A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?

I should use the glucocorticoid as needed when symptoms flare.

I will need to use the beta2-adrenergic agonist drug daily even when I don't have any symptoms.

The beta2-adrenergic agonist suppresses the synthesis of inflammatory mediators.

The glucocorticoid is used as prophylaxis to prevent exacerbations every day.

Answer and Explanation

The Correct Answer is D

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.

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Correct Answer is B

Explanation

Choice A reason: This is not the preferred agent for the initial treatment of heart failure. Vasodilators are a class of medications that lower the blood pressure by relaxing the blood vessels and reducing the resistance to blood flow. They can be used to treat hypertension, angina, and heart failure, but they are usually added to other medications, such as diuretics or beta blockers, to improve the symptoms and outcomes.

Choice B reason: This is the preferred agent for the initial treatment of heart failure. Diuretics are a class of medications that increase the urine output and reduce the fluid retention in the body. They can be used to treat hypertension, edema, and heart failure, as they reduce the preload and afterload on the heart, and decrease the pulmonary congestion and peripheral edema.

Choice C reason: This is not the preferred agent for the initial treatment of heart failure. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias, but they are not recommended for most patients with heart failure, as they may worsen the cardiac function and increase the mortality.

Choice D reason: This is not the preferred agent for the initial treatment of heart failure. Direct renin inhibitors are a class of medications that lower the blood pressure by inhibiting the enzyme renin, which initiates the renin-angiotensin-aldosterone system, a hormonal pathway that regulates the blood pressure and fluid balance. They can be used to treat hypertension, but they have not been proven to be effective or safe for patients with heart failure.

A. Hypertension B. Dyspnea upon exertion C. Significant edema to both lo D. Decreased urine output

Correct Answer is C

Explanation

Choice A reason: This is not a symptom of right heart failure. Hypertension is a risk factor for developing heart failure, but it does not indicate the severity or location of the heart failure.

Choice B reason: This is not a symptom of right heart failure. Dyspnea upon exertion is a symptom of left heart failure, which occurs when the left ventricle fails to pump blood effectively to the lungs.

Choice C reason: This is a symptom of right heart failure. Significant edema to both lower legs and feet is a result of increased pressure in the systemic circulation, which occurs when the right ventricle fails to pump blood effectively to the rest of the body. This causes fluid to accumulate in the dependent areas, such as the lower extremities.

Choice D reason: This is not a symptom of right heart failure. Decreased urine output is a symptom of left heart failure, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes reduced renal perfusion and oliguria.

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A patient with stable COPD receives prescriptions for an inhaled glucocorticoid and an inhaled beta2-adrenergic agonist. Which statement by the patient indicates understanding of this medication regimen?

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Naxlex Comprehensive Predictor Exams

Which agent is preferred for the initial treatment of heart failure?

Correct Answer is B

Explanation

A 72-year-old female has a history of right heart failure caused by a right ventricular myocardial infarction. Which of the following symptoms are specifically related to her right heart failure?

Correct Answer is C

Explanation

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