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A nurse is explaining to a patient with asthma what her new prescription for prednisone is used for. What would be the most accurate explanation that the nurse could give?
- A. To ensure long-term prevention of asthma exacerbations
- B. To cure any systemic infection underlying asthma attacks
- C. To prevent recurrent pulmonary infections
- D. To gain prompt control of inadequately controlled, persistent asthma
Correct Answer: D
Rationale: Prednisone is used for a short-term (3-10 days) burst to gain prompt control of inadequately controlled, persistent asthma. It is not used to treat infection or to prevent exacerbations in the long term.
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A nurse is reviewing the pathophysiology of cystic fibrosis (CF) in anticipation of a new admission. The nurse should identify what characteristic aspects of CF?
- A. Alveolar mucus plugging, infection, and eventual bronchiectasis
- B. Bronchial mucus plugging, inflammation, and eventual bronchiectasis
- C. Atelectasis, infection, and eventual COPD
- D. Bronchial mucus plugging, infection, and eventual COPD
Correct Answer: B
Rationale: The hallmark pathology of CF is bronchial mucus plugging, inflammation, and eventual bronchiectasis. Commonly, the bronchiectasis begins in the upper lobes and progresses to involve all lobes. Infection, atelectasis, and COPD are not hallmark pathologies of CF.
A nurse is teaching a patient with asthma about Azmacort, an inhaled corticosteroid. Which adverse effects should the nurse be sure to address in patient teaching?
- A. Dyspnea and increased respiratory secretions
- B. Nausea and vomiting
- C. Cough and oral thrush
- D. Fatigue and decreased level of consciousness
Correct Answer: C
Rationale: Azmacort has possible adverse effects of cough, dysphonia, oral thrush (candidiasis), and headache. In high doses, systemic effects may occur (e.g., adrenal suppression, osteoporosis, skin thinning, and easy bruising). The other listed adverse effects are not associated with this drug.
A clinic nurse is caring for a patient who has just been diagnosed with chronic obstructive pulmonary disease (COPD). The patient asks the nurse what he could have done to minimize the risk of contracting this disease. What would be the nurses best answer?
- A. The most important risk factor for COPD is exposure to occupational toxins.
- B. The most important risk factor for COPD is inadequate exercise.
- C. The most important risk factor for COPD is exposure to dust and pollen.
- D. The most important risk factor for COPD is cigarette smoking.
Correct Answer: D
Rationale: The most important risk factor for COPD is cigarette smoking. Lack of exercise and exposure to dust and pollen are not risk factors for COPD. Occupational risks are significant but are far exceeded by smoking.
A nurse is caring for a patient who has been admitted with an exacerbation of chronic bronchiectasis. The nurse should expect to assess the patient for which of the following clinical manifestations?
- A. Copious sputum production
- B. Pain on inspiration
- C. Pigeon chest
- D. Dry cough
Correct Answer: A
Rationale: Clinical manifestations of bronchiectasis include hemoptysis, chronic cough, copious purulent sputum, and clubbing of the fingers. Because of the copious production of sputum, the cough is rarely dry. A pigeon chest is not associated with the disease and patients do not normally experience pain on inspiration.
A patients severe asthma has necessitated the use of a long-acting beta agonist (LABA). Which of the patients statements suggests a need for further education?
- A. I know that these drugs can sometimes make my heart beat faster.
- B. Ive heard that this drug is particularly good at preventing asthma attacks during exercise.
- C. Ill make sure to use this each time I feel an asthma attack coming on.
- D. Ive heard that this drug sometimes gets less effective over time.
Correct Answer: C
Rationale: LABAs are not used for management of acute asthma symptoms. Tachycardia is a potential adverse effect and decreased protection against exercise-induced bronchospasm may occur with regular use.