Nokea
A client with chronic asthma comes to the clinic for a follow-up visit. A nurse should question the client about which of the following? Select all that apply.
- A. Allergies
- B. Frequency of attacks
- C. Severity of attacks
- D. Antiasthma drugs currently being taken
- E. Antiasthma drugs taken in the past
Correct Answer: A,B,C,D,E
Rationale: In clients with chronic asthma, the nurse questions the client concerning allergies, frequency and severity of attacks, factors that cause or relieve attacks, and any antiasthma drugs used currently or taken previously.
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A nurse is caring for a client who is receiving cromolyn orally. Which of the following instructions would the nurse include in the client's teaching plan?
- A. Do not take the drug at bedtime.
- B. Swallow the drug without chewing.
- C. Take the drug with food or milk.
- D. Take the drug at least 30 minutes before meals.
Correct Answer: D
Rationale: When administered orally, cromolyn is given 30 minutes before meals and at bedtime. The oral form of the drug comes in an ampule. The ampule is opened and the contents are poured into a glass of water. The nurse stirs the mixture thoroughly. The client must drink all of the mixture. The drug may not be mixed with any other substance (e.g., fruit juice, milk, or foods).
A nurse is developing a teaching plan about measures to reduce the risk of infection with Candida albicans from antiasthma therapy. The nurse includes this information because the client is prescribed which of the following? Select all that apply.
- A. Albuterol (Ventolin)
- B. Cromolyn (Gastrocrom)
- C. Fluticasone (Flovent)
- D. Tiotropium (Spiriva)
- E. Budesonide/formoterol (Symbicort)
Correct Answer: B,C,E
Rationale: Mast cell aerosols such as cromolyn and inhaled corticosteroids (ICSs) such as fluticasone and budesonide/formoterol have been associated with the development of oral thrush. Therefore, the client needs instructions on how to reduce his risk. Albuterol, a short-acting beta-2 agonist, and tiotropium, a cholinergic blocker, are not associated with the development of thrush.
A client is prescribed zileuton (Zyflo). The nurse instructs the client to contact the primary health care provider if which of the following occur? Select all that apply.
- A. Jaundice
- B. Pruritus
- C. Fatigue
- D. Dizziness
- E. Restlessness
Correct Answer: A,B,C
Rationale: Zileuton may cause liver damage, which may present with the following symptoms: upper right quadrant pain, nausea, fatigue, lethargy, pruritus, and jaundice.
A client is demonstrating how to use a peak flow meter. The nurse determines that the client is successful when he does which of the following? Select all that apply.
- A. Inhales as forcibly as possible
- B. Stands upright to allow the best inhalation possible
- C. Makes sure indicator is at lowest level on scale
- D. Makes sure lips are sealed tightly around the mouthpiece
- E. Measures peak flow rate at different times each day
Correct Answer: B,C,D
Rationale: When teaching a client to use a peak flow meter, instruct the client to make sure the indicator is at the lowest level, stand upright, make sure the lips form a tight seal around the mouthpiece, exhale as forcibly and as quickly as possible, and test peak flow at the same time each day.
A client has been admitted to a health care facility with acute bronchospasm. The primary health care provider prescribes the drug epinephrine. The nurse anticipates administering this drug by which route?
- A. Intravenous
- B. Intramuscular
- C. Subcutaneous
- D. Intradermal
Correct Answer: C
Rationale: The nurse should use the subcutaneous route to administer epinephrine for acute bronchospasm. Doses of epinephrine are measured in tenths of a milliliter. A tuberculin syringe is used for measuring and administering these drugs by the parenteral route. The other routes are not appropriate for this situation.