pharm 44, 45, 58, 59
d
A client admitted with persistent asthma has a history of hypertension. Which class of asthma drugs must be used cautiously with clients who have hypertension? A. Mast cell stabilizers B. Inhaled anticholinergic medications C. Inhaled corticosteroids D. Oral short-acting beta-adrenergic agonists
d
A client asks how the nutrients from food enter the blood. How can the nurse best explain this process? A. "Only nutrients from liquid sources make it into the blood. That is why it is important to drink fluids with meals." B. "When food hits the stomach, hydrochloric acid liquefies it and transports it into your blood." C. "The teeth and saliva break food into their smallest portions and transport nutrients to the blood." D. "Chemical digestion breaks down food molecules into simpler substances."
bde
A client asks the nurse why the healthcare provider has ordered the asthma medication in inhalant rather than oral form. What is the nurse's best response? Select all that apply. A. "Inhaling an asthma medication is an effective way to get the medication right into your lungs and is also a lot less expensive than oral medications." B. "Inhaling an asthma medication will control your symptoms with smaller doses, reducing the risk of systemic effects." C. "Inhaling an asthma medication automatically decreases the onset of the medication, resulting in quicker relief of your symptoms." D. "Inhaling an asthma medication results in an almost instantaneous onset of action, which will relieve your symptoms much more quickly." E. "Inhaling an asthma medication offers a rapid and efficient way to get the medication directly into your lungs."
abd
A client asks the nurse why the physician has ordered an antihistamine for insomnia that is the same one a neighbor takes for seasonal allergies. The nurse explains that antihistamines are effective in treating a number of problems, including: Select all that apply. A. Parkinson's disease. B. motion sickness. C. hypotension. D. hives. E. bronchoconstriction.
be
A client asks the nurse why the physician prescribed an oral rather than an intranasal decongestant. The nurse responds Select all that apply. A. "Oral decongestants carry a lower risk of systemic adverse effects." B. "You will need medication for the length of the allergy season, but intranasal decongestants shouldn't be taken for longer than 5 days." C. "Oral decongestants are more effective at relieving severe congestion." D. "Oral decongestants take less time to alleviate symptoms." E. "Intranasal decongestants can worsen congestion once the effects of the drug wear off."
c
A client has a newly placed percutaneous endoscopic gastrostomy tube. When checking the gastric pH, the nurse expects to find a pH of: A. 5.0 to 7.30. B. 3.5 to 5.0. C. 1.5 to 3.5. D. 7.35 to 7.45.
a
A client has been receiving a cough medicine with guaifenesin for 48 hours. Which nursing diagnosis would this medication best address? A. Airway Clearance, Ineffective related to large amount of tenacious mucus B. Perfusion: Gastrointestinal, Risk for Ineffective related to abdominal distention from gas buildup in stomach C. Pain, Acute related to swollen tonsils and discomfort rated at 7 on 0 long dash —10 VAS D. Gas Exchange, Impaired related to inability to discharge carbon dioxide
a
A client has been taking oral antibiotic therapy for 3 days when the client develops diarrhea. The most likely cause of the diarrhea is: A. disruption of normal flora. B. idiopathic causes. C. hospital-acquired infection. D. fluid volume excess.
a
A client has been taking oral antibiotic therapy for 3 days when the client develops diarrhea. The most likely cause of the diarrhea is: A. disruption of normal flora. This is the correct answer. B. idiopathic causes. C. hospital-acquired infection. D. fluid volume excess.
b
A client in acute respiratory distress on a medical unit is receiving a nebulizer albuterol treatment. The client is annoyed because he already has an albuterol metered-dose inhaler (MDI). The nurse's response to the client's concern is based on the knowledge that: A. the nebulized form of the drug will have fewer negative effects on this distressed client. B. suspension of the medication in liquid and delivery over a longer period increase the bronchodilator's effectiveness. C. the client who is agitated and dyspneic is unlikely to be able to use a metered-dose albuterol inhaler effectively. D. nebulized therapy is more cost effective in the inpatient setting.
b
A client is being treated in the emergency department for an anaphylactic reaction to an antibiotic. The client will be receiving an antihistamine in addition to other preparations. Which drug would the nurse anticipate administering? A. Loratadine (Claritin) B. Diphenhydramine (Benadryl) C. Azelastine (Astelin) D. Fexofenadine (Allegra)
d
A client is being treated with dornase alfa (Pulmozyme). The nurse anticipates that the client is most likely to experience which cluster of adverse effects? A. Headache, nasal stuffiness, and earaches B. Nausea, vomiting, and diarrhea C. Epigastric pain, belching, and flatulence D. Sore throat, conjunctivitis, and hoarseness
a
A client is complaining of esophageal reflux. In order for stomach contents to reflux backward, the nurse knows they must go through: A. the cardiac sphincter. B. the pyloric sphincter. C. the urethral sphincter. D. Oddi's sphincter.
cde
A client is prescribed zafirlukast (Accolate) for persistent, chronic asthma. Which nursing interventions take priority? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. Encourage the client to report any hair loss. B. Instruct the client to prevent falls by avoiding sudden changes in position. C. Discuss the possibility of headache. D. Instruct the client to take zafirlukast on an empty stomach. E. Instruct the client not to take aspirin while on a zafirlukast regimen.
b
A client is receiving a phenylephrine (Afrin) nasal spray for the symptoms of a cold. Which assessment parameter would the nurse expect to see improved? A. Fewer nasal secretions B. A decrease in nasal stuffiness C. Less coughing D. Improved energy leve
b
A client is scheduled to have a segment of the terminal ileum removed secondary to cancer. The nurse anticipates this client is at risk for: A. decubitus ulcers. B. pernicious anemia. C. atelectasis. D. sepsis.
abce
A client is scheduled to undergo gastric bypass surgery. Which structures does the nurse include in a discussion about accessory organs of digestion? Select all that apply. A. Gallbladder B. Liver C. Salivary glands D. Stomach E. Pancreas
d
A client with a severe cough has a new order for a hydrocodone-based antitussive. Which history assessment would result in changing the prescription? A. The client has a history of lung cancer. B. The client has been unable to sleep for four nights due to coughing. C. Hydrocodone makes the client drowsy. D. The client has a history of persistent intermittent asthma.
a
A client with chronic obstructive pulmonary disease (COPD) is experiencing difficulty with copious amounts of tenacious sputum. A mucolytic drug is prescribed. The outcome the nurse would track is: A. increase in clearance of sputum. B. decrease in respiratory rate with increase in depth. C. resolution of atrial tachycardia. D. decrease in wheezing.
abe
A client with cirrhosis of the liver asks the nurse why the liver is so important to bodily function. How can the nurse respond most accurately? Select all that apply. A. "The liver synthesizes clotting factors." B. "The liver helps the body synthesize plasma proteins." C. "The liver helps the body retain ammonia." D. "The liver synthesizes glucose for use by the body." E. "The liver helps the body synthesize bile
b
A client with degenerative arthritis is provided with a spacer along with a corticosteroid metered-dose inhaler. The nurse recognizes that the spacer assists this client to: A. avoid thrush infections. B. compensate for decreased dexterity. C. progress with weaning from the steroid drug. D. use a larger dose of the steroid.
b
A client with limited strength in the hands is being prepared for discharge with a dry powder inhaler (DPI). The discharge nurse teaches the client that an advantage of this inhaler is that: A. the client can activate the inhaler with less pressure than is needed for a metered-dose inhaler. B. the client can activate the inhaler simply by inhaling. C. the client can increase the effectiveness of the powder by instilling it into a small nebulizer. D. this inhaler has no dose limits.
c
A client with moderate and persistent asthma has obtained control with an arformoterol inhaler QID for bronchospasm for several years. In the past couple of weeks, however, the client has been reporting more chest tightness and wheezing during the day. The nurse recognizes that the most likely problem is that the client: A. needs an inhaled steroid. B. needs to have the dose reduced and work back up to the full dose. C. has developed a tolerance to the medication. D. is not taking the medication as directed.
b
A client with persistent asthma has a history of multiple allergies, including peanuts and soy. The nurse knows that, given this history, which prophylactic medication should be avoided? A. Cromolyn (Intal) B. Ipratropium (Atrovent) C. Triamcinolone (Azmacort) D. Zafirlukast (Accolate)
d
A client with severe anxiety asks the nurse if anxiety can affect the stomach and digestion. What is the nurse's most accurate response? A. "Mental health conditions do not affect digestive processes." B. "Everyone with anxiety develops irritable bowel disease." C. "I will ask your doctor to speak with you about this." D. "Mental health conditions can affect digestive processes."
b
A mother is asking the nurse about relief of cold symptoms in her 4-year-old. Which preparation should the nurse advise the mother to avoid? A. Loratadine (Claritin) B. Dextromethorphan (Robitussin) C. Acetaminophen (Tylenol) D. Ibuprofen (Advil)
b
A mother is struggling to manage her child's moderate persistent asthma at home. The mother asks the nurse if there are any nonpharmacologic measures she can use. Which strategies are most likely to be effective? A. Homeschooling the child and limiting his contact with other children who might have upper respiratory infections B. Avoiding stimuli such as secondhand smoke, pollutants, and cold air C. Keeping the child's immunizations up-to-date and wearing a face mask in public D. Limiting intake of protein and foods with red and yellow dyes
a
A nurse is caring for several clients receiving bronchodilator therapy for asthma. The nurse has noted that some clients develop hyperglycemia during therapy. Which bronchodilator would the nurse consider problematic? A. Albuterol (Proventil) B. Theophylline C. Aminophylline (Truphylline) D. Ipratropium (Atrovent)
c
A nurse is planning to administer acetaminophen (Tylenol) per rectum to a client. The nurse expects: A. the onset of action to be faster than that of the intravenous route. B. the onset of constipation. C. the onset of action to be slower than that of the oral route. D. the onset of action to be faster than that of the oral route.
acd
A pediatric nurse is educating a 6-year-old and the mother on the use of a metered-dose inhaler (MDI) with a spacer. The mother asks what the spacer is for. The nurse responds: Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. A. "Without the spacer, most of the medication does not get into the lungs because the heavier particles fall out into the throat." B. "The spacer vaporizes the medication so your child can inhale it. More medication gets directly into the lungs." C. "It can be difficult to properly coordinate pressing the canister and inhaling so the medication falls into the mouth instead of getting to the lungs." D. "The spacer holds the medication during inhalation, so your child will not have to worry about coordination." E. "The spacer is automatically activated when your child inhales, making it a lot easier to get the medication into the lungs."
ace
A pediatric nurse is triaging a 6-year-old in an urgent care facility and suspects the child is experiencing complications from allergic rhinitis. Which symptoms did the nurse assess? Select all that apply. A. Plugged ears B. Scratchy throat C. Hoarseness D. Red, swollen, itchy eyes E. Loss of smell and taste
c
A pediatric nurse, teaching new parents about the body's structural defenses against respiratory infections, explains that pathogens are "swept" away from the lungs by the: A. internal nares. B. vestibule. C. cilia. D. mucous membranes.
a
A student needs to take an antihistamine for chronic rhinitis. Which preparation is least likely to make the student sleepy in class? A. Fexofenadine (Allegra) B. Cetirizine (Zyrtec) C. Hydroxyzine (Atarax) D. Diphenhydramine (Benadryl)
b
A trauma client has experienced a ruptured diaphragm. The nurse would anticipate that this client will have difficulty: A. maintaining a high enough respiratory rate. B. carrying out the respiratory cycle. Your is correct. C. with an elevated oxygen level. D. primarily during exhalation.
abde
Allergy testing is most likely to be useful in directing therapy for a client with which allergy profile? Select all that apply. A. Multiple indoor allergens B. Possible allergy to animal dander C. Possible allergy to a medication D. Single outdoor allergen E. Possible allergy to mold
a
An older male client with several chronic conditions is using pseudoephedrine (Sudafed) for cold symptoms. Which adverse effect does the nurse teach the client to report to the physician? A. Decreased urinary stream B. Irritated, crusty nares C. Thickening and color change of nasal drainage D. Increased coughing
b
A 12-year-old with allergies has been prescribed desloratadine (Clarinex). The nurse instructs the client and the mother about possible adverse effects, including: Select all that apply. A. confusion. B. insomnia. C. urinary hesitancy. D. nervousness. E. dizziness.
a
A middle-aged male is taking pseudoephedrine (Sudafed) for nasal congestion. What adverse effect is most likely if he also has benign prostatic hypertrophy? A. Urinary retention B. Elevated creatine level C. Incontinence of urine D. Elevated uric acid level
c
Because of the first-pass effect, clients may require: A. a smaller dose of oral medication than of intravenous medication. B. the same oral and intravenous dosage of a medication. C. a larger dose of oral medication than of intravenous medication. D. a smaller dose of oral medication than of rectal medication.
d
In administering medications, the nurse is aware that most drugs are excreted by the kidneys after being metabolized by the: A. small intestine. B. gallbladder. C. pancreas. D. liver.
ade
It has been determined that a client's rhinitis is not the result of previous exposure to an allergen. The nurse explains that a nonallergic response can occur with: Select all that apply. A. plasma expanders. B. animal dander. C. pollens. D. x-ray dye. E. certain drugs
b
Over the course of treatment for chronic asthma, a client develops an allergy to the propellants in rapid-acting metered-dose inhalers (MDIs). What option would the nurse expect to be used to address this problem after discharge? A. Oral medication of the same class as the metered-dose inhaler B. A dry powder inhaler (DPI) C. Nebulizer treatments D. A concentrated-dose metered-dose inhaler
d
Rebound congestion is occasionally a problem after use of some drugs for allergic rhinitis. Which preparation is mostly likely to cause this concern? A. Oral decongestants B. Intranasal steroids C. Oral antihistamines D. Intranasal decongestants
bce
The admitting nurse suspects a client has moderate persistent asthma because: Select all that apply. A. symptoms occasionally affect daily activity. B. symptoms occur every day. C. symptoms occur more than one night a week. D. symptoms occur two times a month. E. symptoms affect daily activity.
bcd
The community nurse explains to a group of clients that taking combination drugs for a cold can be dangerous and cites several examples, such as: Select all that apply. A. a young adult with sinusitis taking a medication containing chlorpheniramine and phenylephrine (Sudafed Sinus and Allergy). B. a client with liver disease taking a medication containing diphenhydramine and acetaminophen (Tylenol PM). C. an older male taking a cold medication with chlorpheniramine and phenylephrine (Actifed Cold and Allergy) for congestion. D. a client with chronic obstructive pulmonary disease (COPD) taking a cold medication containing triprolidine and pseudoephedrine (Actifed Plus) for seasonal allergies. E. a middle-aged client with a cough taking a medication containing diphenhydramine and phenylephrine (Benadryl Allergy and Cold caplets).
b
The nurse explains to a client that drugs that activate beta2-adrenergic receptors: A. result in airway diameter narrowing. B. relax bronchiolar smooth muscle. C. decrease production of viscous secretions. D. increase labored breathing
abce
The nurse explains to a client that inhaled corticosteroid medications are used in the long-term management of asthma to decrease: Select all that apply. A. bronchial hyperresponsiveness to allergens. B. mucus production. C. inflammation of the airways. D. bronchial constriction. E. edema.
d
The nurse explains to a nursing student that drugs that activate the parasympathetic branch of the autonomic nervous system: A. increase production of viscous secretions. B. decrease labored breathing C. relax bronchiolar smooth muscle. D. result in airway diameter narrowing.
acd
The nurse in a pulmonary clinic is evaluating several clients' theophylline levels. Which levels would have the highest priority? Select all that apply. A. 21 mcg/mL B. 15 mcg/mL C. 19 mcg/mL D. 8 mcg/mL E. 12 mcg/mL
cde
The nurse in a pulmonary clinic knows that theophylline should not be prescribed for: Select all that apply. A. a client with elevated liver enzymes. B. a client taking St. John's wort for menopausal symptoms. C. a teenager taking erythromycin for acne. D. a client taking ciprofloxacin for prostatitis. E. a client taking lorazepam for anxiety.
abd
The nurse instructing a client with allergic rhinitis would recommend which actions to decrease exposure to allergens? Select all that apply. A. Remove pets from the home or limit exposure. B. Clean frequently to remove dust mites from bedding, carpets, and furniture. C. Buy new mattresses every 2 years. D. Routinely clean moldy surfaces. E. Remove all carpeting and replace with wood floors
ad
The nurse instructs a client with asthma that quick-relief medications that should be used for acute symptoms include: Select all that apply. A. albuterol (Proventil). B. cromolyn (Intal). C. beclomethasone (Beconase). D. ipratropium (Atrovent). E. montelukast (Singulair).
c
The nurse is administering a drug that antagonizes H1 histamine receptors. Which is the most likely expected outcome of this therapy? A. The client will cough less. B. The client will report less wheezing and more energy. C. The client will report less sneezing and tearing. D. The client will report that headache is improved.
b
The nurse is administering an antihistamine to a client with nasal allergies. The nurse is aware that antihistamines have which distinct limitation? A. They are useful only during acute attacks. B. They are most effective when taken prophylactically. C. They have potent cholinergic side effects. D. They block both H1 and H2 receptors.
a
The nurse is admitting a client with a history of asthma attacks every other day and three episodes at night in the last month. The client reports activity is somewhat limited. The nurse anticipates that the healthcare provider will determine the client's level of asthma to be: A. mild persistent. B. intermittent. C. severe. D. moderate persistent.
d
The nurse is admitting a client with an exacerbation of asthma. The medication list includes albuterol, salmeterol, budesonide, cromolyn, and zafirlukast. The client takes these medicines every day, except for the albuterol. When planning the client's care, the nurse recognizes that: A. the client is taking too many medications, and several should be discontinued. B. the therapy is adequate, except that the client should be using the albuterol daily. C. the client needs several additional preparations if the asthma control standards of the Agency for Healthcare Research and Quality (AHRQ) are to be met. D. the client's combination of medications is appropriate according to current practice guidelines.
c
The nurse is advising a client who been using over-the-counter (OTC) diphenhydramine (Benadryl) to induce sleep. The client complains about a dry mouth. The nurse explains that: A. diphenhydramine causes less dryness if taken in the liquid form. B. drowsiness caused by the diphenhydramine caused the client to reduce fluid intake. C. drying of the mouth membranes is common after taking diphenhydramine. D. diphenhydramine has a muscle relaxant effect, so the client is likely sleeping with the mouth open.
b
The nurse is assessing a client who regularly takes an oral first-generation antihistamine for nasal allergies. Which medication order would trigger concerns about drug interaction with the antihistamine? A. Hydrochlorothiazide, a diuretic B. Tylenol with codeine, an opiate analgesic C. Atenolol, an antihypertensive D. Enoxaparin (Lovenox), an anticoagulant
d
The nurse is assisting with the administration of an acetylcysteine (Mucomyst) nebulizer treatment by mask. What warning to the client is essential prior to the start of the treatment? A. "Tell us right away if you develop chest pain." B. "Tell us right away if your fingers start to tingle." C. "This treatment may make you feel dizzy." D. "This treatment does not smell very good."
c
The nurse is aware that the alimentary canal extends from the: A. mouth to the liver. B. stomach to the large intestine. C. mouth to the anus. D. esophagus to the small intestin
a
The nurse is aware that which structure does not secrete digestive enzymes? A. Esophagus B. Stomach C. Small intestine D. Salivary glands
b
The nurse is caring for a client who is taking benzonatate (Tessalon) for a cough. The client accidentally bites into one of the gelcaps prior to swallowing it. What should the nurse do next? A. Explain that the client is likely to become very nauseated. B. Explain that the client might experience numbness of the tongue. C. Call the physician and complete a variance report. D. Assess blood pressure frequently for the next hour.
b
The nurse is caring for a client with chronic bronchitis and a history of glaucoma. The nurse recognizes that which drug would not be an appropriate choice for the control of the client's bronchospasm? A. Cromolyn (Intal) B. Ipratropium (Atrovent) C. Dyphylline (Lufyllin) D. Formoterol (Foradil)
de
The nurse is caring for a newborn who has been NPO since birth. Due to the lack of normal flora in the GI tract, the nurse anticipates the infant will require supplementation with: Select all that apply. A. vitamin C. B. electrolytes. C. vitamin A. D. vitamin B-complex. E. vitamin K.
a
The nurse is evaluating outcomes for a client who has been using a nasal steroid consistently for several months. Which is the desired outcome? A. The client reports decreased nasal congestion. B. The client is free of wheezing. C. The client's upper respiratory system is free of infection. D. The client's tonsils are pink and free of swelling and exudate.
3
The nurse is explaining the role of hydrochloric acid in the digestive process to the family member of a client who has just had gastric bypass surgery. The nurse explains that the parietal cells in the stomach secrete 1 to liters of hydrochloric acid each day.
a
The nurse is instructing a client on the proper use of an intranasal decongestant. The nurse's caution about rebound effect will center primarily on: A. the need to stop the medication after 3 to 5 days of use. B. the need to minimize the drug's systemic effects. C. the need to count the number of sprays of medication at each application. D. concerns about chest pain with repeated use.
c
The nurse is planning care for a client with allergies who has an order for a sympathomimetic drug. The nurse is aware that the desired effect for this client is: A. calming of a wet cough. B. relief of nasal dryness. C. relief of nasal stuffiness. D. increased blood flow to the nose.
c
The nurse is planning care for a client with hepatitis. The nurse anticipates that drug metabolism: A. will not be affected. B. will never occur. C. might be delayed. D. might be accelerated.
b
The nurse is planning care for a group of clients and determines that the client most likely to experience malnutrition from a lack of digestive enzymes is the client with: A. the jaw wired closed. B. pancreatic disorder. C. pernicious anemia. D. a percutaneous endoscopic gastrostomy (PEG) tube.
2
The nurse is preparing to administer a drug to a client. The nurse anticipates that the medication will be destroyed completely in the stomach because the pH of the stomach is 1 to ___
c
The nurse is preparing to administer a sublingual nitroglycerin tablet. With regard to the first-pass effect, the nurse understands that: A. The first-pass effect will decrease the drug's effectiveness by one third. B. Drugs given sublingually are subject to the first-pass effect. C. Drugs given sublingually bypass the first-pass effect. D. The first-pass effect will neutralize this drug's effect.
ace
The nurse is providing discharge instruction to a client newly diagnosed with asthma. The client has been prescribed albuterol (Proventil) for bronchospasm. Which side effects should the nurse explain to the client? Select all that apply. A. Nervousness B. Hypertensive crisis C. Restlessness D. Abnormal EKG E. Tremor
bce
The nurse is reviewing medication orders for a client and anticipates that which medications may cause adverse effects due to their extended half-life caused by enterohepatic recirculation? Select all that apply. A. Demerol B. Estrogen C. Morphine D. Fentanyl E. Digoxin
ade
The nurse is reviewing the admission history of a client taking zileuton (Zyflo CR) in the emergency department. Which patient reports would take highest priority during the physical assessment? Select all that apply. A. Abdominal pain B. Throat pain C. Sinusitis D. Nausea E. Yellow skin
c
The nurse is teaching a client about beclomethasone (Beconase) nasal spray prior to discharge. Which side effects will the nurse prepare the client to manage? A. Dyspepsia and gastric irritation B. Salt sensitivity and elevation of blood pressure C. Nasal irritation and nosebleed D. Bone demineralization and increased risk of fracture
d
The nurse is teaching a client about the actions of an intranasal inhaler containing ipratropium (Atrovent). Which statement by the nurse is most accurate? A. "You will not have as much postnasal drip." B. "Your throat won't feel so scratchy." C. "You will notice you are not sneezing as much." D. "You will notice a decrease in nasal secretions."
abd
The nurse is teaching a client about the importance of enzymes to digestion. The nurse explains that digestive enzymes are secreted by the: Select all that apply. A. salivary glands. B. stomach. C. large intestine. D. small intestine. E. liver.
b
The nurse is teaching a client about the side effects of intranasal beclomethasone (Beconase), including: A. nuchal rigidity and headache. B. burning and nosebleed. C. frequent sneezing and hiccups. D. muscle aches and conjunctivitis.
d
The nurse is teaching a client about the use of an albuterol rescue inhaler. Which nursing diagnosis is most appropriate to avoid the adverse effects of albuterol? A. Airway Clearance, Ineffective related to excess mucus formation B. Gas Exchange, Impaired related to inadequate response to albuterol C. Activity Intolerance related to ineffective drug therapy D. Knowledge, Deficient related to proper use of albuterol inhaler
c
The nurse is teaching a client about the use of antihistamines for allergic rhinitis. Which pointer is appropriate for increasing effectiveness? A. "Take this drug at the same time every day." B. "Take this drug when your symptoms are the worst." C. "Take this drug before you are exposed to your allergens." D. "Take this drug with the largest meal of the day."
c
The nurse is teaching a client with asthma about the use of a corticosteroid inhaler prior to discharge. The expected outcome of this therapy is: A. decreased inflammation of the midsized bronchial tubes. B. resolution of all asthma symptoms. C. less swelling and mucus formation, and decreased hyperresponsiveness to allergens. D. less histamine formation, with less mucus in the upper airwa
d
The nurse is teaching a group about the use of cough medications. Which preparation should be used for nonproductive coughs? A. Guaifenesin (Robitussin GF) B. Acetylcysteine (Mucomyst) C. Guaifenesin (Mucinex) D. Dextromethorphan (Delsym)
abd
The nurse is teaching a group of teens with asthma how the structures of the upper respiratory tract protect against infections. Which statement by a teen demonstrates that teaching has been successful? Select all that apply. A. "The passages of the nose and throat filter, warm, and humidify air when I inhale." B. "The structures of the upper respiratory tract trap particulate matter and pathogens, preventing them from going down into my lungs." C. "The saliva in my mouth contains cells that can eat bacteria." D. "The upper respiratory tract is lined with tiny hairs that move back and forth, pushing foreign matter away from the lungs." E. "Mucous membranes inside the nose produce allergens that neutralize pathogens."
a
The nurse is teaching a group of grade-school children about body functions. A student asks, "Why do I sneeze?" The nurse's best response is: A. "A sneeze is your body's way of getting rid of something irritating." B. "A sneeze is caused by a contraction of your throat and lungs." C. "You sneeze because your body needs to take a really deep breath." D. "The back part of your brain is in charge of sneezes and coughs."
ad
The nurse keeps which therapeutic goals in mind when teaching a client with allergic rhinitis about prescribed medications? Select all that apply. A. Prevent its occurrence. B. Avoid the use of medications that cause drowsiness. C. Decrease the risk of infection. D. Relieve symptoms. E. Treat evidence of infection.
d
The nurse recognizes that respiratory depression is a risk with some cough suppressants. Which preparation has the least risk of causing respiratory depression? A. Hydrocodone with homatropine (Hycodan) B. Codeine with bromodiphenhydramine (Ambenyl) C. A codeine-based preparation D. Dextromethorphan (Delsym)
c
The nurse teaches the client with seasonal allergies that the most effective way to prevent allergy symptoms is to: A. take allergy medication as soon as symptoms begin. B. take supplemental nonpharmacologic measures. C. take allergy medication before allergy season begins. D. take as little allergy medication as possible so the body will not become sensitized to the medication.
bce
The nurse teaching a client with gastroesophageal reflux disorder (GERD) about digestion explains that the process is regulated by: Select all that apply. A. peristalsis. B. the sympathetic nervous system. C. the parasympathetic nervous system. D. medications. E. hormones.
bce
The nurse would expect to see an order for a drug that blocks H2 receptors in a client with: Select all that apply. A. seasonal allergies. B. gastroesophageal reflux disease (GERD). C. peptic ulcer disease. D. allergic rhinitis. E. excess gastric acid production.
acd
The priority assessment for a client receiving asthma medications to determine effectiveness of therapy should include: Select all that apply. A. increased ease of breathing. B. therapeutic levels of medications. C. absence of adventitious sounds. D. improved signs of peripheral oxygenation. E. normal hepatic function.
cde
The nurse, discharging a client recently diagnosed with asthma, explains that symptoms that should be reported immediately to the healthcare provider include: Select all that apply. A. increased activity level. B. increased appetite. C. feeling breathless when speaking. D. difficulty breathing. E. increased anxiety.
2
The nurse, instructing a client prior to gastric bypass surgery, explains that chyme cannot pass into the small intestine until it is mm in size.
b
What is an expected outcome of antihistamine therapy for allergic rhinitis? A. Coughing becomes productive. B. Sneezing and tearing decrease. C. The sinuses drain more effectively. D. The nasal airway opens wider.
c
Which assessment data would provide the nurse with the best evidence of allergic rhinitis? A. Productive cough, sneezing, and low-grade fever B. Copious thick, green nasal drainage and postnasal drip C. Coughing, sneezing, and watery eyes D. Severe frontal headache and pressure along both sides of the nose
b
Which assessment is most relevant to the care of a client with a new order for an inhaled nasal steroid? A. History of chronic bronchitis B. History of allergic rhinitis C. History of emphysema D. History of asthma
bc
Which outcomes would be most appropriate for a client who is receiving pharmacotherapy for cough and cold relief? Select all that apply. A. The client will report dry mouth and drowsiness to the provider. B. The client will easily expectorate excess mucus. C. The client will experience decreased congestion and drainage. D. The client will reduce fluid intake to assist in liquefying mucus. E. The client will contact the healthcare provider if the cough becomes productive.
c
Which point should the nurse include when instructing a client in the use of a budesonide (Rhinocort) nasal preparation? A. "Avoid the use of ultrasonic humidifiers with this preparation." B. "You should see improvement in your symptoms in about a week." C. "You could experience nosebleeds." D. "Use this preparation before your nasal decongestant."
b
he nurse is collaboratively setting goals for the inpatient management of new-onset asthma in a child. The nurse prioritizes the client's nursing diagnoses and gives which goal the highest priority? A. The client's mother will correctly demonstrate the use of an inhaler with a spacer by discharge. B. The client will report improved ease of breathing by discharge. C. The client will sleep uninterrupted for 4 hours at a stretch every night during admission. D. The client's parents will verbalize the importance of the medication regimen by discharge.
