Pharm. Exam 2
A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client?
"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."
The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification?
"I can take over-the-counter pseudoephedrine, too." pg.945
The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?
"I need to shake the inhaler well before taking the medication." pg.972
After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?
"I'll keep it warm and toasty" pb.940-941
When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?
"When I am short of breath, I will increase the use of my fluticasone." pg.974-976
A client has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?
A 65 year old male with asthma pg.962-963
The nurse is performing a routine assessment of a client whose medical record indicates a history of asthma. What assessment findings would the nurse expect? Select all that apply.
Airway inflammation Damaged airway mucosa pg.961
After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?
Albuterol pg.969
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
Albuterol causes relaxation of the bronchial smooth muscles pg.969
The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?
Albuterol first, wait five minutes and then follow with flunisolide pg.964
A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?
Asthma pg.977
A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.)
Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the dru
Which of the following would a nurse identify as a surfactant?
Beractant pg.979
What is the most common first-line therapy for relief of an acute asthma attack?
Beta2-adrenergic agonist pg.969
A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?
Breathing pattern is regular and without difficulty pg.942
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?
Chocolate pg.967-968
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?
Cigarette smoking pg.967-968
A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?
Coffee pg.967-968
An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine?
Diphenhydramine pg.952
A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?
Drowsiness pg.948
A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?
Dry mouth
Which of the following would be most important to assess before administering calfactant? (Select all that apply.)
Endotracheal tube placement Lung sounds Oxygen saturation levels pg.979-980
A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?
Epinephrine pg.969
What is the chemical mediator released in immune and inflammatory response to allergic reactions?
HIstamine pg.948
The nurse has admitted a client with COPD to the unit with an acute exacerbation. The client takes ipratropium. When writing a plan of care for this client, what would be an appropriate nursing diagnosis to use?
Imbalanced nutrition: Less than body requirements pg.973-974
The nurse is providing education to a client diagnosed with the common cold. What measure should the nurse recommend implementing to help liquefy cold-related secretions?
Increase fluid intake pg.940
The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?
Inform the health care provider that the client has toxic theophylline levels pg.967-968
The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?
Inform the health care provider that the client has toxic theophylline levels. pg.967-968
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
Inhalation pg.965
A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective?
Monitoring respirations for bilateral chest movement pg.979-980
Which agent would the nurse instruct a client to use orally?
Pseudoephedrine (it is the only oral decongestant currently available for use) pg. 945
A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion?
Rebound nasal swelling pg.943
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?
Relaxation of smooth muscle pg.973
A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?
Salmeterol is contraindicated based on his wife's condition. pg.969-970
The nurse is providing education to a client who has been prescribed albuterol. What adverse reaction should the nurse discuss during teaching?
Tachycardia pg.970
A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition?
Take the tablet with food
A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device?
Use a spacer pg.972
The nurse teaching a client about theophylline will include the identification of which possible symptoms of toxicity?
agitation and arrhythmias pg.967-968
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
rebound bronchoconstriction
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?
15 mcg/mL pg.966
The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?
15 minutes prior to exercise pg.963
A client is prescribed salmeterol as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?
30 minutes before engaging in exercise pg.964
A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?
Antihistamine pg.950
A client exhibiting signs and symptoms of the common cold asks the nurse if taking an antihistamine would be helpful. What is the nurse's best response?
Antihistamines are not recommended for treating a cold
A client asks "what is the difference between antitussive medications and expectorants?"
Antitussives suppress coughing while exponants loosen bronchial secretions
An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention?
Assess the client for health problems that may contraindicate the use of a particular remedy.
A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?
Cromolyn pg.978
A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?
Decongestants pg.941
When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?
Decreases sedation pg.948
A patient tells you that a friend of theirs has recommended the use of caffeine to treat the patient's asthma. What would be the most important reason a nurse should counsel this patient not to delay prescribed treatment for the use of natural health products?
Delays in appropriate treatment can have serious, even fatal, consequences pg.968-969
An adult client with newly diagnosed asthma presents for client education regarding situations that could precipitate an asthma attack. In this teaching, which precipitants would the nurse state may trigger an attack? Select all that apply.
Exercise Allergens Mold Cigarette smoke pg.963
After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?
Fluticasone pg.977
A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?
Guaifenesin (currently it is the only available expectorant.) *Mucinex and others* pg.953
An older adult client has been prescribed an inhaled corticosteroid for the treatment of chronic obstructive pulmonary disease. When administering the drug, what action should the nurse perform to reduce the client's risk for developing oral candidiasis?
Have the resident rinse his or her mouth after each dose of the drug. pg.976
A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?
I'll keep taking my medications until I'm not experiencing any more symptoms." pg.975
When teaching a client about his prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death?
Long-acting beta-2 agonists pg.970
A client reports increased sedation after the initiation of chlorpheniramine to treat her allergies. Which antihistamines could the nurse recommend to the client to treat her allergy symptoms that would result in less sedation? (Select all that apply.)
Loratadine (Claritin) Cetirizine (Zyrtec) pg.949
A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason?
Misuse could result in overdose pg.950
A history of an allergy to which would be a contraindication to the use of anticholinergics? (Select all that apply.)
Peanuts Soy pg.971
A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which oral decongestant drugs can be administered to the patient?
Pseudoephedrine (it is the only oral decongestant currently available for use) pg. 945
A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis?
Risk for falls related to sedation pg.953
The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?
SABA pg.969
Why are inhaled steroids used to treat asthma and COPD?
They act locally to decrease release of inflammatory mediators pg.974
Katie, 14 years old, is seen by the health care provider due to increased nasal congestion and a sore throat lasting 2 days. Katie reports to the provider that every fall at this time she has increased nasal congestion and pressure. Upon examination, the provider notes enlarged turbinates with excessive mucus in the nose and at the back of the throat and a reddened throat. The provider prescribes pseudoephedrine. Why is Katie being prescribed this medication?
To provide relief of nasal congestion
When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?
Vasoconstriction of small blood vessels of the nasal membranes pg.941
Adrenergics are a category of bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease. In what conditions is cautious use of these drugs recommended? Select all that apply.
diabetes mellitus seizure disorders hypertension pg.969
A client is hospitalized with acute bronchitis, a dry, nonproductive cough, elevated temperature, and complaints of being unable to sleep well at night due to coughing. The nurse notes diminished breath sounds in both lower lung lobes. Which medication will the nurse most anticipate the health care provider to prescribe for this client?
expectorant pg.953
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
rebound bronchoconstriction pg.971