NUR 565 FINAL EXAM
- A patient takes oral theophylline twice daily for chronic stable angina. After developing an
infection, the patient went to an after-hours clinic where ciprofloxacin was prescribed. What action will the patient's primary provider take when the patient follows up the next day?
Answer
Reduce the theophylline dose
- A child with allergic rhinitis has used budesonide for several years. The parents are
concerned that the child's rate of growth has slowed. What action will the provider take to address the parent's concerns?
Answer
Discuss changing to fluticasone with the parents.
- A patient with seasonal and perennial rhinitis requests a prescription for the most effective
drug for treating the condition. Which medication will the provider recommend?
Answer
Fluticasone propionate
- A patient with a cold used phenylephrine nasal spray, 2 sprays every 4 hours for a week. Since
then it has been impossible to discontinue the medication because the nasal congestion has increased. What action will the provider take?
Answer
Order an intranasal glucocorticoid to be used while the phenylephrine is withdrawn.
- A patient requests medication for insomnia. The provider notes that the patient is restless
and anxious with a heart rate of 90 beats/minute, and blood pressure of 130/85 mmHg. Current 1 / 4
medications are the combination product loratadine/pseudoephedrine every 12 hours for allergic rhinitis. What action will the provider take?
Answer
Discuss changing to an intranasal glucocoricoid and loratidine
- A patient with a cough has been advised to use guaifenesin. When the pa- tient asks why this
particular drug, what response will the provider provide?
Answer
It stimulates the flow of secretions so they are easier to cough up.
- A child with perennial allergic rhinitis has been using an intranasal glu- cocorticoid. After
the child develops frequent nosebleeds, the provider orders montelukast to replace the inhaler.What statement will the provider include when teaching the child's parents about montelukast?
Answer
This drug will help prevent inflammation without causing nosebleeds.
- A patient who recently recovered from acute bronchitis reports a lingering dry cough that
prevents sleep. Which over-the-counter medication will the provider recommend to best manage the symptoms?
Answer
Diphenhydramine
- Which medication for asthma can a provider prescribe off-label to treat allergic rhinitis?
Answer
Omalizumab 2 / 4
- A provider prescribes montelukast for a child with asthma. Which state- ment by the
child's parent indicates understanding of this medication?
Answer
I may noticde mood changes in my child.
- A patient with asthma reports daily symptoms requiring a short-acting B2-agonist for
- second (FEV1) is 75% of predicted values. Which regimen does the provider determine is best
relief. The patient has used oral glucocorticoids three times in the past three months and reports awakening at night with symptoms about once a week.The patient's forced expiratory volume in
for this patient?
Answer
Daily low-dose inhaled glucocorticoid/LABA with a SABA as needed.
- Which medication will a provider prescribe for an asthma patient as part of step 1
management?
Answer
Short acting B2 agonists
- A patient with stable COPD is prescribed a bronchodilator by the provider. Which type of
bronchodilator is preferred for this patient?
Answer
A long-acting inhaled B2 agonist (LABA)
- A patient with severe, chronic COPD uses an inhaled long-acting inhaled B2 agonist
(LABA)/glucocorticoid but continues to have frequent exacerba- tion of symptoms. What change in therapy will the provider discuss with the patient? 3 / 4
Answer
Adding roflumilast
- A patient develops an asthma exacerbation. The patient's medication his- tory lists an
inhaled glucocorticoid, montelukast, and short acting B2 agonist as needed via metered-dose inhaler (MDI).The patient's respiratory rate is 18 breaths/minute, heart rate is 96 beats/min, and an oxygen saturation is 95%. The provider auscultates mild expiratory wheezes bilaterally. What action will the provider take first?
Answer
Question the patient about how much albuterol has been used.
- A provider is conducting a smoking cessation class in the community. Which effects will
be included in the discussion about physiologic effects of nicotine?
Answer
Increased blood pressure
Vomiting Increased alertness Suppression of appetite
- A patient reports a desire to stop smoking and asks about nonprescrip- tion aids to help
with smoking cessation. What intervention will the provider recommend for this patient?
Answer
Start a nicotine replacement product and call 1 800 QUIT NOW
- A patient with a desire to stop smoking asks a provider about nicotine chewing gum. The
patient currently smokes 30 cigarettes per day. What in- structions willJUsee the provider give the patient?
Answer
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