Question

The nurse is preparing to discharge a client after a three day admission for an asthma exacerbation. The client has a history of diabetes mellitus and depression with suicidal ideation.

Answer 1

Correct Answers

Beclomethasone [ Anticipated ]
Montelukast [ Contraindicated ]
Albuterol [ Anticipated ]
Loratadine [ Nonessential ]

Rationale :

🫁Beclomethasone is an inhaled corticosteroid for long-term asthma control.

🚰Rinsing the mouth after beclomethasone helps prevent oral thrush.

🚨Albuterol is a rescue bronchodilator for acute asthma symptoms.

🧠Montelukast is avoided with depression and suicidal ideation.

🌿Loratadine treats allergies, not essential asthma control.

📌Core Message

Asthma discharge care needs a controller inhaler and rescue inhaler, while montelukast is unsafe with suicidal ideation.

Answer 2

Correct Answers:

This medication can be given intravenously.

Rationale :

💉Methylprednisolone is a systemic corticosteroid that can be administered by IV route in acute inflammatory conditions.

🔥It helps reduce airway inflammation, which is useful during asthma exacerbations.

⏱️It is not primarily taught as a bronchodilator because it does not provide immediate airway relaxation.

🏥IV administration is especially useful when a client needs rapid systemic anti-inflammatory therapy.

📌Core Message

Methylprednisolone is a systemic corticosteroid that may be given IV for acute inflammation.

Answer 3

Correct Answers:

Exercise-induced bronchospasm

Rationale :

🏃Montelukast is indicated for prevention of exercise-induced bronchospasm.

🌬️It works by blocking leukotrienes, which contribute to airway swelling and bronchoconstriction.

📅It is used as a preventive medication, not as a rescue drug for sudden symptoms.

⚠️Clients should still be screened for neuropsychiatric risks before use.

📌Core Message

Montelukast helps prevent leukotriene-mediated bronchospasm, including symptoms triggered by exercise.

Answer 4

Correct Answers:

"Use a spacer if you have difficulty timing the medication delivery."

Rationale :

🫧A spacer helps coordinate inhalation with medication release from a metered-dose inhaler.

🌬️It improves delivery of medication into the lower airways instead of the mouth or throat.

🎯This is especially helpful for clients who struggle with timing inhalation correctly.

🫁Proper inhaler technique increases the effectiveness of asthma medication delivery.

📌Core Message

A spacer improves inhaler technique by helping medication reach the lungs more effectively.

Answer 5

Correct Answers:

Prednisone

Rationale :

🧪Prednisone is a systemic corticosteroid used to reduce airway inflammation in asthma exacerbations.

🫁It helps improve breathing by decreasing swelling and inflammatory response in the airways.

📉It is commonly used for short courses during worsening asthma symptoms.

⚠️Long-term use requires monitoring because systemic corticosteroids can cause significant adverse effects.

📌Core Message

Prednisone manages asthma by reducing inflammation, especially during exacerbations.

Answer 6

Correct Answers:

"I should stay away from caffeine."

Rationale :

☕Albuterol can cause stimulant-like effects such as tremors, nervousness, palpitations, and increased heart rate.

⚡Caffeine may worsen these stimulant effects and increase jitteriness.

🫀Clients should report serious symptoms such as chest pain or irregular heartbeat.

🫁Albuterol is used as a rescue medication, not usually taken at the same fixed time every day unless prescribed.

📌Core Message

Albuterol may cause stimulant effects, so clients should avoid triggers like caffeine that can intensify them.

Answer 7

Correct Answers:

Bone loss
Peptic ulcer
Muscle weakness
Infection

Rationale :

🦴Long-term prednisone can cause bone loss because corticosteroids reduce bone formation and increase bone breakdown.

🩺Prednisone increases risk for peptic ulcer, especially with prolonged systemic use.

💪Chronic corticosteroid use can cause muscle weakness due to protein breakdown and muscle wasting.

🛡️Prednisone suppresses the immune response, increasing infection risk and sometimes masking infection signs.

📌Core Message

Long-term prednisone can weaken bones, irritate the GI tract, reduce muscle strength, and increase infection risk.

Answer 8

Correct Answers:

Sedation

Rationale :

😴Dextromethorphan can cause drowsiness, which may appear as sedation.

🧠It acts on the cough center in the brain to reduce the cough reflex.

🚗Clients should use caution with activities requiring alertness if sedation occurs.

💊Teaching should include avoiding other sedating medications unless approved by a provider.

📌Core Message

Dextromethorphan suppresses cough and may cause sedation or drowsiness.

Answer 9

Correct Answers:

Rinse your mouth after administration

Rationale :

🚰Clients using inhaled beclomethasone should rinse the mouth after use to reduce oral fungal infection risk.

🦠Inhaled corticosteroids can increase risk for oropharyngeal candidiasis.

🫁Beclomethasone is a maintenance medication, not a rescue medication for immediate relief.

📅It works best when used consistently as prescribed for long-term asthma control.

📌Core Message

After inhaled beclomethasone, rinsing the mouth helps prevent oral candidiasis.

Answer 10

Correct Answers:

Increased ability to cough out secretions

Rationale :

💧Guaifenesin is an expectorant that thins mucus in the airways.

🤧Thinner mucus is easier for the client to cough out.

🫁This helps clear airway secretions and improves airway clearance.

🥤Clients are often encouraged to maintain fluid intake to support mucus thinning.

📌Core Message

Guaifenesin helps loosen mucus so the client can cough out secretions more effectively.

1 :
The nurse is preparing to discharge a client after a three day admission for an asthma exacerbation. The client has a history of diabetes mellitus and depression with suicidal ideation.

Correct Answers

2 :
Which instruction would be included in client teaching on methylprednisolone?

3 :
Which condition is an indication for montelukast?

4 :
Which statement would be included in client teaching on the use of a metered-dose inhaler?

5 :
Which medication is indicated for the management of asthma?

6 :
Which statement made by the client indicates understanding of teaching related to albuterol?

7 :
Which adverse effect is associated with long-term use of prednisone? Select 4 correct responses.

8 :
Which adverse effect is associated with dextromethorphan?

9 :
Which instruction would be included in client teaching on inhaled beclomethasone?

10 :
Which finding is expected after administering guaifenesin?

Potential Prescription	Anticipated	Nonessential	Contraindicated
Beclomethasone
Montelukast
Albuterol
Loratadine

1 : The nurse is preparing to discharge a client after a three day admission for an asthma exacerbation. The client has a history of diabetes mellitus and depression with suicidal ideation.

Correct Answers

2 : Which instruction would be included in client teaching on methylprednisolone?

3 : Which condition is an indication for montelukast?

4 : Which statement would be included in client teaching on the use of a metered-dose inhaler?

5 : Which medication is indicated for the management of asthma?

6 : Which statement made by the client indicates understanding of teaching related to albuterol?

7 : Which adverse effect is associated with long-term use of prednisone? Select 4 correct responses.

8 : Which adverse effect is associated with dextromethorphan?

9 : Which instruction would be included in client teaching on inhaled beclomethasone?

10 : Which finding is expected after administering guaifenesin?

1 :
The nurse is preparing to discharge a client after a three day admission for an asthma exacerbation. The client has a history of diabetes mellitus and depression with suicidal ideation.

2 :
Which instruction would be included in client teaching on methylprednisolone?

3 :
Which condition is an indication for montelukast?

4 :
Which statement would be included in client teaching on the use of a metered-dose inhaler?

5 :
Which medication is indicated for the management of asthma?

6 :
Which statement made by the client indicates understanding of teaching related to albuterol?

7 :
Which adverse effect is associated with long-term use of prednisone? Select 4 correct responses.

8 :
Which adverse effect is associated with dextromethorphan?

9 :
Which instruction would be included in client teaching on inhaled beclomethasone?

10 :
Which finding is expected after administering guaifenesin?