Exam 16: Asthma and Chronic Obstructive Pulmonary Disease Medications

A patient with asthma is given an asthma action plan and returns to the clinic in 2 weeks to follow up on symptoms.Which statement by the patient indicates a need for further teaching?

A patient who was recently diagnosed with COPD comes to the clinic for a follow-up evaluation after beginning therapy with a SABA as needed for dyspnea.The patient reports occasional mild exertional dyspnea but is able to sleep well.The patient's FEV₁ in the clinic is 85% of predicted,and oxygen saturation is 96%.The primary care NP should recommend:

A primary care NP sees a child with asthma to evaluate the child's response to the prescribed therapy.The child uses an ICS twice daily and an albuterol metered-dose inhaler as needed.The child's symptoms are well controlled.The NP notes slowing of the child's linear growth on a standardized growth chart.The NP should change this child's medication regimen to a:

A 75-year-old patient requires frequent use of corticosteroids to control COPD exacerbations.To monitor adverse drug effects in this patient,the primary care NP should:

A 50-year-old patient who recently quit smoking reports a frequent morning cough productive of yellow sputum.A chest x-ray is clear,and the patient's FEV₁ is 80% of predicted.Pulse oximetry reveals an oxygen saturation of 97%.The primary care NP auscultates clear breath sounds.The NP should:

A primary care NP sees an adolescent patient for a hospitalization follow-up after an asthma exacerbation.The patient reports having daily symptoms with nighttime awakening 4 or 5 nights per week and misses school several days each month.The patient currently uses a salmeterol/fluticasone LABA twice daily and albuterol as needed.The patient requires a refill of the albuterol prescription once a month.The patient does not have any known allergies.The NP should:

A primary care nurse practitioner (NP)is evaluating a patient with asthma who reports having wheezing and coughing 1 or 2 days each week and awakening from sleep three or four times each month with asthma symptoms.The patient's forced expiratory volume in 1 second (FEV₁)is 80% of the predicted value.The patient's current medication regimen is an albuterol metered-dose inhaler,2 puffs every 4 hours as needed.The NP should prescribe:

A 70-year-old patient who has COPD takes theophylline daily and uses a SABA for exacerbation of symptoms.The patient reports using the SABA three or four times each week when short of breath.The patient reports feeling jittery and nauseated and having trouble sleeping.The primary care NP should:

A primary care NP is evaluating a patient who has COPD.The patient uses a LABA twice daily.The patient reports having increased exertional dyspnea,a frequent cough,and poor sleep.The patient also uses a short-acting b-adrenergic agonist (SABA)five or six times each day.Pulse oximetry reveals an oxygen saturation of 92%.The patient's FEV₁/forced vital capacity is 65,and FEV1 is 55% of predicted.The NP should prescribe a(n):