Nokea
The nurse is reviewing the history of a client who is prescribed a long-acting beta-2 agonist. Which of the following would alert the nurse to the need to administer this drug cautiously to the client? Select all that apply.
- A. Hyperlipidemia
- B. Hypertension
- C. Glaucoma
- D. Hyperthyroidism
- E. Diabetes
Correct Answer: B,C,D,E
Rationale: Long-acting beta-2 agonists should be used cautiously in clients with hypertension, cardiac dysfunction, hyperthyroidism, glaucoma, diabetes, prostatic hypertrophy, and history of seizures.
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A nurse is providing care to a client receiving theophylline. The client has received two loading doses and the nurse is evaluating the client's theophylline levels. Which finding would the nurse interpret as a therapeutic drug level?
- A. 5 mcg/L
- B. 8 mcg/L
- C. 13 mcg/L
- D. 20 mcg/L
Correct Answer: C
Rationale: Therapeutic theophylline levels range from 10 to 20 mcg/L. The possibility of toxicity increases with levels over 15 mcg/L, with toxicity indicated with levels over 20 mcg/L.
A group of nursing students are reviewing information about mast cell stabilizers. The students demonstrate understanding of the information when they identify which of the following as an example?
- A. Beclomethasone
- B. Cromolyn
- C. Albuterol
- D. Montelukast
Correct Answer: B
Rationale: Cromolyn is an example of a mast cell stabilizer. Beclomethasone is an inhaled corticosteroid. Albuterol is a short-acting beta-2 agonist. Montelukast is an example of a leukotriene modifier.
During stable chronic phases of asthma, the nurse should advise the client to monitor which of the following? Select all that apply.
- A. Blood pressure
- B. Wheezing
- C. Respiratory rate
- D. Coughing
- E. Peak flow changes
Correct Answer: B,D,E
Rationale: Clients with chronic stable asthma should monitor for symptoms such as wheezing, coughing, peak flow changes, and things that might be making the asthma worse.
A nurse is teaching a client who is prescribed albuterol about the adverse reactions associated with the drug. Which of the following symptoms, if experienced, should the nurse instruct the client to report to the health care provider?
- A. Fall in blood pressure
- B. Increased nighttime urination
- C. Hearing impairment or deficit
- D. Headache and flushing
Correct Answer: D
Rationale: The nurse should instruct the client to contact the health care provider if palpitations, tachycardia, chest pain, muscle tremors, dizziness, headache, flushing, or difficulty with urination or breathing occurs. Fall in blood pressure, increased nighttime urination, and hearing impairment are not adverse effects associated with a sympathomimetic bronchodilator.
Before administering a prescribed bronchodilator to a client experiencing acute breathing distress, which of the following would be appropriate for the nurse to assess? Select all that apply.
- A. Blood pressure
- B. Blood glucose
- C. Pulse
- D. Lung sounds
- E. Respiratory rate
Correct Answer: A,C,D,E
Rationale: Prior to initiation of a bronchodilator during acute breathing distress, the nurse needs to assess vital signs, including blood pressure, pulse, and respiratory rate and lung sounds.