cough reflex must be maintained for pulmonary toilet
Antitussives always cure the underlying respiratory infection causing cough
Antitussives act only locally and do not cross the blood-brain barrier
Fill in the blank: The slide advises patients to push fluids and stay well hydrated because irritants in lower airways and water will _______ secretions and decrease _______; this helps keep upper airways patent.
(a)
Which site of action is correctly matched with the medication class as labeled in the diagram?
Codeine, hydrocodone, and dextromethorphan act at the alveoli
Topical nasal decongestants and nasal steroids work at the medullary cough center
Antihistamines work in the bronchioles
Benzonatate and guaifenesin work at the level of the mucus-producing epithelial surface
A post-operative patient requires frequent turning, coughing, and deep breathing to maintain pulmonary toilet. Based on the antitussive key points, what is the most appropriate rationale for avoiding centrally acting antitussives in this patient?
They increase mucus viscosity, making airway clearance more effective
They may suppress the cough reflex and cause CNS depression, interfering with needed airway clearance
They act only locally in the nose and will not affect the cough reflex
They cure the underlying cause of cough and are therefore unnecessary
Which statement best describes the mechanism of action (MOA) of codeine as an antitussive?
Non-opioid antagonist that stimulates cough reflex
Opioid agonist that suppresses the cough reflex
Peripheral bronchodilator that relaxes smooth muscle
Anticholinergic that dries secretions to stop cough
Fill in the blank: Key adverse effects of codeine include (a) .
A patient with mild to moderate pain and persistent cough is prescribed an opioid antitussive. Based on the indications provided, which agent fits this profile and what critical nursing monitoring is required?
Codeine; monitor respiratory rate and bowel function
Hydrocodone; no monitoring needed for respiratory status
Codeine; monitor liver enzymes only
Hydrocodone; monitor serum potassium levels
Hydrocodone’s site of antitussive action is specified as suppression of the cough reflex in the medulla. Which option correctly pairs this MOA with a listed adverse effect and a nursing consideration?
MOA: medullary suppression; AE: hypertension; NC: encourage fluid restriction
MOA: medullary suppression; AE: respiratory depression; NC: monitor RR and constipation with risk of dependence
MOA: peripheral receptor blockade; AE: diarrhea; NC: monitor electrolytes only
MOA: beta-2 agonism; AE: tachycardia; NC: assess peak flow
Fill in the blank: Hydrocodone is indicated for pain and cough and is commonly given in combination with _______ or _______.
(a)
Which statement best describes the mechanism of action (MOA) of dextromethorphan?
NMDA antagonist and sigma-1 agonist that suppresses the cough reflex
Opioid mu-receptor agonist that enhances mucus clearance
Blocks muscarinic receptors to reduce bronchoconstriction
Local anesthetic that numbs the mouth and throat only
Fill in the blank: Dextromethorphan should be avoided with MAOIs/SSRIs due to the risk of (a) .
A patient presents with a nonproductive cough and reports dizziness and hallucinations after taking an over-the-counter suppressant. Based on the adverse effect profile shown, which agent is most likely responsible?
Benzonatate
Dextromethorphan
Guaifenesin
Codeine
Which mechanism explains how benzonatate suppresses the cough reflex?
Anesthetizing stretch receptors in the lungs
Antagonizing NMDA receptors in the brain
Stimulating beta-2 receptors in the bronchi
Blocking histamine H1 receptors in the airways
A caregiver plans to open and chew a benzonatate capsule to help the patient swallow it more easily. Using the nursing considerations provided, what is the most appropriate instruction?
Chewing reduces sedation so it is preferred
Open the capsule and sprinkle on food
Swallow whole; chewing increases choking risk and can be fatal if ingested by children
Crush with water to numb the throat faster
According to the diagram, decongestants act via local vasoconstriction primarily to (a) swollen mucus membranes.
Which statement best describes the onset and duration differences noted in the diagram between adrenergic decongestants and topical steroids?
Adrenergics provide instant relief and are for long-term use; topical steroids act immediately.
Adrenergics provide instant relief for short-term use; topical steroids take longer to work.
Both adrenergics and topical steroids provide instant relief; both are short-term rescue drugs.
Topical steroids provide instant relief, while adrenergics take longer to work.
What adverse phenomenon should clinicians watch for with topical nasal decongestants, as labeled in the diagram text?
Bronchospasm
Rebound congestion (rhinitis medicamentosa -> rebound vasodilation)
Hypoglycemia
Pulmonary edema
Oxymetazoline (Afrin) primarily acts as an (a) agonist leading to vasoconstriction of nasal mucosa.
Which of the following is a key nursing consideration for Oxymetazoline (Afrin) use?
Limit to 7 days; monitor liver enzymes
Limit to 3 days; monitor BP in HTN patients
Use continuously for allergy season; monitor potassium
Avoid in renal disease; monitor creatinine
Select the adverse effects specifically listed for Oxymetazoline (Afrin).
Bradycardia and miosis
Rebound congestion, hypertension, tachycardia
Dry cough and rash
Sedation and constipation
Phenylephrine’s mechanism of action in decongestion is best described as:
Nonselective beta agonist causing bronchodilation
Selective alpha-1 agonist causing vasoconstriction
Muscarinic antagonist reducing secretions
Corticosteroid reducing inflammation
A patient with glaucoma and hypertension asks about using phenylephrine for a stuffy nose. Based on the slide’s nursing considerations, what is the most appropriate advice?
Safe to use without monitoring
Avoid phenylephrine; if used, monitor BP and HR
Use only intranasal form; no monitoring needed
Take with beta-blocker to prevent reflex tachycardia
Which statement best describes the mechanism of action (MOA) of fluticasone as presented?
It is a leukotriene antagonist that bronchodilates airways
It is a glucocorticoid that reduces airway inflammation
It is a beta-2 agonist that provides rapid rescue in acute attacks
It is an anticholinergic that decreases mucus secretion
Fill in the blank: According to the nursing considerations shown, fluticasone inhaled formulations are (a) and require patients to rinse the mouth after use.
Histamine is released during inflammation and causes increased secretions and (a) of airways.
According to the diagram and bullet points, which statement best describes the primary action of anti-histamines?
Stimulate the medullary cough center to suppress cough
Selectively block histamine receptor sites decreasing allergic response
Break down mucus to improve clearance
Directly bronchodilate the alveoli
First-generation antihistamines compared with second-generation antihistamines are more likely to cause which effect?
Insomnia and hypertension
Anticholinergic effects and sedation
Enhanced bronchodilation
Severe hypoglycemia
Diphenhydramine’s mechanism of action is best described as a (a) .
A 72-year-old with glaucoma and a history of urinary retention asks about taking diphenhydramine for insomnia. Based on the nursing considerations provided, what is the most appropriate guidance?
Recommend diphenhydramine as first-line due to minimal side effects in elderly
Avoid diphenhydramine due to Beers criteria and use caution in glaucoma/urinary retention
Use diphenhydramine only with a steroid and epinephrine
Advise doubling the dose to overcome tolerance
Fill in the blank: One way the Beers List promotes patient safety is by highlighting medications that increase risks for (a) , delirium, kidney injury, or other complications common in older adults.
Which statement best describes the mechanism of action (MOA) of Hydroxyzine?
1st-generation H1 blocker
2nd-generation H1 blocker
Dopamine antagonist only
Beta-2 agonist
Fill in the blank: Hydroxyzine is unique because it’s often used for (a) and is a sedating antihistamine.
A patient prescribed Hydroxyzine reports severe drowsiness and dry mouth. Based on documented adverse effects, which additional effect should the nurse monitor for?
Hypertension
Dizziness
Hypoglycemia
Bradycardia
Which nursing consideration is emphasized for Hydroxyzine?
Encourage alcohol to enhance effect
Safe in all elderly patients
Avoid alcohol/CNS depressants; use caution in elderly
Prefer IV route for rapid action
Meclizine’s primary therapeutic use is most closely linked to which physiologic action described?
Bronchodilation
Vestibular suppression via 1st-gen H1 blockade
Serotonin reuptake inhibition
Central dopamine agonism
Fill in the blank: Common adverse effects of Meclizine include drowsiness, dry mouth, and (a) .
A 70-year-old with a history of vertigo asks about Meclizine. Which nursing consideration from the material is most appropriate?
It is contraindicated in all patients with vertigo
Use with caution in the elderly and advise to avoid alcohol
Administer IV for rapid vestibular suppression
Combine with CNS depressants for better effect
Promethazine differs from the other agents by having which additional mechanism of action?
Serotonin antagonist
Dopamine antagonist
Alpha-1 blocker
Muscarinic agonist
Which is an indication for Promethazine according to the content?
Hypertension
Nausea/vomiting
Asthma prophylaxis
Parkinson’s disease
Fill in the blank: Due to the risk of respiratory depression, Promethazine should be avoided in children _______ years old, and it should be given _______ (not IV).
(a)
Which statement best describes the mechanism of action (MOA) of loratadine?
1st-generation H2 blocker
2nd-gen H1 blocker
Leukotriene receptor antagonist
Mast cell stabilizer
Fill in the blank: Loratadine is described as a go-to (a) antihistamine and is considered less sedating because it is 2nd generation.
A patient with allergic rhinitis needs a non-sedating option that is considered safe for the elderly. Based on the nursing considerations provided, which drug is the best choice?
Diphenhydramine
Loratadine
Cetirizine
Chlorpheniramine
Compared with loratadine, cetirizine is noted to be:
More sedating than loratadine but still non-sedating overall
Equally sedating as loratadine and not effective
A 1st-generation H1 blocker with strong sedation
Non-sedating and less effective for urticaria
Select the adverse effects listed for both loratadine and cetirizine.
Headache and dry mouth
Severe hypotension and bradycardia
Hepatotoxicity and tinnitus
Constipation and blurred vision
Fill in the blank: The shared indications for loratadine and cetirizine are _______ and _______.
(a)
According to the diagram, expectorants primarily help by increasing productive cough through what specific change to respiratory secretions?
Increasing the viscosity of mucus to trap pathogens
Reducing the viscosity (thinning) of secretions to make them easier to cough up and clear airways
Suppressing the medullary cough center to reduce coughing
Blocking histamine receptors to prevent mucus production
Fill in the blank: The diagram labels indicate that benzonalate and (a) work at the level of the mucus and airway lining to affect cough.
Based on the labeled sites of action in the respiratory tract diagram, which intervention is depicted as working in the alveoli?
Topical nasal decongestants
Lung surfactants
Mucolytics
Antihistamines
Guaifenesin (Mucinex) is categorized as an expectorant. Which set of statements best matches its key points shown: mechanism, adverse effects, indications, and nursing considerations?
MOA bronchodilation; adverse effects bradycardia; indicated for asthma; nursing: restrict fluids
MOA thins respiratory secretions; adverse effects nausea, vomiting, dizziness; indicated for cough with thick mucus (bronchitis, cold); nursing: encourage fluids and monitor cough effectiveness
MOA antitussive suppression; adverse effects constipation; indicated for dry cough; nursing: encourage bed rest only
MOA antihistamine; adverse effects sedation only; indicated for allergic rhinitis; nursing: avoid fluids
Fill in the blank: The slide notes that Guaifenesin (Mucinex) is best when taken with (a) to thin mucus and is often combined with dextromethorphan.
According to the diagram, mucolytics primarily act on (a) by breaking disulfide bonds to decrease tenacity and viscosity.
Which patient population is explicitly listed as high risk and may benefit from mucolytics due to decreased mucus tenacity and viscosity?
Asthma only
COPD, cystic fibrosis, pneumonia, tuberculosis
Healthy adults
Patients with pulmonary embolism
Select the correct mechanism of action for Acetylcysteine as presented.
Stimulates beta-2 receptors to bronchodilate
Blocks histamine H1 receptors
Mucolytic that breaks disulfide bonds in mucus
Inhibits leukotriene synthesis
Fill in the blank: Acetylcysteine is indicated for cystic fibrosis, COPD, and (a) overdose.
A patient receiving nebulized Acetylcysteine develops coughing and tightness in the chest. Based on the documented adverse effects, which reaction is most likely occurring?
Bronchospasm
Hypoglycemia
Bradycardia
Urinary retention
Identify the chapter focus introduced on the title page: Ch. 55 addresses drugs acting on which part of the respiratory system?
Upper respiratory tract
Lower respiratory tract
Cardiovascular system
Central nervous system
Fill in the blank: One learning objective is to describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse effects, and important (a) associated with drugs used to treat lower respiratory tract disorders.
According to the slide, asthma is immune mediated and causes (a) and narrowing due to inflammatory chemicals released from mast cells.
Which of the following is identified as the leading cause of COPD in the slide?
Allergen exposure
Cigarette smoking
Viral infections
Genetic deficiency of alpha-1 antitrypsin
A patient with chronic bronchitis and ongoing tobacco use presents for counseling. Using the treatment goals shown, which TWO initial priorities should be emphasized?
Initiate bronchodilation and reduce exposure (STOP SMOKING)
Increase environmental exposure to build tolerance and start antibiotics
Reduce exposure (STOP SMOKING) and decrease inflammation
Schedule surgery and begin supplemental oxygen
According to the diagram, which class of bronchodilators relaxes smooth muscle in the airways?
Xanthines
Sympathomimetics
Anticholinergics
Leukotriene receptor blockers
Fill in the blank: The device shown that delivers medication as a fine mist through tubing and a mask is a (a) .
Which statement best aligns with the preparation and administration notes shown?
All inhalers must be shaken and primed before use
Powder inhalers require a spacer for correct dosing
Some devices need shaking and/or priming; avoid eye contact and watch the patient demonstrate use
Nebulizers are used while the patient lies supine and breathes rapidly
A patient using a metered-dose inhaler (MDI) has trouble coordinating an initial deep breath. Based on the content, which practical adjustment is recommended and why?
Switch to a dry-powder inhaler because it uses a spacer
Use an MDI with a spacer to assist with timing and reduce the need for initial deep breath
Continue with the standard MDI but shake and prime twice as long
Use a nebulizer while lying down to improve deposition
Which statement best describes the mechanism of action (MOA) of Theophylline as shown?
It blocks beta-2 receptors to reduce cAMP and constrict bronchioles
It is a xanthine that inhibits phosphodiesterase, increasing cAMP and causing bronchodilation
It activates muscarinic receptors to increase mucus production
It chelates calcium to prevent acetylcholine release
Fill in the blank: Theophylline has a (a) therapeutic index and toxicity can cause seizures and arrhythmias.
A patient on Theophylline reports drinking several cups of coffee daily. Using the nursing considerations provided, which action is most appropriate?
Reassure the patient this is safe because caffeine lowers cAMP
Advise the patient to avoid caffeine and arrange monitoring of serum levels (10–20 mcg/mL)
Increase the Theophylline dose to offset caffeine’s effects
Stop monitoring serum levels once the patient is stable
According to the slide, Albuterol’s mechanism of action (MOA) is as a (a) leading to bronchodilation.
Which adverse effect is specifically listed for Albuterol on the slide?
Hyperkalemia
Tremor
Bradycardia
Sedation
For which clinical situation is Albuterol indicated, as highlighted on the slide?
COPD maintenance therapy
Asthma/COPD rescue (acute bronchospasm)
Seasonal allergic rhinitis
Pulmonary fibrosis
Fill in the nursing consideration from the Albuterol slide: Teach inhaler use; carry (a) always.
Levalbuterol is described as a (a) Beta-2 agonist that leads to bronchodilation.
Compared with Albuterol, Levalbuterol is associated with which difference in adverse effects as stated on the slide?
More tremor/tachycardia
Less tremor/tachycardia
No cardiovascular effects
More hypokalemia
According to the Levalbuterol slide, when should this medication be used from a nursing perspective?
When albuterol not tolerated
As first-line maintenance therapy
Only for nocturnal symptoms
With every corticosteroid dose
Both Albuterol and Levalbuterol share which indication listed on their respective slides?
Prevention of asthma-related death
Asthma/COPD rescue
Long-term COPD maintenance
Treatment of pulmonary edema
