Nokea
The nurse is reviewing the medication record of a client with asthma and notes that the health care provider has prescribed a monoclonal antibody as part of the treatment plan. The nurse would anticipate administering which drug?
- A. Zafirlukast
- B. Zileuton
- C. Omalizumab
- D. Salmeterol
Correct Answer: C
Rationale: Omalizumab (Xolair) is a monoclonal antibody used in the treatment of asthma. Leukotriene receptor antagonists include montelukast (Singulair) and zafirlukast (Accolate). Zileuton (Zyflo) is classified as a leukotriene formation inhibitor. Salmeterol (Serevent Diskus) is a long-term beta-2 agonist.
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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 client who is experiencing an acute asthmatic attack receives prescribed therapy with a bronchodilator. As part of the plan of care, the nurse would continue to assess which of the following every 4 hours? Select all that apply.
- A. Intake
- B. Blood pressure
- C. Output
- D. Lung sounds
- E. Accessory muscle use
Correct Answer: A,C,D,E
Rationale: The nurse should note the client's respiratory rate, lung sounds, intake, and output and use of accessory muscles in breathing every 4 hours during an acute asthma attack.
A client with asthma has been prescribed an antiasthmatic drug. Before administering the drug, the nurse assesses the respiratory rate of the client. The nurse notifies the primary health care provider based on which finding?
- A. 10 breaths/min
- B. 14 breaths/min
- C. 18 breaths/min
- D. 22 breaths/min
Correct Answer: A
Rationale: The nurse should consider 10 breaths/min an abnormal respiratory rate and notify the primary health care provider. Respiratory rates below 12 breaths/min or above 24 breaths/min are considered abnormal. A respiratory rate between 12 breaths/min and 24 breaths/min is considered normal.
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.
Before leaving the hospital after an acute asthma attack, a client is given a prescription for fluticasone/salmeterol (Advair) 250/50 to inhale one puff twice a day. The nurse completing the client's discharge teaching should tell the client which of the following? Select all that apply.
- A. Take the medication as needed.
- B. Continue to carry a rescue inhaler.
- C. Check peak flow daily.
- D. Rinse mouth after each use.
- E. Shake meter well before using.
Correct Answer: B,C,D
Rationale: The drug is a dry powder inhaler that contains an inhaled corticosteroid and a long-acting beta agonist. The medication should be taken every day as per the directions on the label to prevent future exacerbations. The client should continue to carry a rescue inhaler and check peak flow around the same time each day. Advair does not need to be shaken prior to use as it is a dry powder inhaler. The client should be advised to rinse his mouth out after each use to prevent oral thrush.