ASTHMA

1. A 19-year-old patient comes to the ED with acute asthma.  His respiratory rate is 44
breaths/minute, and he appears to be in acute respiratory distress.  Which of the following
actions should you take first?
a. Take a full medical history.
b. Give a bronchodilator by nebulizer.
c. Apply a cardiac monitor to the patient.
d. Provide emotional support for the patient.

2. Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnose asthma.
When teaching the patient about this drug, the nurse should explain that it may cause:
a. Nasal congestion
b. Nervousness
c. Lethargy
d. Hyperkalemia

3.  A nurse instructs a female client to use the pursed-lip method of breathing and the client
asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that
the primary purpose of pursed-lip breathing is to:
a.    Promote oxygen intake
b.    Strengthen the diaphragm
c.    Strengthen the intercostal muscles
d.    Promote carbon dioxide elimination

4. While volunteering at the local free clinic for the urban homeless, you assess an elderly black
man who presents with dyspnea and wheezing. After instructing him on the effective use of an
inhaler for his asthma, you tell him that African Americans have a higher death rate from
asthma than whites and Hispanics. Why is the African American death rate higher from
asthma?

a. Urban living
b. Increased access to healthcare
c. Race or ethnicity
d. Genetics

5. A 6-year-old boy presents at your primary care office with an elevated temperature, bilateral
ear pain, and irritability. He has a history of asthma. What instructions are quite important for
antipyretics and analgesics before leaving the office?

a. Administer twice the recommended dose for the first 2 days.

b. Administer half the recommended dose for the first 2 days.
c. Administer only acetaminophen for fever and discomfort.
d. Administer only NSAIDs for fever and discomfort.
6. Your patient, a 53-year-old overweight woman, presents with increasing asthma symptoms.
She also reports heartburn at least four nights per week. What would you expect the physician
to prescribe?

a. Initiate corticosteroid inhalers

b. Antihistamines
c. NSAIDs
d. Proton-pump inhibitor therapy

7. Your patient, an elderly woman, insists her asthma is exacerbated by her least favorite
television show. While explaining that her dislike for the show’s host may be a contributing
factor, you explain that an asthma attack is caused by substances released from mast cells,
which cause:
a. Smooth muscle dilation.
b. Decreased capillary permeability and fluid leakage.
c. Bronchoconstriction and inflammation.
d. Bronchodilation and capillary permeability.

8. The goals of pharmacotherapy for asthma management are to reduce acute asthma episodes
and maintain long-term control of persistent asthma. Two major groups of medications are
used, one with a directly positive effect on the other’s efficacy. Which medication group affects
both pathophysiologies?
a. Anti-inflammatory drugs
b. Proton-pump inhibitors
c. Bronchodilators
d. H2-blockers

9. Your patient, a 27-year-old athlete with newly diagnosed asthma, presents at your office for
patient education regarding situations that could precipitate an asthma attack. Your teaching
includes that acute episodes of asthma may last minutes to hours. In your teaching, which of the
following precipitants do you state may cause the asthma? Select all that apply.
a. Exercise
b. Allergens
c. Warm weather
d. Pollutants

10. A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a
high-pitched, whistling sound caused by turbulent airflow through an obstructed airway).
Those who have asthma chronically present with what signs, even when they may appear
symptom free? Select all that apply.
a. Airway inflammation
b. Damaged airway mucosa
c. Elevated temperature
d. Bradycardia