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A nurse administers albuterol via metered-dose inhaler to a patient experiencing acute bronchospasm. Which assessment finding indicates the medication is having the desired therapeutic effect?
A. Decreased wheezing and improved air movement
B. Decreased heart rate
C. Increased mucus production
D. Increased respiratory secretions
A – Bronchodilators relieve bronchospasm, improving airflow and reducing wheezing.
A patient with GERD is prescribed omeprazole. The nurse should instruct the patient to take the medication:
A. Before meals
B. After meals
C. With milk
D. At bedtime only
A – PPIs work best when taken before meals.
Which mechanism explains how proton pump inhibitors work?
A. Blocking acid production in parietal cells
B. Neutralizing gastric acid
C. Increasing gastric motility
D. Increasing mucus production
A – PPIs block proton pumps in gastric parietal cells, reducing acid secretion.
A patient receiving furosemide should be monitored closely for which electrolyte imbalance?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypermagnesemia
A – Loop diuretics cause potassium loss.
Which assessment finding indicates effective treatment with furosemide?
A. Decreased edema
B. Increased blood pressure
C. Decreased urine output
D. Weight gain
A – Decreased edema indicates effective fluid removal.
A patient with asthma is prescribed fluticasone inhaler twice daily. Which instruction should the nurse provide?
A. Rinse mouth after each use
B. Use only during acute asthma attacks
C. Take the medication with food
D. Use the medication only at bedtime
A – Corticosteroid inhalers can cause oral candidiasis; patients must rinse their mouth.
A patient is taking sucralfate for a duodenal ulcer. When should the nurse administer this medication?
A. On an empty stomach
B. With food
C. After meals
D. At bedtime only
A – Sucralfate must coat the stomach lining, so it is taken on an empty stomach.
A patient taking hydrochlorothiazide reports muscle weakness and fatigue. What should the nurse suspect?
A. Hypokalemia
B. Hyperkalemia
C. Hypercalcemia
D. Hypernatremia
A – Thiazides can cause hypokalemia, leading to weakness.
Which diuretic class is considered potassium-sparing?
A. Spironolactone
B. Furosemide
C. Hydrochlorothiazide
D. Mannitol
A – Spironolactone is a potassium-sparing diuretic.
A patient receiving mannitol is at risk for which complication?
A. Pulmonary edema
B. Hypoglycemia
C. Hyperkalemia
D. Bradycardia
A – Mannitol increases circulating fluid volume and may cause pulmonary edema.
The nurse is caring for a patient receiving ipratropium bromide. Which condition would require the nurse to use caution when administering this medication?
A. Glaucoma
B. Hypotension
C. Hyperthyroidism
D. Anemia
A – Anticholinergics like ipratropium can worsen glaucoma.
A patient receives acetylcysteine via nebulizer. What is the priority nursing assessment?
A. Monitoring airway patency
B. Checking blood glucose
C. Monitoring potassium levels
D. Monitoring blood pressure
6. A – Acetylcysteine thins mucus; airway obstruction is a priority risk.
Which adverse effect should the nurse monitor for when a patient is receiving systemic corticosteroids for asthma?
A. Hyperglycemia
B. Bradycardia
C. Hypokalemia
D. Hypoglycemia
7. A – Corticosteroids increase blood glucose levels.
The nurse teaches a patient using both a corticosteroid inhaler and albuterol inhaler. In which order should the patient take the medications?
A. Corticosteroid first
B. Albuterol first
C. Both at the same time
D. Either order is acceptable
B – Bronchodilator first opens the airways so the corticosteroid can penetrate deeper.
A patient receiving lactulose for hepatic encephalopathy should have which outcome?
A. Increased bowel movements
B. Decreased urine output
C. Increased blood glucose
D. Increased blood pressure
A – Lactulose causes bowel movements to remove ammonia in hepatic encephalopathy.
A patient taking theophylline reports nausea, vomiting, and palpitations. What should the nurse suspect?
A. Drug toxicity
B. Therapeutic effect
C. Dehydration
D. Infection
A – Nausea, vomiting, and palpitations are signs of theophylline toxicity.
Which medications are commonly used to treat peptic ulcer disease?
A. Proton pump inhibitors
B. H2 receptor blockers
C. Antibiotics for H. pylori
D. Beta blockers
E. Antacids
A, B, C, E – Ulcer treatment includes PPIs, H2 blockers, antibiotics, and antacids.
Which patient would most benefit from spironolactone?
A. Patient with heart failure and hypokalemia risk
B. Patient with severe dehydration
C. Patient with hyperkalemia
D. Patient with renal failure
A – Spironolactone prevents potassium loss, useful in heart failure.
The nurse teaches a patient taking loop diuretics about foods high in potassium. Which foods should the nurse include? (SATA)
A. Bananas
B. Spinach
C. Oranges
D. White bread
E. Potatoes
A, B, C, E – These foods contain potassium.
The nurse administers hydrochlorothiazide. Which lab value requires intervention?
A. Potassium 2.9 mEq/L
B. Sodium 138 mEq/L
C. Creatinine 1.0 mg/dL
D. Glucose 100 mg/dL
A – Potassium 2.9 indicates severe hypokalemia.
A patient is prescribed montelukast for asthma control. Which statements indicate the patient understands the teaching?
A. “This medication helps prevent asthma attacks.”
B. “I should take this medication daily even if I feel well.”
C. “This medication works best during an acute asthma attack.”
D. “This medication reduces inflammation caused by leukotrienes.”
E. “This medication will replace my rescue inhaler.”
5. A, B, D – Montelukast prevents asthma attacks and reduces leukotriene inflammation but does not treat acute attacks.
A patient receiving ondansetron should be monitored for which adverse effect?
A. QT prolongation
B. Hypoglycemia
C. Hypokalemia
D. Hypertension
A – Ondansetron may cause QT prolongation, increasing risk for arrhythmias.
Which patient finding requires the nurse to hold furosemide and notify the provider?
A. Blood pressure 88/50
B. Respiratory rate 18
C. Pulse 84
D. Oxygen saturation 96%
A – Hypotension may worsen with diuretics.
A patient taking spironolactone should avoid which foods?
A. Salt substitutes containing potassium
B. Apples
C. White rice
D. Bread
A – Spironolactone causes potassium retention; potassium-rich substitutes should be avoided.
A patient with GERD has been taking Omeprazole for 8 weeks. During a follow-up visit, the nurse evaluates the patient for potential long-term adverse effects of proton pump inhibitor therapy. Which assessment finding would be most concerning?
A. Muscle cramps and numbness in the fingers
B. Mild headache after taking the medication
C. Occasional nausea after meals
D. Temporary bloating after eating
A. Muscle cramps and numbness in the fingers
Long-term use of proton pump inhibitors such as omeprazole can lead to hypomagnesemia (low magnesium levels). Symptoms include muscle cramps, tetany, numbness, seizures, and cardiac arrhythmias, making this the most concerning finding.