A patient with persistent, frequent asthma exacerbations asks a nurse about a long-acting beta2-agonist medication. What will the nurse tell this patient?
LABAs reduce the risk of asthma-related deaths.
LABAs can be used on an as-needed basis to treat symptoms.
LABAs are safer than short-acting beta2 agonists.
LABAs should be combined with an inhaled glucocorticoid.
The Correct Answer is D
Choice A reason: This is not a correct statement. LABAs stand for long-acting beta2-agonists, which are a class of medications that relax the smooth muscles of the airways and improve the airflow in patients with asthma or COPD. However, LABAs do not reduce the risk of asthma-related deaths, and may even increase it if used alone without an inhaled glucocorticoid, which is a type of anti-inflammatory medication.
Choice B reason: This is not a correct statement. LABAs cannot be used on an as-needed basis to treat symptoms, as they have a slow onset of action and a long duration of effect. LABAs are meant to be used as a maintenance therapy to prevent asthma exacerbations, not to relieve acute symptoms. For quick relief of symptoms, patients should use a short-acting beta2-agonist, such as albuterol or salbutamol.
Choice C reason: This is not a correct statement. LABAs are not safer than short-acting beta2 agonists, as they have similar side effects, such as tachycardia, tremors, and hypokalemia. LABAs also have a black box warning that they may increase the risk of asthma-related deaths if used without an inhaled glucocorticoid.
Choice D reason: This is the correct statement. LABAs should be combined with an inhaled glucocorticoid, as this combination has been shown to improve the asthma control, reduce the frequency and severity of exacerbations, and decrease the inflammation and airway hyperresponsiveness. The inhaled glucocorticoid also reduces the risk of adverse effects and mortality associated with LABAs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: The patient should not use the glucocorticoid as needed when symptoms flare. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, not as a rescue medication.
Choice B reason: The patient does not need to use the beta2-adrenergic agonist drug daily even when they don't have any symptoms. The beta2-adrenergic agonist is a short-acting bronchodilator that relaxes the smooth muscles of the airways and improves airflow. It should be used as needed for relief of acute symptoms, not as a maintenance medication.
Choice C reason: The beta2-adrenergic agonist does not suppress the synthesis of inflammatory mediators. The beta2-adrenergic agonist is a bronchodilator that acts on the beta2 receptors of the airways and causes relaxation of the smooth muscles. It does not have any anti-inflammatory effects.
Choice D reason: The glucocorticoid is used as prophylaxis to prevent exacerbations every day. This is the correct statement that indicates understanding of this medication regimen. The glucocorticoid is a long-term controller medication that reduces inflammation and prevents exacerbations of COPD. It should be used regularly as prescribed, along with the beta2-adrenergic agonist as needed for relief of acute symptoms.
Correct Answer is B
Explanation
Choice A reason: Respiratory acidosis does not cause no change in affinity of hemoglobin with oxygen. It causes a decrease in affinity of hemoglobin with oxygen, which means that hemoglobin releases more oxygen to the tissues. This is known as the Bohr effect, which is a physiological response to low pH and high CO2 levels.
Choice B reason: Respiratory acidosis causes a decrease in affinity of hemoglobin with oxygen, which means that hemoglobin releases more oxygen to the tissues. This is the correct statement that describes the expected finding in this patient. The decrease in affinity of hemoglobin with oxygen is a compensatory mechanism that tries to restore the oxygen balance in the body.
Choice C reason: Respiratory acidosis does not cause an increase in affinity of hemoglobin with oxygen. It causes a decrease in affinity of hemoglobin with oxygen, which means that hemoglobin releases more oxygen to the tissues. An increase in affinity of hemoglobin with oxygen would mean that hemoglobin holds on to oxygen more tightly, which would worsen the hypoxia in the patient.
Choice D reason: Respiratory acidosis does not cause a decrease in blood CO2. It causes an increase in blood CO2, which is the primary cause of the low pH. A decrease in blood CO2 would indicate respiratory alkalosis, which is a condition of high pH and low CO2 levels.
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