This is a pharmacology NCLEX practice question on bronchodilators and corticosteroids used to treat asthma. This question provides a scenario about prescribed medications for a patient with asthma. As the nurse, you must determine which inhaler you will administer first.
This question is one of the many questions we will be practicing in our new series called “Weekly NCLEX Question”.
So, every week be sure to tune into our YouTube Channel for the NCLEX Question of the Week.
NCLEX Pharmacology Question on Bronchodilators and Corticosteroids for Asthma
The physician prescribes a patient to take inhaled Fluticasone (Flovent HFA) and inhaled Albuterol (Ventolin HFA) for the treatment of asthma. As the nurse, how will you administer these medications?
A. First administer the Fluticasone, and then 5 minutes later administer the Albuterol.
B. First administer the Albuterol and, then 1 minute later administer the Fluticasone.
C. First administer the Fluticasone, and then immediately administer the Albuterol.
D. First administer the Albuterol, and then 5 minutes later administer the Fluticasone.
For this particular scenario, we know that our patient has asthma and is prescribed by the physician to use two metered-dose inhalers (Fluticasone and Albuterol). As the nurse, we need to know how to properly administer these medications.
To answer this question correctly, we must know what type of drug categories Fluticasone and Albuterol fall into:
Fluticasone (also called Flovent HFA) is a corticosteroid. Corticosteroids can be given various ways (by mouth, intravenous, inhaled, topical).
Fluticasone is used to suppress the immune system, which in turn will decrease the inflammation presenting in the lungs. When the patient inhales the Fluticasone it will enter the small airways and decrease the inflammation, which is WHY it is important the lungs are opened (not constricted) prior to inhalation so this medication can do its job.
This medication is best in preventing symptoms in patients with asthma. Note: it will not treat an acute asthma attack (a bronchodilator is best for this, and you will see why below).
NCLEX Tip: After administering an inhaled corticosteroid, what will you have the patient do? Answer: Gargle and rinse the mouth with water and spit. This will remove any residue of corticosteroids left in the mouth during inhalation. Remember corticosteroids are irritating to the mouth and can cause thrush.
Albuterol (also called Ventolin HFA) is a short-acting bronchodilator. Bronchodilators (just as their name says) open the bronchi and bronchioles of the lungs. When this happens, more air is able to flow through the lungs. Therefore, this drug is great in treating a patient who experiencing an acute asthma attack because the patient is experiencing bronchoconstriction.
So, with all that information about these two drugs we know that the nurse will FIRST administer the BRONCHODILATOR and then the corticosteroid.
But now the question is: “How much time will the nurse wait in between giving each drug?”
The answer to this is 5 minutes. Five minutes allows the bronchodilator enough time to work and dilate the airways and then the corticosteroid can be administered.
NCLEX Tip: If 2 “puffs” of Albuterol were ordered how long would you wait in between each puff? Answer: 1 minute. Therefore, if you are giving the same drug, but more than one dose, you would wait just 1 minute in between doses.
The answer to this question is: D. First administer the Albuterol, and then 5 minutes later administer the Fluticasone.
More NCLEX Reviews