PULMONARY DRUGS

1. The client diagnosed with arterial hypertension develops a cold. Which information regarding over-the-
counter (OTC) medications should the nurse teach?

A. Try to find a medication that will not cause drowsiness.

B. OTC medications are not as effective as a prescription.

C.OTC medications are more expensive than prescriptions.

D. Do not take OTC medication unless approved by the HCP.

2. The client with the flu is prescribed the OTC cough suppressant dextromethorphan. Which information
should the nurse teach regarding this medication?

A. Take the medication every 4 to 8 hours as needed for cough.

B. The medication can cause addiction if taken too long.

C. Do not drive or operate machinery while taking the drug.

D. Do not take a beta blocker while taking this medication.

3. The HCP prescribed amoxicillin/clavulanate for a client diagnosed with chronic obstructive pulmonary
disease (COPD) who has a cold. Which intervention should the nurse implement?

A. Discuss the prescription with the HCP because antibiotics do not help viral infections.

B. Teach the client to take all the antibiotics as ordered.

C. Encourage the client to seek a second opinion before taking the medication.

D. Ask the client if he or she is allergic to sulfa drugs or shellfish.

4. The mother of a teenage girl asks the nurse why her daughter would have many boxes of
pseudoephedrine in her room. Which statement is the nurse’s best response?

A. “Has your child always had allergy problems?”

B. “Teenagers will try to take care of their own health problems.”

C. “Has your daughter’s behavior at school or at home changed recently?”

D. “Remove the medication and say nothing to your daughter about it.”

5. The client with the flu has been taking acetylcysteine. Which adverse effect should the nurse assess
for?

A. Bronchospasm.

B. Nausea.

C. Fever.

D. Drowsiness.

6. The client who has been using oxymetazoline nasal spray for several weeks reports to the nurse that
the spray no longer seems to work to clear the nasal passages. Which information should the nurse
teach?

A. “Increase the amount of sprays used until the desired effect has been reached.”

B. “This type of medication can cause rebound congestion if used too long.”

C. “Alternate the oxymetazoline with a saline nasal spray every 2 hours.”

D. “Place the oxymetazoline nasal spray in a vaporizer at night for the best results.”

7. Which statement is the scientific theory for prescribing zinc preparations for a client with a cold?

A. Zinc binds with the viral particle and reduces the symptoms of a cold.

B. Zinc decreases the immune system’s response to a virus.

C. Zinc activates viral receptors in the body’s immune system.

D. Zinc blocks the virus from binding to the epithelial cells of the nose.
8. The client diagnosed with the flu is prescribed the cough medication hydrocodone. Which information
should the nurse teach the client regarding this medication?

A. Teach the client to monitor the bowel movements for constipation.

B. Tell the client that it is fine to drive or operate machinery while taking this medication.

C. Instruct the client to plan for rest periods, as this medication usually causes insomnia.

D. Explain that this medication is more effective when taken with a mucolytic.

9. The nurse on a medical unit is administering 0900 medications. Which medication should the nurse
question administering?

A. Acetylcysteine to a client who is coughing forcefully.

B. Cefazolin IV piggyback (IVPB) to a client diagnosed with the flu.

C. Diphenhydramine to a client who is congested.

D. Dextromethorphan to a client who has pneumonia.

10. The male client diagnosed with COPD tells the nurse that he has been expectorating “rusty-colored”
sputum. Which medication should the nurse anticipate the HCP prescribing?

A. Prednisone.

B. Nicotine (transdermal).

C. Dextromethorphan.

D. Ceftriaxone.

11.The female client is being admitted to a medical unit with a diagnosis of pneumonia. Which
intervention would the nurse implement FIRST?

A. Start an IV access line.

B. Administer the IVPB antibiotic.

C. Teach to notify the nurse of any vaginal itching.

D. Obtain sputum and blood cultures.

E. Place an identity band on the client.

12. The client diagnosed with emphysema is admitted to the surgical unit for a cholecystectomy
(gallbladder removal). Which postoperative interventions should the nurse implement? Select all that
apply.

A. Have the patient turn, cough, and breathe deeply every 2 hours.
B. Administer oxygen to the client at 4 L/min.
C. Assess the surgical dressing every 4 hours.
D. Medicate frequently with morphine 15 mg IV push (IVP).
E. Use the incentive spirometer every 4 hours.

13. The nurse is discharging a client diagnosed with COPD. Which discharge instructions should the
nurse provide regarding the client’s prescription for prednisone?

A. Take all the prednisone as ordered until the prescription is empty.

B. Take the prednisone on an empty stomach with a full glass of water.
C. Stop taking the prednisone if a noticeable weight gain occurs.
D. Do not abruptly discontinue taking the prednisone.

14. The nurse is preparing to administer medications on a pulmonary unit. Which medication should the
nurse administer first?

A. Prednisone for a client diagnosed with chronic bronchitis.

B. Oxygen via nasal cannula at 2 L/min for a client diagnosed with pneumonia.
C. Lactic acidophilus to a client receiving IVPB antibiotics.
D. Cephalexin to a client being discharged.
15. The client diagnosed with COPD is prescribed morphine sulfate continuous release. Which statement
is the scientific rationale for prescribing this medication?

A. Morphine will depress the respiratory drive.

B. Morphine dilates the bronchi and improves breathing.
C. Morphine is not addicting, so it can be given routinely.
D. Morphine causes bronchoconstriction and decreased sputum.

16. The client diagnosed with adult respiratory distress syndrome (ARDS) has been found to have a
disease-causing organism resistant to the antibiotics being given. Which intervention should the nurse
implement?

A. Monitor for therapeutic blood levels of the aminoglycoside antibiotic prescribed.

B. Prepare to administer the glucocorticoid medication ordered intramuscularly.
C. Obtain an order for repeat cultures to confirm the identity of the resistant organism.
D. Place the client on airborne isolation precautions.

17. The client diagnosed with COPD is prescribed methylprednisolone IVP. Which laboratory test should
the nurse monitor?

A. The white blood cell (WBC) count.

B. The hemoglobin (Hgb) and hematocrit (Hct).
C. The blood glucose level.
D. The blood urea nitrogen (BUN) and creatinine levels.

18. Which data indicates the antibiotic therapy has not been successful for a client diagnosed with a
bacterial pneumonia?

A. The client’s Hct is 45%.

B. The client is expectorating thick, green sputum.
C. The client’s lung sounds are clear to auscultation.
D. The client has no report of pleuritic chest pain.

19. Which information should the nurse discuss with the client diagnosed with reactive airway disease
who is prescribed theophylline slow release?

A. Instruct the client to take the medication on an empty stomach.

B. Explain that an increased heart rate and irritability are expected side effects.
C. Discuss the need to avoid large amounts of caffeine-containing drinks.
D. Tell the client to double the next dose if a dose is missed.

20. The client with chronic reactive airway disease is taking montelukast. Which statement by the client
warrants intervention by the nurse?

A. “I have been having a lot of headaches lately.”

B. “I have started taking an aspirin every day.”
C. “I keep this medication up on a very high shelf.”
D. “I must protect this medication from extreme temperatures.”

21. The client with reactive airway disease is taking oral metaproterenol three times a day. Which
intervention should the nurse implement?

A. Instruct the client to take the last dose a few hours before bedtime.
B. Teach the client to decrease the fluid intake when taking this medication.
C. Have the client demonstrate the correct way to use the inhaler.
D. Encourage the client to take the medication with an antacid.

22. The client is prescribed albuterol metered-dose inhaler. Which behavior indicates the teaching
concerning the inhaler is effective?

A. The client holds his or her breath for 5 seconds and then exhales forcefully.
 B. The client states the canister is full when it is lying on top of the water.
C. The client exhales and then squeezes the canister as the next inspiration occurs.
D. The client connects the oxygen tubing to the inhaler before administering the dose.

23. The client admitted for an acute exacerbation of reactive airway disease is receiving IV aminophylline.
The client’s serum theophylline level is 28 mg/mL. Which intervention should the nurse implement first?

A. Continue to monitor the aminophylline drip.

B. Assess the client for nausea and restlessness.
C. Discontinue the aminophylline drip.
D. Notify the HCP immediately.

24. Which assessment data indicates the client with reactive airway disease has “good” control with the
medication regimen?

A. The client’s peak expiratory flow rate (PEFR) is greater than 80% of his or her personal
best.
B. The client’s lung sounds are clear bilaterally, both anterior and posterior.
C. The client has only had three acute exacerbations of asthma in the last month.
D. The client’s monthly serum theophylline level is 18 mg/mL.
E. The client is taking the medication as directed by the HCP.

25. The client with an acute exacerbation of reactive airway disease is prescribed a nebulizer treatment.
Which statement best describes how a nebulizer works?

A. Nebulizers are small, handheld pressurized devices that deliver a measured dose of an
antiasthma drug with activation.
B. A nebulizer is an inhaler that delivers an antiasthma drug in the form of a dry, micronized power
directly to the lungs.
C. A nebulizer is a small machine used to convert an antiasthma drug solution into a mist that is
delivered though a mouthpiece.
D. Nebulizers are small devices that are used to crush glucocorticoids so that the client can place
them under the tongue for better absorption.

26. Which information should the nurse teach the client who is prescribed a glucocorticoid inhaler?

A. Advise the client to gargle after each administration.

B. Instruct the client to use the inhaler on a PRN basis.
C. Encourage the client not to use a spacer when using the inhaler.
D. Teach the client to check his or her forced expiratory volume daily.

27. The 28-year-old female client with chronic reactive airway disease is taking montelukast sodium.
Which statement by the client indicates the client teaching is effective?

A. “I will not drink coffee, tea, or any type of cola drinks.”

B. “I will take this medication at the beginning of an asthma attack.”
C. “It is all right to take this medication if I am trying to get pregnant.”
D. “I should not decrease the dose or suddenly stop taking this medication.”

28. Which medical treatment is recommended for the client who is diagnosed with mild intermittent?

A. This classification of asthma requires a combination of long-term control medication plus a quick-
relief medication.
B. Mild intermittent asthma needs a routine glucocorticoid inhaler and a sustainedrelief theophylline.
C. This classification requires daily inhalation of an oral glucocorticoid and daily nebulizer
treatments.
 D. Mild intermittent asthma is treated on a PRN basis and no long-term control medication is
needed.

29. The 8-year-old male child diagnosed with reactive airway disease is prescribed a cromolyn inhaler.
The child shares with the nurse that he wants to play baseball but can’t because of his asthma. Which
intervention should the nurse discuss with the child and parents?

A. Instruct the child to take the medication as soon as shortness of breath starts.
B. Teach the child to take a puff of the cromolyn inhaler 15 minutes before playing ball.
C. Encourage the child to play another sport that does not require running outside.
D. Inform the parents to notify the pediatrician if the child complains of a yellow haze.

30. The 6-year-old child is experiencing an acute exacerbation of reactive airway disease. The child
passed out and the parents brought the child to the emergency department (ED). Which intervention
should the nurse implement first?

A. Administer subcutaneous epinephrine via a tuberculin syringe.

B. Administer albuterol via nebulizer.
C. Administer IV methylprednisolone.
D. Administer oxygen to maintain oxygen saturation above 95%.

31. The clinic nurse is teaching the parent of a child with reactive airway disease about nebulizer
treatments. Which statement indicates the teaching has been effective?

A. “I will use half the medication in the nebulizer at each treatment.”

B. “The nebulizer treatment will take about 30 minutes or longer.”
C. “I will use a disinfectant solution weekly when cleaning the nebulizer.”
D. “I will rinse the nebulizer in clean water after each breathing treatment.”

32. The child with an acute asthma attack is prescribed a 7-day course of prednisolone. The mother asks
the nurse, “Doesn’t this medication cause serious side effects?” Which statement is the nurse’s best
response?

A. “Yes, this medication does have serious side effects, but your child needs the medication.”
B. “The doctor would not have ordered a medication that has serious side effects.”
C. “A short-term course of steroids will not cause serious side effects.”
D. “There may be serious side effects if your child takes the medication for a long time.”

33. The child diagnosed with reactive airway disease is prescribed a cromolyn inhaler. The mother asks
the nurse to explain how this medication helps control her child’s asthma. Which statement is the best
explanation to give to the mother?

A. This medication diminishes the mediator action of leukotrienes.

B. This medication blocks the release of mast cell mediators.
C. This medication causes relaxation of the bronchial smooth muscle.
D. This medication decreases bronchial airway inflammation.

34. Which statement indicates to the nurse that the 13-year-old child understands the zone system for
monitoring the treatment of asthma?

A. “When I am in the green zone, it means good control and I do not need any medication.”
B. “If I am in the black zone, it means I should go to the emergency department.”
C. “If I am in the red zone, it means I should take my cromolyn and steroid inhaler.”
D. “The yellow zone means I tell my mom so she can give me a nebulizer treatment.”

35. The pediatric nurse is caring for a 7-year-old child with chronic reactive airway disease who is being
discharged. The nurse must evaluate the breathing capacity of the child to determine the effectiveness of
the medication regimen. Which interventions should the nurse implement when using the peak flow
meter? Select all that apply.

A. Instruct the child to lie down in the bed in the supine position.
 B. Tell the child to seal the lips tightly around the mouthpiece.
C. Note the number on the scale after the client gives a sharp, long breath.
D. Have the child blow into the peak flow meter one time and obtain the results.
E. Move the pointer on the peak flow meter to one.

36. The 10-year-old child is being prescribed a cromolyn inhaler. Which statement indicates the child
needs more teaching concerning the cromolyn inhaler?

A. “If I cannot take a deep breath, I will not use my cromolyn inhaler.”
B. “I should not exhale into my inhaler after I have finished taking a puff.”
C. “I should wait at least 1 hour to rinse my mouth after taking my inhaler.”
D. “I should not stop taking my inhaler because I might have an asthma attack.”

37. The nurse is teaching the mother of a 9-year-old child with severe reactive airway disease. The child
is prescribed salmeterol by metered-dose inhaler every 12 hours. Which instruction should the nurse
include when discussing the medication with the mother?

A. Instruct the mother to perform and record a daily salmeterol level.

B. Inform the mother to notify the HCP if the child vomits or becomes irritable.
C. Tell the mother to observe the child for a sore throat and respiratory infection.
D. Recommend that the medication be refrigerated at all times.

38. The client diagnosed with rule-out deep vein thrombosis (DVT) is experiencing dyspnea and
chestpain on inspiration. On assessment, the nurse finds a respiratory rate of 40. Which medication
should the nurse anticipate the HCP ordering?

A. Warfarin.
B. Aspirin.
C. Heparin.
D. Ticlopidine.

39. The HCP has ordered streptokinase intravenously for the client diagnosed with a pulmonary embolus.
The client has IV heparin infusing at 1,600 units per hour via a 20-gauge angiocath. Which intervention
should the nurse implement?

A. Administer the streptokinase via a Y-tubing.

B. Start a second IV site to infuse the streptokinase.
C. Discontinue the heparin and infuse streptokinase via the 20-gauge angiocath.
D. Piggyback the streptokinase through the heparin line at the port closest to the client.

40. The client diagnosed with a massive pulmonary embolus is prescribed streptokinase. The nurse notes
on the medication administration record that the client is allergic to the “-mycin” medications, including
streptomycin. Which intervention should the nurse implement?

A. Call the HCP to report the allergy.

B. Administer the medication as ordered.
C. Call the pharmacist to substitute medication.
D. Check the bleeding-time laboratory values.

41. The nurse is discharging the female client diagnosed with a pulmonary embolism (PE) who is
prescribed warfarin. Which statement indicates the client understands the medication teaching?

A. “I should use a straight razor when I shave my legs.”

B. “I will use a hard-bristled toothbrush to clean my teeth.”
C. “An occasional nosebleed is common with this drug.”
D. “It will be important for me to have regular bloodwork done.”

42. The client diagnosed with a pulmonary embolism (PE) is receiving IV heparin, and the HCP
prescribes 5 mg warfarin orally once a day. Which statement best explains the scientific rationale for
prescribing these two anticoagulants?
 A. Coumadin interferes with production of prothrombin.
B. It takes 3 to 5 days to achieve a therapeutic level of Coumadin.
C. Heparin is more effective when administered with warfarin.
D. Coumadin potentiates the therapeutic action of heparin.

44. The nurse is administering alteplase to a client diagnosed with massive pulmonary embolism (PE).
Which data indicates the medication is effective?

A. The client’s partial thromboplastin time (PTT) level is within therapeutic range.
B. The client is able to ambulate to the bathroom.
C. The client denies chest pain on inspiration.
D. The client’s chest x-ray is normal.

45. The client who was been prescribed rivaroxaban following a diagnosis of PE presents to the clinic with
reports of dark, tarry stools. Which intervention should the nurse implement first?

A. Call 911 and have the paramedics take the client to the ED.
B. Assess the client for any other signs of bleeding.
C. Check the client’s prothrombin time (PT)/international normalized ration (INR) levels
D. Notify the HCP of the dark, tarry stools.