To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

To abort an asthma attack

Only in an emergency

On a daily basis

2 weeks on, 2 weeks off

Answer and Explanation

The Correct Answer is C

Choice A reason: Inhaled glucocorticoids, like budesonide, reduce airway inflammation over time but don’t act quickly enough to abort acute asthma attacks. Short-acting beta-agonists (e.g., albuterol) are used for acute relief, as glucocorticoids lack immediate bronchodilatory effects, making this choice incorrect for chronic asthma management.

Choice B reason: Using inhaled glucocorticoids only in emergencies is ineffective for chronic asthma. These drugs prevent inflammation and exacerbations through consistent use, not acute intervention. Emergency use is reserved for rescue inhalers like albuterol, making this choice inappropriate for long-term asthma control.

Choice C reason: Inhaled glucocorticoids require daily use to maintain anti-inflammatory effects, reducing airway hyperresponsiveness and preventing asthma exacerbations. Consistent dosing ensures steady suppression of chronic inflammation, improving lung function and reducing symptoms, making this the correct choice for managing chronic asthma effectively.

Choice D reason: A 2-week on/off schedule disrupts the consistent anti-inflammatory action of inhaled glucocorticoids needed for chronic asthma control. Intermittent use reduces efficacy, allowing inflammation to rebound, increasing exacerbation risk. Daily use is standard to maintain therapeutic benefits, making this choice incorrect.

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Correct Answer is ["A","C","E"]

Explanation

Choice A reason: Enterochromaffin-like (ECL) cells release histamine, which stimulates parietal cells to secrete hydrochloric acid via H2 receptors. This increases gastric acid production, critical for digestion, and is a key component in the acid secretion pathway, making this a correct choice for acid-increasing cells.

Choice B reason: Beta cells, located in the pancreas, secrete insulin to regulate glucose, not gastric acid. They have no role in stomach acid production or regulation, which is controlled by gastric cells like parietal or G cells, making this choice incorrect.

Choice C reason: Parietal cells directly secrete hydrochloric acid into the stomach lumen via the H+/K+-ATPase pump, significantly increasing gastric acidity for digestion. Activated by histamine, gastrin, and acetylcholine, they are central to acid production, making this a correct choice for the question.

Choice D reason: Mucus cells secrete protective mucus to shield the stomach lining from acid and pepsin, not acid itself. They reduce damage from acidity but don’t contribute to its production, making this choice incorrect for cells that increase stomach acid.

Choice E reason: G cells secrete gastrin, a hormone that stimulates parietal cells to produce hydrochloric acid. Gastrin enhances acid secretion indirectly by activating parietal cells and ECL cells, playing a key role in gastric acid regulation, making this a correct choice.

A. Synthesis of more receptor sites in response to the medication B. Decreased selectivity of receptor sites, resulting in a variety of effects C. Desensitization of receptor sites by continual exposure to the drug D. Antagonists produced by the body that compete with the drug for receptor sites

Correct Answer is C

Explanation

Choice A reason: Synthesis of more receptor sites (upregulation) typically occurs with receptor antagonists, not agonists, as the body compensates for blocked receptors. This would increase drug sensitivity, not decrease effectiveness. For most medications, continuous exposure leads to desensitization, not receptor proliferation, making this choice incorrect for explaining tolerance.

Choice B reason: Decreased receptor selectivity implies a drug binding to unintended receptors, causing varied effects, not reduced efficacy. Tolerance results from receptor desensitization, not altered selectivity. This mechanism doesn’t explain the patient’s “immunity” to the drug’s therapeutic effects, making this choice scientifically inaccurate for the scenario.

Choice C reason: Desensitization occurs when continuous drug exposure reduces receptor responsiveness, leading to tolerance. For example, opioid receptors downregulate or internalize with prolonged agonist exposure, decreasing drug efficacy. This explains the patient’s perception of “immunity” as the drug’s effect diminishes over time, making this the correct choice.

Choice D reason: The body does not produce antagonists to compete with drugs for receptor sites. Tolerance arises from receptor desensitization or metabolic changes (e.g., enzyme induction), not endogenous antagonist production. This mechanism is not a recognized pharmacological process for reduced drug effectiveness, making this choice incorrect.

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To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following cells increase acid in the stomach? (Select all that apply)

Correct Answer is ["A","C","E"]

Explanation

A patient reports becoming “immune” to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:

Correct Answer is C

Explanation

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