Bronchodilators: Understanding Medications for Opening Airways

Question 1

Which of the following bronchodilators is not a beta-agonist?

Accepted Answer

Ipratropium bromide

Answer

Albuterol

Answer

Salmeterol

Answer

Formoterol

Question 2

What is the primary mechanism of action for beta-agonists?

Accepted Answer

Relaxation of bronchial smooth muscle

Answer

Blockade of histamine receptors

Answer

Inhibition of acetylcholine release

Answer

Increased mucus production

Question 3

Which of the following is a potential adverse effect of ipratropium bromide?

Accepted Answer

Dry mouth

Answer

Tachycardia

Answer

Tremors

Answer

Bronchospasm

Question 4

Which of the following instructions is incorrect when teaching a patient to use a metered-dose inhaler (MDI) with a spacer?

Accepted Answer

Hold your breath for 10-15 seconds after each puff

Answer

Shake the inhaler well before each use

Answer

Prime the inhaler with two puffs before first use

Answer

Exhale slowly and deeply before attaching the spacer

Question 5

When should a patient with asthma seek emergency medical attention?

Accepted Answer

Persistent wheezing despite bronchodilator use

Answer

Fever and chills

Answer

Productive cough with green or yellow sputum

Answer

Mild shortness of breath

Question 6

Which of these medications is a long-acting beta-agonist bronchodilator?

Accepted Answer

Salmeterol

Answer

Albuterol

Answer

Ipratropium

Answer

Theophylline

Question 7

Which of the following is a potential adverse effect of beta-2 agonists?

Accepted Answer

Tachycardia

Answer

Dry mouth

Answer

Hypotension

Answer

Nausea

Question 8

Which of the following conditions is a contraindication to the use of methylxanthines?

Accepted Answer

Heart failure

Answer

Asthma

Answer

COPD

Answer

Glaucoma

Question 9

Which of the following is the primary mechanism of action of beta2-agonists?

Accepted Answer

Stimulation of beta2-adrenergic receptors

Answer

Inhibition of phosphodiesterase enzyme

Answer

Blockage of muscarinic acetylcholine receptors

Question 10

For rapid relief of bronchospasm in a patient with asthma, which route of administration is most appropriate for albuterol sulfate?

Accepted Answer

Oral inhalation

Answer

Intravenous injection

Answer

Topical application

Question 11

Which of the following is a contraindication to the use of systemic corticosteroids in asthma management?

Accepted Answer

Active tuberculosis

Answer

Severe hypertension

Answer

History of peptic ulcer disease

Answer

Pregnancy

Question 12

What is the primary benefit of combination therapy with an anticholinergic and a beta2-agonist inhaler in a patient with COPD?

Accepted Answer

Improved bronchodilation

Answer

Reduced adverse effects

Answer

Prevention of asthma attacks

Answer

Enhanced mucus production

Question 13

When assessing the effectiveness of bronchodilators, which parameter is most important?

Accepted Answer

Peak expiratory flow rate (PEFR)

Answer

Vital capacity

Answer

Tidal volume

Answer

Respiratory rate

Question 14

Which assessment finding is most indicative of bronchospasm?

Accepted Answer

High-pitched wheezing

Answer

Coarse crackles

Answer

Musical rhonchi

Answer

Purulent sputum production

Question 15

What is the recommended route of administration for ipratropium bromide?

Accepted Answer

Inhalation via nebulizer or metered-dose inhaler

Answer

Oral tablet

Answer

Intravenous infusion

Answer

Subcutaneous injection

Question 16

Which of the following conditions is a contraindication for the use of beta-agonists?

Accepted Answer

Tachycardia

Answer

Asthma

Answer

Hyperthyroidism

Answer

COPD

Question 17

What is the primary advantage of using a spacer device with a metered-dose inhaler?

Accepted Answer

Increased delivery of medication to the lungs, reducing oropharyngeal deposition.

Answer

Reduced risk of developing oropharyngeal candidiasis.

Answer

Improved patient coordination and ease of use.

Answer

Elimination of static charge on drug particles, enhancing particle dispersion.

Question 18

Which of the following nursing interventions is essential when administering theophylline?

Accepted Answer

Monitoring for signs and symptoms of seizures.

Answer

Assessing for bradycardia, a potential adverse effect.

Answer

Checking blood pressure every 4 hours to monitor for hypertension.

Answer

Encouraging adequate fluid intake to prevent dehydration.

Question 19

What is the primary role of anticholinergics in the treatment of chronic obstructive pulmonary disease (COPD)?

Accepted Answer

Bronchodilation, reducing airway resistance.

Answer

Expectoration, thinning and loosening airway secretions.

Answer

Anti-inflammation, reducing airway inflammation.

Answer

Immunosuppression, suppressing the immune response in the airways.

Question 20

In cases of severe, persistent bronchospasm, which treatment option is most effective?

Accepted Answer

Combination of ipratropium bromide and albuterol sulfate

Answer

Ipratropium bromide (anticholinergic) only

Answer

Albuterol sulfate (beta-agonist) only

Question 21

Which of the following is the primary mechanism of action of β2-agonist bronchodilators?

Accepted Answer

Stimulation of β2-receptors in airway smooth muscle, causing bronchodilation

Answer

Stimulation of β1-receptors in airway smooth muscle

Answer

Inhibition of phosphodiesterase enzyme

Answer

Inhibition of acetylcholinesterase enzyme

Question 22

A patient with COPD experiences paradoxical bronchospasm after using a short-acting β2-agonist. Which of the following would be an appropriate nursing intervention?

Accepted Answer

Administer an anticholinergic medication

Answer

Administer a long-acting β2-agonist

Answer

Increase the dose of the short-acting β2-agonist

Answer

Discontinue the use of all bronchodilators

Question 23

When assessing a patient's response to bronchodilator therapy, which of the following parameters is most important to monitor?

Accepted Answer

Peak expiratory flow rate

Answer

Blood pressure

Answer

Heart rate

Answer

Oxygen saturation

Question 24

A patient presents with symptoms of asthma and is prescribed an inhaled corticosteroid. Which of the following instructions is most important to reinforce with the patient?

Accepted Answer

Rinse your mouth after using the inhaler

Answer

Use the inhaler only when symptoms occur

Answer

Use the inhaler before using a bronchodilator

Answer

Store the inhaler in the refrigerator

Question 25

After giving a bronchodilator, a nurse checks a patient's spirometry results. Which change indicates the medication is working?

Accepted Answer

Increased FVC

Answer

Lowered FEV1

Answer

Unchanged PEFR

Question 26

When administering nebulized bronchodilators to a patient experiencing a severe asthma exacerbation, which nursing intervention should be the top priority?

Accepted Answer

Continuously monitor the patient's respiratory rate and oxygen saturation

Answer

Administer the bronchodilator as ordered

Answer

Teach the patient about proper inhaler technique

Answer

Position the patient in a semi-Fowler's position

Question 27

Which novel bronchodilator, approved by the FDA, selectively targets the P2Y12 receptor, resulting in the inhibition of airway smooth muscle contraction?

Accepted Answer

Fevipiprant

Answer

Tiotropium

Answer

Aclidinium

Answer

Roflumilast

Question 28

The mechanism of action for beta2-agonists primarily involves:

Accepted Answer

Elevation of cyclic AMP levels

Answer

Blockade of muscarinic receptors

Answer

Inhibition of phosphodiesterase enzymes

Answer

Stimulation of alpha1-adrenergic receptors

Question 29

Which bronchodilator is commonly employed as a rescue medication for treating acute bronchospasm?

Accepted Answer

Albuterol

Answer

Salmeterol

Answer

Formoterol

Answer

Tiotropium

Question 30

Ipratropium bromide is generally contraindicated in patients with a history of:

Accepted Answer

Glaucoma

Answer

Prostate hyperplasia

Answer

Tachycardia

Answer

Asthma

Question 31

When comparing short-acting beta-agonists (SABAs) and long-acting muscarinic antagonists (LAMAs), which of the following correctly describes their relative speed of onset and duration of action?

Accepted Answer

SABAs: Rapid onset, short duration; LAMAs: Gradual onset, long duration

Answer

SABAs: Gradual onset, long duration; LAMAs: Rapid onset, short duration

Answer

Both SABAs and LAMAs: Rapid onset, long duration

Question 32

Which drug interaction involving a beta-agonist bronchodilator and a common antihypertensive medication should you be aware of? Explain the reason for this interaction.

Accepted Answer

Beta-agonist and beta-blocker: Increased risk of bronchospasm

Answer

Beta-agonist and ACE inhibitor: Increased risk of hypotension

Answer

Beta-agonist and calcium channel blocker: Increased risk of bradycardia

Answer

Beta-agonist and diuretic: Increased risk of hypokalemia

Question 33

Which of the following is the primary mechanism of action of beta-2 adrenergic agonists?

Accepted Answer

Relaxes bronchial smooth muscle by stimulating beta-2 receptors, leading to increased intracellular cyclic AMP (cAMP) levels

Answer

Decreases mucus production by reducing goblet cell activity

Answer

Inhibits histamine release from mast cells

Question 34

Which of the following is a contraindication for the use of theophylline?

Accepted Answer

Severe hepatic impairment (Child-Pugh class C)

Answer

Asthma

Answer

COPD

Question 35

What is the recommended first-line bronchodilator for acute asthma exacerbations in adults?

Accepted Answer

Short-acting beta-2 agonist (e.g., albuterol, levalbuterol)

Answer

Long-acting beta-2 agonist (e.g., salmeterol, formoterol)

Answer

Anticholinergic (e.g., ipratropium bromide, tiotropium bromide)

Answer

Theophylline

Question 36

What is the mechanism of action of anticholinergics?

Accepted Answer

Blocks muscarinic receptors on bronchial smooth muscle, leading to bronchodilation

Answer

Stimulates beta-2 adrenergic receptors, leading to increased intracellular cyclic AMP (cAMP) levels

Answer

Inhibits the release of inflammatory mediators from mast cells

Question 37

Which of the following is a potential benefit of using a combination bronchodilator therapy?

Accepted Answer

Increased bronchodilation through different mechanisms of action, leading to improved symptom control

Answer

Fewer dosing intervals, resulting in increased convenience for patients

Answer

Reduced side effects, as different medications can counteract each other's adverse effects

Answer

Improved patient compliance due to reduced dosing frequency

Question 38

What is the appropriate route of administration for albuterol sulfate in the treatment of acute bronchospasm?

Accepted Answer

Inhalation (e.g., via nebulizer, metered-dose inhaler)

Answer

Intravenous injection

Answer

Oral tablet

Question 39

What is the recommended monitoring parameter for patients receiving theophylline therapy?

Accepted Answer

Serum theophylline levels, to ensure therapeutic efficacy and avoid toxicity

Answer

Heart rate, as theophylline can cause tachycardia

Answer

Blood pressure, as theophylline can cause hypertension

Question 40

Which of the following is a potential drug interaction with theophylline?

Accepted Answer

Ciprofloxacin (an antibiotic), which inhibits the metabolism of theophylline, leading to increased serum levels and potential toxicity

Answer

Ipratropium bromide (an anticholinergic), which has no significant interaction with theophylline

Answer

Salmeterol (a long-acting beta-2 agonist), which has a synergistic effect with theophylline

Answer

Albuterol (a short-acting beta-2 agonist), which has a similar mechanism of action to theophylline

Question 41

How do comorbidities, such as cardiovascular disease or diabetes, impact the selection and management of bronchodilators for patients with chronic respiratory conditions?

Accepted Answer

Bronchodilator dosage and administration may need adjustments for patients with comorbidities.

Answer

Comorbidities have no effect on bronchodilator selection.

Answer

Comorbidities do not influence monitoring for bronchodilator side effects.

Question 42

Which of the following is the primary mechanism of action of β2-adrenergic agonists?

Accepted Answer

Relaxation of bronchial smooth muscles, leading to bronchodilation.

Answer

Inhibition of phosphodiesterase

Answer

Blockage of muscarinic receptors

Answer

Reduction of mucus production

Question 43

Which of the following is a commonly reported adverse effect associated with the use of inhaled anticholinergics?

Accepted Answer

Dry mouth

Answer

Hypertension

Answer

Bronchospasm

Answer

Tachycardia

Question 44

Which of the following patient populations is most appropriate for long-acting β2-adrenergic agonists?

Accepted Answer

Patients with persistent asthma requiring daily controller medication

Answer

Patients with acute exacerbations of COPD

Answer

Patients with occasional cough and shortness of breath

Question 45

What is the primary goal of administering a bronchodilator?

Accepted Answer

To improve airflow by relaxing the muscles in the airways, thereby reducing resistance and increasing lung capacity.

Answer

To eliminate pathogens

Answer

To suppress coughing

Answer

To reduce inflammation

Question 46

What is the recommended route of administration for theophylline in adults?

Accepted Answer

Oral

Answer

Inhaled

Answer

Intravenous

Question 47

What is the primary contraindication for the use of xanthine derivatives?

Accepted Answer

Epilepsy due to the risk of seizures

Answer

Asthma

Answer

COPD

Answer

Heart failure

Question 48

Which of these bronchodilators is a short-acting beta-agonist (SABA)?

Accepted Answer

Albuterol

Answer

Salmeterol

Answer

Ipratropium

Answer

Tiotropium

Question 49

What is the primary mechanism of action for theophylline?

Accepted Answer

Inhibition of phosphodiesterase

Answer

Stimulation of alpha-adrenergic receptors

Answer

Blockade of muscarinic receptors

Answer

Activation of beta-adrenergic receptors

Question 50

Which of the following is an indication for ipratropium bromide?

Accepted Answer

Chronic obstructive pulmonary disease (COPD)

Answer

Pneumonia

Answer

Cystic fibrosis

Answer

Asthma

Question 51

Which side effect is commonly associated with the use of long-acting beta-agonists (LABAs)?

Accepted Answer

Tachycardia

Answer

Constipation

Answer

Blurred vision

Answer

Nausea

Question 52

What is the recommended route of administration for salmeterol?

Accepted Answer

Inhalation

Answer

Intravenous

Answer

Oral

Answer

Subcutaneous

Question 53

What is a key advantage of using combination bronchodilators?

Accepted Answer

Improved efficacy and reduced side effects

Answer

No additional benefits

Answer

Increased convenience

Answer

Lower cost

Question 54

Which of the following medications is NOT a bronchodilator?

Accepted Answer

Prednisone

Answer

Theophylline

Answer

Ipratropium bromide

Answer

Salmeterol