Untitled Flashcard Set

I made NCLEX-style questions directly from your slides (your pharm lecture). I mixed in priority, SATA, pharmacology, and clinical reasoning questions like your professor would likely test. Everything is based on the content from your lecture slides.

Below are 100 questions. I did multiple choice + SATA because NCLEX loves those.

NCLEX-Style Questions: Respiratory Drugs (100)

Asthma & COPD Basics

1. A nurse is reviewing the pathophysiology of asthma. Which finding is expected?
A. Alveolar destruction
B. Bronchial hyperresponsiveness
C. Decreased mucus production
D. Increased lung elasticity

2. Which condition is classified as an obstructive lung disease?
A. Asthma
B. COPD
C. Pneumonia
D. Pulmonary fibrosis

3. Which symptom is commonly seen in COPD?
A. Hypercapnia
B. Hypoglycemia
C. Bradycardia
D. Hypotension

4. A patient with asthma is experiencing bronchospasm. Which medication class should the nurse anticipate for immediate relief?
A. Corticosteroids
B. Leukotriene modifiers
C. Short-acting beta-2 agonists
D. Mast cell stabilizers

5. Which finding is expected during an asthma attack?
A. Airway dilation
B. Bronchial muscle spasms
C. Decreased mucus
D. Reduced airway inflammation

Anti-Inflammatory Drugs

6. Which medication is a leukotriene modifier?
A. Montelukast
B. Cromolyn
C. Prednisone
D. Salmeterol

7. Which medication is classified as a mast cell stabilizer?
A. Cromolyn
B. Albuterol
C. Tiotropium
D. Theophylline

8. A patient uses inhaled corticosteroids daily. What should the nurse teach to prevent oral candidiasis?
A. Drink milk after inhaler
B. Rinse mouth after inhalation
C. Brush teeth before inhaler
D. Drink warm fluids

9. Which medication is an inhaled corticosteroid?
A. Fluticasone
B. Montelukast
C. Albuterol
D. Ipratropium

10. Inhaled corticosteroids are primarily used for:
A. Acute asthma attacks
B. Long-term asthma control
C. Immediate bronchodilation
D. Emergency COPD treatment

Corticosteroids

11. A patient taking long-term prednisone suddenly stops the medication. Which complication is most concerning?
A. Hypoglycemia
B. Adrenal insufficiency
C. Tachycardia
D. Renal failure

12. Which adverse effect is associated with long-term corticosteroid therapy?
A. Osteoporosis
B. Hypoglycemia
C. Bradycardia
D. Weight loss

13. Which medication is commonly used for short-term treatment of asthma exacerbations?
A. Prednisone
B. Cromolyn
C. Salmeterol
D. Loratadine

14. A nurse should monitor which lab value in a patient taking corticosteroids?
A. Blood glucose
B. Calcium
C. Sodium
D. Albumin

15. Which medication interaction increases the risk of GI bleeding with corticosteroids?
A. NSAIDs
B. Beta blockers
C. Antihistamines
D. Calcium supplements

Leukotriene Modifiers

16. Montelukast is used for:
A. Acute asthma attacks
B. Long-term asthma prevention
C. Immediate bronchodilation
D. Emergency COPD

17. Leukotrienes cause which airway effect?
A. Bronchodilation
B. Bronchoconstriction
C. Decreased mucus
D. Vasodilation

18. A patient taking montelukast asks when the medication will start working. The nurse states:
A. Immediately
B. Within 1 hour
C. Within 24 hours
D. After 1 week

Bronchodilators

19. Which mnemonic helps remember bronchodilator classes?
A. SLM
B. BAM
C. ABC
D. AIR

20. Which drug is a short-acting beta-2 agonist (SABA)?
A. Albuterol
B. Salmeterol
C. Tiotropium
D. Cromolyn

21. Which medication is a long-acting beta-2 agonist (LABA)?
A. Albuterol
B. Salmeterol
C. Ipratropium
D. Theophylline

22. Which medication is used for acute bronchospasm?
A. Albuterol
B. Montelukast
C. Cromolyn
D. Fluticasone

23. How quickly does inhaled albuterol begin to work?
A. <5 minutes
B. 20 minutes
C. 1 hour
D. 4 hours

24. Which adverse effect is common with beta-2 agonists?
A. Bradycardia
B. Tremors
C. Hypotension
D. Sedation

Anticholinergics

25. Which medication is an anticholinergic bronchodilator?
A. Ipratropium
B. Montelukast
C. Cromolyn
D. Prednisone

26. Which medication is a long-acting muscarinic antagonist (LAMA)?
A. Ipratropium
B. Tiotropium
C. Albuterol
D. Terbutaline

27. A common adverse effect of anticholinergics is:
A. Dry mouth
B. Hypoglycemia
C. Sedation
D. Diarrhea

Methylxanthines

28. Which medication requires serum drug monitoring?
A. Theophylline
B. Montelukast
C. Cromolyn
D. Ipratropium

29. Therapeutic theophylline levels are:
A. 1–5 mcg/mL
B. 5–15 mcg/mL
C. 20–30 mcg/mL
D. 30–40 mcg/mL

30. Theophylline toxicity can cause:
A. Seizures
B. Bradycardia
C. Hypotension
D. Respiratory depression

31. SATA
Which substances interact with theophylline?
A. Caffeine
B. Smoking
C. Cimetidine
D. Phenobarbital
E. Vitamin C

Combination Drugs

32. Which medication is a combination inhaler?
A. Advair
B. Cromolyn
C. Montelukast
D. Prednisone

33. Advair contains:
A. Steroid + LABA
B. SABA + LAMA
C. Antihistamine + steroid
D. Beta blocker + steroid

Allergic Rhinitis

34. Which medication treats allergic rhinitis by blocking histamine receptors?
A. Loratadine
B. Pseudoephedrine
C. Cromolyn
D. Prednisone

35. Which antihistamine commonly causes sedation?
A. Diphenhydramine
B. Loratadine
C. Cetirizine
D. Fexofenadine

36. SATA
Which medications are second-generation antihistamines?
A. Loratadine
B. Cetirizine
C. Fexofenadine
D. Diphenhydramine

Decongestants

37. Which medication is a nasal decongestant?
A. Pseudoephedrine
B. Montelukast
C. Cromolyn
D. Fluticasone

38. Decongestants work by:
A. Bronchodilation
B. Vasoconstriction
C. Histamine blockade
D. Mucus thinning

39. Overuse of nasal sprays can cause:
A. Rebound congestion
B. Respiratory depression
C. Bradycardia
D. Hypoglycemia

Cough Medications

40. Which medication is an opioid antitussive?
A. Codeine
B. Guaifenesin
C. Dextromethorphan
D. Benzonatate

41. Which medication is a non-opioid cough suppressant?
A. Dextromethorphan
B. Hydrocodone
C. Codeine
D. Morphine

42. Benzonatate should be administered how?
A. Chewed
B. Dissolved
C. Swallowed whole
D. Crushed

43. Chewing benzonatate can cause:
A. Severe bronchospasm
B. Tachycardia
C. Hyperglycemia
D. Diarrhea

Expectorants

44. Which medication helps produce a more productive cough?
A. Guaifenesin
B. Codeine
C. Hydrocodone
D. Benzonatate

45. Guaifenesin works by:
A. Suppressing cough reflex
B. Thinning mucus
C. Bronchodilation
D. Blocking histamine

Mucolytics

46. Which medication is a mucolytic?
A. Acetylcysteine
B. Albuterol
C. Montelukast
D. Loratadine

47. Acetylcysteine works by:
A. Breaking down mucus
B. Suppressing cough reflex
C. Bronchodilation
D. Blocking histamine

Nursing Considerations

48. SATA
Which teaching points should the nurse provide for inhaler use?
A. Use proper inhaler technique
B. Rinse mouth after steroid inhaler
C. Use spacer if prescribed
D. Hold breath after inhalation

49. Which patient requires monitoring for infection and hyperglycemia?
A. Patient taking prednisone
B. Patient taking loratadine
C. Patient taking guaifenesin
D. Patient taking benzonatate

50. Which medication class should NOT be used for acute asthma attacks?
A. Inhaled corticosteroids
B. Albuterol
C. Ipratropium
D. Aminophylline

Mixed NCLEX Clinical Questions

51. A patient with asthma reports using their rescue inhaler 5 times per day. What should the nurse do first?
A. Notify provider
B. Increase dose
C. Stop medication
D. Encourage exercise

52. A patient taking theophylline develops nausea and restlessness. What should the nurse suspect?
A. Toxicity
B. Allergic reaction
C. Dehydration
D. Hypoglycemia

53. SATA
Which adverse effects are associated with beta-2 agonists?
A. Tachycardia
B. Tremors
C. Palpitations
D. Hypertension

54. Which medication should a patient use before exercise-induced asthma?
A. Albuterol
B. Prednisone
C. Montelukast
D. Cromolyn

55. Which medication is best for quick relief of bronchospasm?
A. Albuterol
B. Montelukast
C. Fluticasone
D. Cromolyn

Priority / Clinical Judgment

56. A patient receiving IV aminophylline develops seizures. What is the priority action?
A. Stop infusion
B. Administer oxygen
C. Call provider
D. Check BP

57. Which patient requires immediate intervention?
A. Patient with tremors after albuterol
B. Patient with thrush after steroid inhaler
C. Patient with seizure on theophylline
D. Patient with dry mouth from ipratropium

58. Which patient teaching is correct for inhaled corticosteroids?
A. Use during asthma attacks
B. Rinse mouth after use
C. Take only PRN
D. Stop immediately if better

59. Which medication should be avoided with antihistamines?
A. Alcohol
B. Calcium
C. Vitamin D
D. Potassium

60. Which medication can cause CNS stimulation?
A. Pseudoephedrine
B. Cromolyn
C. Montelukast
D. Fluticasone

Inhalers + Steroids

61. A patient is prescribed an inhaled corticosteroid for chronic asthma. Which statement shows correct understanding?
A. “I will use this inhaler only during an asthma attack.”
B. “This medication is for long-term control and prevention.”
C. “This inhaler will work in less than 5 minutes.”
D. “I can stop it as soon as I feel better.”

62. Which adverse effect is most associated with inhaled corticosteroids?
A. Hypoglycemia
B. Oropharyngeal candidiasis (thrush)
C. Constipation
D. Rebound congestion

63. The nurse is teaching a patient how to reduce the risk of thrush from an inhaled steroid. Which instruction is best?
A. “Use the inhaler before meals.”
B. “Rinse your mouth after each use.”
C. “Take this inhaler only at bedtime.”
D. “Increase the dose if wheezing starts.”

64. SATA A patient is taking oral corticosteroids long-term. Which adverse effects should the nurse monitor for?
A. Infection/immunosuppression
B. Hyperglycemia
C. Osteoporosis
D. Cataracts/glaucoma
E. Bradycardia

65. A patient on long-term prednisone needs surgery next week. Which concept is most important for the nurse to remember?
A. The patient should stop prednisone the day before surgery
B. The provider may prescribe additional glucocorticoids for stress
C. The patient should double their decongestant dose
D. The patient should start montelukast immediately for quick relief

66. Which contraindication is listed for corticosteroids?
A. Seasonal allergies
B. Systemic fungal infections
C. Exercise-induced asthma
D. COPD

67. A patient taking prednisone also takes ibuprofen daily. The nurse is most concerned about:
A. Kidney stones
B. Increased risk of bleeding/GI complications
C. Rebound congestion
D. Reduced cough threshold

Leukotriene Modifiers + Mast Cell Stabilizers

68. Montelukast is best described as:
A. Rescue medication for acute asthma
B. Leukotriene antagonist for prevention/maintenance
C. Opioid antitussive for cough
D. Alpha-1 agonist for congestion

69. A patient asks if montelukast will stop an acute asthma attack. The best response is:
A. “Yes, it works within minutes.”
B. “Yes, take it as your rescue inhaler.”
C. “No, it’s for prevention and maintenance, not quick relief.”
D. “Only if taken with diphenhydramine.”

70. Cromolyn is used primarily for:
A. Emergency bronchodilation
B. Chronic asthma prevention
C. Immediate relief of bronchospasm
D. Treating pneumonia

Beta-2 Agonists (SABA/LABA)

71. Which medication is a short-acting beta-2 agonist (SABA)?
A. Salmeterol
B. Albuterol
C. Tiotropium
D. Montelukast

72. The nurse expects albuterol inhaled onset to be:
A. 30 minutes
B. <5 minutes
C. 2 hours
D. 12 hours

73. Which adverse effect is expected with albuterol?
A. Sedation
B. Tremors and increased heart rate
C. Constipation
D. Bradycardia

74. A patient is prescribed salmeterol for asthma. Which statement is correct?
A. “This is my rescue inhaler for sudden symptoms.”
B. “This is for long-term control and not used alone.”
C. “It works in under 5 minutes.”
D. “I only take it when I feel wheezy.”

75. The expected duration of a LABA like salmeterol is about:
A. 3–5 hours
B. 6 hours
C. 12 hours
D. 24 hours

Anticholinergics (Muscarinic Antagonists)

76. Which medication is an anticholinergic bronchodilator often used for COPD?
A. Ipratropium
B. Fluticasone
C. Guaifenesin
D. Dextromethorphan

77. Ipratropium works by:
A. Blocking muscarinic receptors → bronchodilation
B. Activating beta-2 receptors → bronchodilation
C. Blocking leukotrienes → decreased mucus
D. Thinning mucus → productive cough

78. A common adverse effect of ipratropium is:
A. Dry mouth and throat irritation
B. Hypoglycemia
C. Respiratory depression
D. Rebound congestion

79. Which medication is a long-acting muscarinic antagonist (LAMA)?
A. Ipratropium
B. Tiotropium
C. Albuterol
D. Codeine

Methylxanthines (Theophylline)

80. Theophylline is ordered for a patient. Which nursing action is priority for safety?
A. Monitor serum drug levels
B. Encourage alcohol intake
C. Give with diphenhydramine
D. Limit all fluids

81. The therapeutic range for theophylline is:
A. 0.5–2 mcg/mL
B. 5–15 mcg/mL
C. 15–25 mcg/mL
D. 25–35 mcg/mL

82. Which finding suggests theophylline toxicity (more severe)?
A. Mild nausea
B. Restlessness/insomnia
C. Dysrhythmias and seizures
D. Dry mouth

83. SATA Which factors/medications can affect theophylline levels per the lecture?
A. Caffeine
B. Smoking
C. Phenobarbital
D. Phenytoin
E. Cimetidine

84. A patient taking theophylline drinks multiple energy drinks daily. The nurse should anticipate:
A. Decreased theophylline levels
B. Increased theophylline levels
C. Rebound congestion
D. Decreased cough threshold from opioids

Allergic Rhinitis

85. Intranasal glucocorticoids (ex: fluticasone nasal) primarily:
A. Cause vasoconstriction of nasal vessels
B. Decrease inflammation of nasal passages
C. Suppress cough center in CNS
D. Thin mucus for expectoration

86. Which adverse effect is common with intranasal glucocorticoids?
A. Epistaxis (nosebleeds)
B. Hyperglycemia
C. Respiratory depression
D. Seizures

87. Antihistamines work by:
A. Activating alpha-1 receptors
B. Blocking H1 histamine receptors
C. Breaking down mucus directly
D. Blocking muscarinic receptors

88. SATA Which are first-generation antihistamines from the slides?
A. Diphenhydramine
B. Chlorpheniramine
C. Loratadine
D. Fexofenadine
E. Desloratadine

Decongestants + Cough Meds

89. Decongestants (ex: pseudoephedrine) reduce congestion by:
A. Bronchodilation
B. Vasoconstriction via alpha-1 activation
C. Blocking leukotrienes
D. Decreasing stretch receptor sensitivity

90. Which is a decongestant associated with rebound congestion when overused as a spray?
A. Oxymetazoline
B. Loratadine
C. Montelukast
D. Fluticasone inhaled

91. Opioid antitussives (codeine/hydrocodone) suppress cough by:
A. Thinning mucus
B. Acting in CNS to raise cough threshold
C. Blocking H1 receptors
D. Activating beta-2 receptors

92. The most serious adverse effect of opioid antitussives is:
A. Respiratory depression
B. Rebound congestion
C. Epistaxis
D. Dry mouth

93. Dextromethorphan is best described as:
A. Non-opioid antitussive with minimal adverse effects
B. Expectorant
C. Mucolytic
D. Antihistamine

94. Benzonatate teaching—what is most important?
A. “Chew the capsule for faster relief.”
B. “Swallow the capsule whole.”
C. “Take with alcohol to sleep.”
D. “Crush and mix in applesauce.”

95. If benzonatate is chewed, the nurse is most concerned about:
A. Severe bronchospasm and choking/aspiration risk
B. Hyperglycemia
C. Constipation
D. Rebound congestion

96. Guaifenesin helps cough by:
A. Suppressing cough reflex
B. Increasing respiratory secretions → more productive cough
C. Blocking histamine receptors
D. Causing bronchodilation by beta-2 activation

97. Acetylcysteine works by:
A. Blocking H1 receptors
B. Reacting with mucus to make it more watery/easier to expectorate
C. Activating alpha-1 receptors
D. Suppressing cough in CNS

Priority / Safety

98. A patient on theophylline reports palpitations and has an irregular rhythm. What should the nurse do first?
A. Check a theophylline level and notify the provider
B. Give caffeine to improve breathing
C. Encourage smoking cessation immediately only
D. Give diphenhydramine for sedation

99. A patient on inhaled corticosteroids reports white patches in the mouth. What is the nurse’s best action?
A. Tell the patient to stop the inhaler abruptly
B. Assess for thrush and reinforce rinsing mouth after use
C. Encourage more frequent use of rescue inhaler
D. Start decongestant nasal spray

100. SATA Which patient education points are key from the lecture?
A. Proper inhaler technique is crucial
B. Rinse mouth after inhaled corticosteroids
C. Theophylline requires serum monitoring
D. Oral steroids should be tapered
E. Use montelukast for immediate rescue relief