Chapter 11 - Drugs for Treating Asthma - Multiple Choice

A patient presents with severe asthma exacerbation. Which of the following findings would be most indicative of a potentially fatal asthma attack, warranting immediate and aggressive intervention?

A patient with a history of asthma is prescribed both albuterol and salmeterol. What is the primary rationale for prescribing these two medications in conjunction?

A patient is prescribed fluticasone via inhaler for long-term asthma management. What is the most important instruction to provide to this patient regarding the use of this medication?

In the management of acute asthma exacerbations in the emergency department, when is the administration of systemic corticosteroids, such as prednisone, most appropriate?

A patient with a known history of asthma presents to the emergency department with acute respiratory distress. After initial assessment, the patient exhibits the following signs: use of accessory muscles, a respiratory rate of 30 breaths/min, heart rate of 125 beats/min, and difficulty speaking in full sentences. Which of the following interventions should be prioritized FIRST?

Which of the following assessment findings in a patient experiencing an asthma exacerbation would be MOST concerning for impending respiratory failure?

A 30-year-old patient with a history of well-controlled asthma presents to the clinic complaining of increased nighttime awakenings due to wheezing and coughing. The patient is currently using fluticasone daily. Which of the following would be the MOST appropriate next step in managing this patient's asthma?

A patient with asthma is prescribed both fluticasone and salmeterol in a single inhaler (combination inhaler). What is the PRIMARY benefit of using a combination inhaler compared to using the two medications separately?

A patient with a history of asthma presents with acute respiratory distress. Upon assessment, the patient is diaphoretic, using accessory muscles, and has a respiratory rate of 35 breaths/min. Auscultation reveals faint wheezing in all lung fields. What is the MOST appropriate initial intervention?

Which of the following statements BEST describes the role of ipratropium in the management of acute asthma exacerbations?

A patient with a history of asthma is admitted to the hospital for an acute exacerbation. Despite receiving frequent nebulized albuterol treatments, the patient's peak expiratory flow (PEF) remains below 40% of their personal best. Which of the following medication adjustments would be MOST appropriate at this time?

When educating a patient about the appropriate use of a short-acting beta-agonist (SABA) inhaler, such as albuterol, which of the following instructions is MOST crucial to emphasize?

A patient with a long-standing history of asthma presents with progressively worsening symptoms, including increased frequency of albuterol use, nocturnal awakenings, and decreased exercise tolerance. Despite consistent use of inhaled corticosteroids, the patient's asthma remains poorly controlled. Which of the following strategies should be considered NEXT in the management of this patient's asthma?

A patient is prescribed a combination inhaler containing both fluticasone and salmeterol. Which of the following statements BEST explains the rationale for using these two medications together in a single inhaler?

In a patient experiencing a severe asthma exacerbation, which of the following clinical findings would be MOST indicative of the need for intubation and mechanical ventilation?

A child with a history of asthma is brought to the emergency department with acute respiratory distress. The child is using accessory muscles, has a respiratory rate of 40 breaths/min, and is only able to speak in short phrases. After initial treatment with nebulized albuterol and oxygen, there is minimal improvement in the child's symptoms. Which of the following interventions should be considered NEXT?

A patient with a history of asthma and allergic rhinitis is undergoing evaluation for persistent and poorly controlled asthma symptoms. Which of the following diagnostic tests would be MOST helpful in identifying potential allergic triggers contributing to the patient's asthma?

What is the PRIMARY mechanism of action by which inhaled corticosteroids, such as fluticasone, help to control asthma symptoms?

A patient with a history of asthma presents to the emergency department with acute respiratory distress. The patient's initial vital signs are: heart rate 130 beats/min, respiratory rate 35 breaths/min, oxygen saturation 88% on room air, and peak expiratory flow (PEF) 25% of predicted. After initial treatment with nebulized albuterol and ipratropium, the patient's PEF improves to 40% of predicted, but the other vital signs remain unchanged. What is the MOST appropriate next step in managing this patient?

A patient with a history of asthma is being discharged from the hospital after an acute exacerbation. Which of the following components is MOST important to include in the patient's discharge plan to prevent future exacerbations?

A 10-year-old child with a history of asthma is brought to the emergency department with severe respiratory distress. The child is cyanotic and has a decreased level of consciousness. Despite receiving initial treatment with oxygen and nebulized albuterol, the child's condition continues to deteriorate. Which of the following interventions should be prioritized FIRST?

A patient with a history of asthma is prescribed a long-acting beta-agonist (LABA) inhaler. Which of the following statements BEST describes the appropriate use of LABA inhalers in asthma management?

A patient with a history of asthma and seasonal allergies presents to the clinic with increased asthma symptoms during the spring pollen season. In addition to adjusting the patient's asthma medications, which of the following strategies would be MOST appropriate to manage the patient's seasonal allergy-related asthma symptoms?

A patient is being treated in the emergency department for a severe asthma exacerbation. Despite aggressive treatment with oxygen, nebulized bronchodilators, and systemic corticosteroids, the patient's arterial blood gas (ABG) results show a pH of 7.25, PaCO2 of 55 mmHg, and PaO2 of 60 mmHg. Which of the following interventions should be considered NEXT?

A patient with a history of asthma is being taught how to use a peak flow meter to monitor their asthma control. Which of the following instructions is MOST important to emphasize when teaching the patient how to use a peak flow meter?

A patient with a history of asthma and frequent exacerbations is found to have persistent airflow limitation on pulmonary function testing, even when asymptomatic. Which of the following potential complications of long-standing asthma should be suspected?

A patient with a history of asthma is being evaluated for possible exercise-induced bronchospasm (EIB). Which of the following strategies would be MOST effective in preventing EIB symptoms?

A patient with a history of asthma is prescribed a leukotriene receptor antagonist (LTRA), such as montelukast. Which of the following statements BEST describes the PRIMARY mechanism of action of LTRAs in asthma management?

A patient with a history of severe asthma presents to the emergency department with acute respiratory distress. Despite receiving maximal medical therapy, the patient's condition continues to deteriorate, and they are now exhibiting signs of hypercapnic respiratory failure. Which of the following interventions should be considered as a LAST RESORT measure to improve the patient's respiratory status?

A 65-year-old patient with a long-standing history of asthma and chronic obstructive pulmonary disease (COPD) presents to the clinic with worsening dyspnea and wheezing. How would you distinguish between asthma and COPD?

A researcher is investigating the inflammatory mechanisms underlying asthma. Which of the following cell types is believed to play a CENTRAL role in initiating and perpetuating the allergic inflammatory cascade in asthma?

A patient with a history of asthma and aspirin sensitivity (Samter's triad) is being evaluated for persistent nasal congestion and sinusitis. Which of the following treatment strategies should be AVOIDED in this patient due to the risk of exacerbating their asthma?

A patient with a history of brittle asthma is started on a low dose of theophylline. Which of the following statements BEST describes the therapeutic goals and monitoring requirements for theophylline in asthma management?

A patient with a history of severe, uncontrolled asthma is being considered for bronchial thermoplasty. Which of the following statements BEST describes the mechanism of action of bronchial thermoplasty in asthma management?

A patient with a history of asthma and gastroesophageal reflux disease (GERD) reports that their asthma symptoms worsen after meals, especially when lying down. Which of the following strategies would be MOST appropriate to manage this patient's asthma-related to GERD?

A patient with a history of asthma and obesity is being evaluated for persistent and poorly controlled asthma symptoms. Which of the following factors related to obesity may contribute to the patient's asthma severity?

A patient is experiencing an asthma exacerbation and presents with a heart rate of 130 beats/min, respiratory rate of 30 breaths/min, and difficulty speaking in full sentences. According to the criteria associated with a potentially fatal asthma attack, which of the following additional signs would MOST strongly suggest impending respiratory failure?

A patient with a history of asthma is prescribed albuterol (ProAir) for PRN use. Which statement indicates the patient understands the appropriate use of this medication?

A patient with persistent asthma symptoms is prescribed both fluticasone propionate and salmeterol in a combination inhaler. What is the MOST important aspect of patient education regarding this medication?

Following the administration of initial therapies for an acute asthma exacerbation, which finding would be MOST indicative of the need to escalate care and consider adjunctive therapies such as magnesium sulfate or heliox?

A patient with a history of asthma and documented allergies presents to the emergency department with an acute asthma exacerbation. The patient received appropriate doses of albuterol and ipratropium via nebulizer without significant improvement. What is the next appropriate step?

Which of the following findings in a patient with an acute asthma exacerbation would warrant HIGH consideration for endotracheal intubation and mechanical ventilation?

A patient with a known history of asthma presents to the emergency department complaining of acute shortness of breath. The patient is speaking in short sentences, has audible wheezing, and is using accessory muscles to breathe. Which of the following interventions should be implemented FIRST?

Which of the following is the MOST concerning sign in a patient experiencing an acute asthma exacerbation?

A 32-year-old patient with a history of mild intermittent asthma typically well-managed with PRN albuterol presents to the clinic complaining of increased frequency of asthma symptoms, including nocturnal cough and wheezing, over the past month. She denies any recent infections or changes in her environment. What is the MOST appropriate next step in managing this patient?

A patient with a history of asthma is prescribed salmeterol via inhaler. Which of the following instructions is MOST important to emphasize when educating the patient about this medication?

A patient with a known history of asthma presents to the emergency department with acute respiratory distress. After initial assessment, the patient exhibits the following signs: use of accessory muscles, a respiratory rate of 32 breaths/min, a heart rate of 125 beats/min, and peak expiratory flow (PEF) at 30% of predicted. Despite initial treatment with nebulized albuterol, the patient shows minimal improvement. Which of the following interventions should be prioritized NEXT?

What is the PRIMARY mechanism of action of ipratropium in acute asthma exacerbations?

A patient with a long-standing history of asthma presents with progressively worsening symptoms, including increased frequency of albuterol use, nocturnal awakenings, and decreased exercise tolerance. The patient has been consistently using inhaled corticosteroids as prescribed. Which of the following strategies should be considered NEXT to optimize asthma management?

Which of the following statements BEST explains the rationale for using fluticasone and salmeterol together in a single inhaler?

A child with a history of asthma presents to the emergency department with acute respiratory distress. After initial treatment with nebulized albuterol and oxygen, there is minimal improvement in the child's symptoms. The child is using accessory muscles, has a respiratory rate of 40 breaths/min, and is only able to speak in short phrases. What intervention should be considered NEXT?

A patient with a history of asthma presents to the emergency department with acute respiratory distress. The patient's initial vital signs are: heart rate 130 beats/min, respiratory rate 35 breaths/min, oxygen saturation 88% on room air, and peak expiratory flow (PEF) 25% of predicted. After initial treatment with nebulized albuterol and ipratropium, the patient's PEF improves to 40% of predicted, but the other vital signs remain unchanged. What is the MOST appropriate next step?

A patient with a long-standing history of asthma and chronic obstructive pulmonary disease (COPD) presents to the clinic with worsening dyspnea and wheezing. Which finding is MOST indicative of diagnosis of asthma?

A patient with a history of asthma and aspirin sensitivity (Samter's triad) is being evaluated for persistent nasal congestion and sinusitis. What treatment strategies should be AVOIDED in this patient due to the risk of exacerbating their asthma?

What statement BEST describes the therapeutic goals and monitoring requirements for theophylline in asthma management?

A 10-year-old child with a history of asthma is in the emergency department with severe respiratory distress. The child is cyanotic and has a decreased level of consciousness. Despite treatment with oxygen and nebulized albuterol, the child's condition continues to deteriorate. Of the interventions below, which should be prioritized?

A researcher is investigating the inflammatory mechanisms underlying asthma. Which cell type is the MOST responsible for perpetuating the allergic inflammatory cascade in asthma?

A patient with a history of asthma is being taught how to use a peak flow meter to monitor their asthma control. Which instruction is MOST important to emphasize when teaching the patient how to use a peak flow meter?

A patient experiencing severe asthma exacerbation demonstrates a sudden absence of wheezing after initial bronchodilator treatment. While diminished breath sounds are noted bilaterally, the patient's respiratory rate remains elevated at 35 breaths/min, and they exhibit increased agitation. Which of the following is the MOST appropriate interpretation of these findings?

A patient receiving albuterol via nebulizer complains of palpitations and tremors. Their heart rate increases from 90 to 120 beats/min. Which of the following mechanisms BEST explains these adverse effects of albuterol?

A patient with a history of asthma and allergic rhinitis is undergoing evaluation to determine triggers, and has a negative skin test. What is the MOST appropriate next step in evaluating hypersensitivity triggers?

A patient with asthma is being treated with omalizumab. What is the primary rationale for using this medication in asthma management?

In a patient with severe asthma exacerbation unresponsive to initial bronchodilator therapy, which of the following arterial blood gas (ABG) findings would be MOST concerning for impending respiratory collapse and the need for mechanical ventilation?

What is the underlying mechanism by which ipratropium bromide leads to bronchodilation in the treatment of asthma?

A patient with a history of severe asthma is prescribed a low dose of theophylline. Which statement about theophylline is correct?

A patient with a history of aspirin-exacerbated respiratory disease (AERD) requires treatment for nasal polyposis. Which treatment is MOST appropriate?

A patient with a long history of poorly controlled asthma develops signs of Cushing's syndrome. Which medication is the MOST likely cause?

A patient uses albuterol for exercise-induced asthma but finds it less effective over time. Which is the BEST approach?

Which finding is MOST indicative of hypercapnic respiratory failure in a patient experiencing a severe asthma exacerbation?

A patient with a history of asthma and obesity is being evaluated for persistent symptoms despite adherence to their prescribed medications. What is the MOST likely reason for the patient experiencing persistent and poorly controlled asthma symptoms?

A patient receiving high-dose inhaled corticosteroids for asthma develops oral candidiasis (thrush). Which of the following is the BEST approach for managing this complication?

A patient with a history of asthma and gastroesophageal reflux disease (GERD) reports increased asthma symptoms, especially at night. Which intervention is MOST appropriate?

A patient presents to the emergency department with an asthma exacerbation. Initial treatment includes oxygen, nebulized albuterol/ipratropium, and IV corticosteroids. Despite these interventions, the patient's peak expiratory flow (PEF) remains below 40% of predicted. Which of the following interventions should be prioritized?

A patient with severe persistent asthma is being considered for bronchial thermoplasty. Which of the following statements BEST describes the mechanism of action of bronchial thermoplasty in asthma management?

A patient with a well-documented history of exercise-induced bronchospasm (EIB) wants to start a new high-intensity workout routine. What's the MOST appropriate prophylactic strategy?

Which finding is the MOST concerning for acute respiratory failure in a patient experiencing a severe asthma exacerbation?

A patient with unstable asthma and frequent exacerbations is started on a new medication. Which finding would warrant immediate discontinuation of the medication??

An adult with a history of allergic asthma has persistent symptoms despite adherence to inhaled corticosteroids and a long-acting beta-agonist. What is the BEST next step?

A patient with asthma is prescribed a combination inhaler containing fluticasone and salmeterol. Which of the following is the MOST appropriate counseling point to emphasize?

What is the MOST appropriate strategy for managing a patient with a history of brittle asthma who presents with frequent, severe exacerbations despite high-dose inhaled corticosteroids and long-acting beta-agonists?

A 60-year-old former smoker with a history of both asthma and COPD presents with increasing dyspnea. Which finding would MOST strongly suggest that the patient's current symptoms are primarily due to asthma?

A patient with a history of severe allergic asthma is undergoing evaluation to determine triggers. The skin test result is negative. What is the next appropriate step?

A patient with asthma is prescribed a long-acting beta-agonist (LABA) inhaler. What is the MOST important counseling point to emphasize?

A patient receiving albuterol via nebulizer complains of palpitations and tremors. The patient's heart rate increases from 80 to 120 beats/min. What is the BEST course of action?

A patient with a history of asthma and allergic rhinitis is undergoing evaluation. What diagnostic test is MOST helpful in identifying potential allergic triggers?

Which treatment is MOST appropriate for a patient with a known history of asthma who presents with acute shortness of breath, audible wheezing, and is using accessory muscles to breathe?

A patient presents to the emergency department with an asthma exacerbation. After initial treatment with oxygen and nebulized albuterol, the patient's oxygen saturation remains at 88% on room air. What is the MOST appropriate next step?

A patient has severe asthma exacerbation and continues to deteriorate despite maximal medical therapy. As a last resort, which intervention should be considered to improve the patient's respiratory status?

Which of the following is the MOST concerning sign for impending respiratory failure in a patient experiencing an acute asthma exacerbation?

A child with a history of asthma is brought to the emergency department with severe respiratory distress. The interventions below are all valid; however, which should be prioritized FIRST?

A patient presents with asthma exacerbation. Which of the following findings indicates a potentially fatal asthma attack?

A patient is prescribed both fluticasone propionate and salmeterol in a combination inhaler. What is the MOST important aspect of patient education regarding this medication?

A patient with a history of asthma presents to the emergency department. Upon assessment, which finding is the MOST indicative of a potentially fatal asthma attack?

A patient with asthma is prescribed both albuterol and ipratropium via nebulizer for acute exacerbations. What is the PRIMARY reason for combining these two medications?

A patient is prescribed fluticasone via inhaler for long-term asthma management. Which of the following statements demonstrates an understanding of the MOST critical aspect of using this medication?

In the management of acute asthma exacerbations, when is the administration of systemic corticosteroids, such as prednisone, MOST crucial?

A patient with a known history of asthma presents to the emergency department with acute respiratory distress. The patient is using accessory muscles, respiratory rate is 30 breaths/min, heart rate is 125 beats/min, and has difficulty speaking in full sentences. Which intervention should be prioritized FIRST?

Which assessment finding in a patient experiencing an asthma exacerbation would be MOST concerning for impending respiratory failure?

A patient with a history of well-controlled asthma presents to the clinic complaining of increased nighttime awakenings due to wheezing and coughing. The patient is currently using fluticasone daily. What is the MOST appropriate next step?

A patient is prescribed both fluticasone and salmeterol in a single inhaler (combination inhaler). What is the PRIMARY benefit of using a combination inhaler compared to using the two medications separately?

A patient with a history of asthma presents with acute respiratory distress. The patient is diaphoretic, using accessory muscles, and has a respiratory rate of 35 breaths/min. Auscultation reveals faint wheezing in all lung fields. What is the MOST appropriate initial intervention?

A patient with a history of asthma and frequent exacerbations is found to have persistent airflow limitation on pulmonary function testing, even when asymptomatic. Which potential complication of long-standing asthma should be suspected?

A patient with a history of asthma is prescribed a leukotriene receptor antagonist (LTRA), such as montelukast. Which statement BEST describes the PRIMARY mechanism of action of LTRAs in asthma management?

A patient with a history of severe asthma presents to the emergency department with acute respiratory distress. The patient shows signs of hypercapnic respiratory failure, despite maximal medical therapy. Which intervention should be a LAST RESORT?

A patient with a history of asthma and aspirin sensitivity (Samter's triad) is being evaluated for persistent nasal congestion and sinusitis. Which treatment strategies should be AVOIDED?

A patient with a history of brittle asthma is started on a low dose of theophylline. Which statement BEST describes the therapeutic goals and monitoring requirements for theophylline in asthma management?

A patient with a history of severe, uncontrolled asthma is being considered for bronchial thermoplasty. Which statement BEST describes the mechanism of action of bronchial thermoplasty in asthma management?

A patient with a history of asthma and gastroesophageal reflux disease (GERD) reports that their asthma symptoms worsen after meals, especially when lying down. What strategies would be MOST appropriate to manage this patient's asthma-related to GERD?

A patient experiencing an asthma exacerbation presents with a heart rate of 130 beats/min, a respiratory rate of 30 breaths/min, and difficulty speaking in full sentences. Which additional sign would MOST strongly suggest impending respiratory failure?