Inhaled Steroid Quiz: Can You Teach Proper Use?

1. Inhaled corticosteroids are contraindicated in patients with which condition?

Active tuberculosis

Mild persistent asthma

Seasonal allergies

Gastroesophageal reflux disease

Submit

4. Inhaled corticosteroids reduce airway inflammation by suppressing which inflammatory cells?

Red blood cells only

T-lymphocytes, eosinophils, and mast cells

Neutrophils exclusively

Platelets and clotting factors

5. Which inhaler technique error is most common and reduces medication effectiveness?

Holding the breath too long after inhalation

Poor coordination between canister depression and inhalation

Using the spacer device

Rinsing the mouth after administration

6. A patient using a combination inhaler (steroid + LABA) should be monitored for which serious adverse effect?

Increased asthma mortality if LABA is used without concurrent steroid

Permanent vocal cord damage

Irreversible adrenal insufficiency

Acute anaphylaxis on first use

7. What is the expected onset of action for inhaled corticosteroids?

Immediate relief within seconds

Several hours to days with consistent use

Only effective during acute attacks

One week minimum before any effect

8. After using an inhaled corticosteroid, a patient should wait how long before using a rescue inhaler?

Use simultaneously for best effect

Wait 1-5 minutes after the steroid

Wait at least 30 minutes

Rescue inhalers should never follow steroids

9. Which patient education point is most critical for inhaled steroid compliance?

Steroids provide immediate symptom relief like bronchodilators

Regular use prevents symptoms; relief is not immediate

Higher doses provide faster results

Steroids only work during acute exacerbations

10. A patient on inhaled beclomethasone develops hoarseness. What nursing intervention is appropriate?

Discontinue the medication immediately

Encourage rinsing mouth after use and staying hydrated

Switch to a higher-dose formulation

Administer antifungal therapy without assessment

11. What is the primary mechanism of action for inhaled corticosteroids in asthma management?

Direct bronchodilation of airway smooth muscle

Reduction of airway inflammation and mucus production

Increased production of surfactant

Inhibition of mast cell degranulation only

12. How often should a patient clean their MDI inhaler device?

Weekly

Monthly

After each use with warm water

Only when visible residue appears

13. A patient asks if inhaled steroids will make them gain weight like oral steroids. What is the best response?

Inhaled steroids cause minimal systemic absorption and weight gain is unlikely

Weight gain is unavoidable with all steroid use

Only inhaled steroids cause weight gain, not oral steroids

Weight gain occurs only in patients over 50 years old

14. When should a patient use a spacer device with their MDI inhaler?

Only when experiencing acute symptoms

To improve coordination and lung deposition

Only if the patient is over 65 years old

When using beta-agonists, not corticosteroids

15. Which systemic side effect may occur with prolonged use of high-dose inhaled corticosteroids?

Hyperthyroidism

Adrenal suppression

Hyperglycemia without diabetes

Osteoporosis in young adults only

16. A patient using an inhaled corticosteroid via dry powder inhaler (DPI) should inhale with what type of breath?

Shallow, slow breath over 5 seconds

Quick, deep inhalation to activate the powder

Normal quiet breathing without force

Prolonged exhalation followed by gentle inhalation

17. Which inhaled corticosteroid is most appropriate for maintenance therapy in moderate asthma?

Albuterol

Beclomethasone or fluticasone

Ipratropium

Theophylline

18. What should a patient do immediately after using an inhaled corticosteroid?

Lie down for 10 minutes to enhance deposition

Rinse mouth and throat with water

Hold breath for 30 seconds without moving

Drink warm fluids to soothe airways

19. A patient on inhaled fluticasone reports a sore throat and white patches in the mouth. What is the most likely cause?

Bacterial infection from contaminated inhaler

Oral candidiasis due to local immunosuppression

Allergic reaction to the propellant

Dry mouth from systemic steroid absorption

20. Which step is essential when teaching a patient to use a metered-dose inhaler (MDI)?

Exhale fully, then inhale while depressing the canister

Inhale first, then depress the canister during exhalation

Depress the canister without coordinating with breathing

Use the inhaler while lying down for better absorption