module 5 practice questions
Which assessment finding will need intervention and is related to the client's use of aluminum hydroxide (Amphojel)? A. Client has not had a bowel movement in 3 days. B. Client has had one loose stool this week. C. Client is complaining of gastric upset. D. Client has trace edema in feet.
A
A histamine (H2) - receptor antagonist will be prescribed for a client. The nurse understands that which of the following medications are H2- receptor antagonists? Select all that apply. A. Ranitidine (Zantac) B. Esomeprazole (Nexium) C. Cimetidine (Tagamet) D. Famotidine (Pepcid) E. Lansoprazole (Prevacid)
ACD -(b and e are PPIs)
A patient is receiving morphine sulfate and promethazine [Phenergan]. It is most important for the nurse to assess what? A. Heart rate B. Alertness C. Blood pressure D. Bowel sounds
B Promethazine is a first-generation H1 blocker that binds selectively to H1 receptors, resulting in central nervous system (CNS) effects. The most common adverse effect of first-generation H1 blockers is sedation, and caution is advised, especially when these drugs are used in combination with other CNS depressants. The heart rate, blood pressure, and bowel sounds do not warrant more frequent monitoring.
The client is prescribed dextromethorphan (Benylin) for treatment of a cold. The nurse teaches that the action of this drug: A.Is an anti-inflammatory. B. Is an opioid. C. Is a non-opioid. D. Is an anti-infective.
C Dextromethorphan (Benylin) is classified as a non-opioid cold medication.
A client has a PRN order for ondansetron (Zofran). The nurse would administer this medication to the postoperative client for relief of: A. paralytic ileus B. incisional pain C. urinary retention D. Nausea and vomiting
D
A client who has constipation is prescribed a bisacodyl suppository. The nurse explains that bisacodyl does what?A. Acts on smooth intestinal muscle to gently increase peristalsis B. Absorbs water into the intestines to increase bulk and peristalsis C. Lowers surface tension and increases water accumulation in the intestines D. Pulls hyperosmolar salts into the colon and increases water in the feces to increase bulk
A
A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? A. Maintenance treatment of asthma B. Treatment of an acute asthma attack C. Reversing bronchospasm associated with COPD D. Treatment of inflammation in chronic bronchiti
A
A client with a history of duodenal ulcer is taking calcium carbonate chewable tablets. The nurse determines that the client is experiencing optimal effects of the medication if: A. Heart burn is relieved B. Muscle twitching stops C. Serum calcium levels rise D. Serum phosphrous levels decrease
A
A male, age 67, reports taking diphenhydramine (Benadryl) for "hay fever." Considering this client's age, the nurse assesses for which of the following findings? A. A history of prostate or urinary conditions B. Any recent weight gain C. A history of allergic reactions D. A history of peptic ulcer disease
A
A nurse reviews a client's medication history and notes that the client is taking a nonselective adrenergic agonist bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention?A. Monitor client for potential chest pain. B. Monitor blood pressure continuously. C. Assess daily for hyperkalemia. D. Assess 12-lead ECG each shift.
A
A patient with a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation?A. Beta agonist - albuterol B. Leukotriene receptor antagonist - montelukast C. corticosteroid - fluticasone D. anticholinergic - ipratropium
A
Discharge teaching to a patient receiving a beta-agonist bronchodilator should emphasize reporting which side effect? A. Tachycardia B. Nonproductive cough C. Hypoglycemia D. Sedation
A
Following administration of phenylephrine (Neo-Synephrine), the nurse would assess for which of the following adverse drug effects? A.Insomnia, nervousness, and hypertension B. Nausea, vomiting, and hypotension C. Dry mouth, drowsiness, and dyspnea D. Increased bronchial secretions, hypotension, and bradycardia
A
The client has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. The nurse will provide which of the following instructions? A. Limit use of this spray to 5 days or less. B. The drug may be sedating so be cautious with activities requiring alertness. C. This drug should not be used in conjunction with antihistamines. D. This is an OTC drug and may be used as needed for congestion.
A
The nurse is caring for a client who is taking a first-generation antihistamine. What is the most important fact for the nurse to teach the client? A. "Do not drive after taking this medication." B. "Make sure you drink a lot of liquids while on this medication." C. "Take this medication on an empty stomach." D. "Do not take this medication for more than 2 days."
A
To prevent the development of oral candidiasis when using corticosteroid inhalers, which instruction is MOST important for the nurse to teach the patient? A. Rinse the mouth after each use. B. Minimize use of an inhaler to every other day. C. Swish and swallow with Mycostatin after each use. D. Report any gingival irritation to the health care provider.
A
What is the role of corticosteroids in the treatment of acute respiratory disorders? A. They decrease inflammation. B. They directly dilate the bronchi. C. They stimulate the immune system. D. They increase gas exchange in the alveoli
A
Your client is dx with end stage liver failure and receiving lactulose/granulote. which lab test tells you it is effective? A. serum ammonia B. BUN C. sodium D. serum Creatinine
A
A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? A. Maintenance treatment of asthma B. Treatment of an acute asthma attack C. Reversing bronchospasm associated with COPD D. Treatment of inflammation in chronic bronchitis
A (Singulair is a maintenance medication and is not intended for treatment of acute asthma attacks)
The nurse will teach clients that antacids are effective in the treatment of hyperacidity based on which mechanism of action? A. Neutralizes gastric acid B. Decreases gastric pH C. Decreases stomach motility D. Decreases duodenal pH
A -Antacids work by neutralizing gastric acid, which would cause an increase in pH. They do not affect gastric motility.
Which drug can be used as an asthmatic rescue agent? A. Albuterol B. Beclomethasone C. Guaifenesin D. Salmeterol
A Albuterol is a short-acting beta agonist which is used as an asthmatic rescue agent. Beclomethasone is an inhaled corticosteroid which reduces bronchial inflammation. Guaifenesin is a mucolytic which reduces the stickiness of respiratory secretions. Salmeterol is a long-acting beta agonist which does smooth bronchial tissue over time.
A patient is prescribed an antitussive medication. What is the most important instruction for the nurse to include in the patient teaching? A. "This medication may cause drowsiness and dizziness." B. "Watch for diarrhea and abdominal cramping." C ."This medication may cause tremors and anxiety." D. "Headache and hypertension are common side effects."
A Antitussive medications also affect the central nervous system, thus causing drowsiness and dizziness. There is no reason to anticipate that the medication will cause diarrhea, abdominal cramping, tremors and anxiety, or headache and hypertension
Which medication is indicated for suppression of cough? A. Benzonatate (Tessalon) B. Guaifenesin (Mucinex) C. Acetylcysteine (Mucomyst) D. Fluticasone furoate (Flonase)
A Benzonatate suppresses cough by reducing the sensitivity of respiratory stretch receptors (components of the cough reflex pathway). Acetylcysteine reacts directly with mucus to make it more watery and is administered by inhalation treatment. Guaifenesin is an expectorant. Fluticasone furoate is an intranasal glucocorticoid used to treat the clinical manifestations of allergic rhinitis.
The client receives antihistamine treatment for a respiratory condition through intranasal route therapy. The nurse explains that the major medication of this type is _______________. A. Azelastine (Astelin) B. Mometasone (Nasonex) C. Cetirizine (Zyrtec) D. Beclomethasone (Beconase)
A Objective: Compare and contrast the oral and intranasal decongestants.Rationale: The medication used is azelastine (Astelin), an intranasal antihistamine. Beclomethasone (Beconase) and mometasone (Nasonex) are intranasal corticosteroids. Cetirizine (Zyrtec) is a second-generation H1-receptor antagonist that is taken p.o.
A patient with emphysema is prescribed beclomethasone. Which of the following side effects should the nurse instruct the patient about in the discharge instructions? (select all that apply) A. Cough B. Fatigue C. Dry mouth D. Oral candidiasis E. Hoarseness
A, C, D, E( Common side effects of beclomethasone and other inhaled corticosteroids include dry mouth, cough, hoarseness, sore throat, nausea, and upset stomach. Local immunosuppression can cause oral candidiasis)
A client is taking beclomethasone. Why is it important for this client to rinse the mouth after administration of the medication? A: avoid mucous membrane breakdown B: increase hydration of the oral mucosa C: it has a bad taste D: slow the development of cavities
A-beclomethasone is a glucocorticoid and can cause candidiasis which causes mucous membrane breakdown, so make sure to have the client rinse their mouth after each use.
Which medication would the nurse be concerned about administering to a client for cough with the following vital signs? HR 62, RR 12, Sat 98%, Temp 98 F, BP 110, 76. A.Promethazine B.Albuterol C.Epinephrine D.Montelukast
A-promethazine can cause respiratory depression, so the nurse would want to use caution when the client's respiratory rate is borderline low.
A client is ordered ipratropium and beclomethasone. Which action by the nurse is appropriate? A: administer ipratropium 5 minutes before beclomethasone B: mix the medications and administer them together C: administer beclomethsone 5 minutes before ipratropium D: administer ipratropium immediately after beclomethasone
A-remember the purpose of ipratropium (anticholinergic) is bronchodilation in which it will allow the beclomethasone (glucocorticoid) to spread among more of the lung area if you administer the bronchodilator first.
Which antihistamine is more sedating? A.Diphenhydramine B.Guaifenesin C.Benzonatate D.Prednisone
A: Diphenhydramine is a first-generation antihistamine. The first-gen is more sedating than the second generation and therefore people need to use precautions when administering these medications. Guaifenesin is an expectorant, benzonatate is a cough suppressant, and prednisone is a glucocorticoid.
A client's theophylline level is 22 mcg/mL. What signs and symptoms could the nurse anticipate seeing? A.Nausea and vomiting B.Dysrhythmias C.Seizures D.Nothing, it is normal
A: This level is only mildly elevated, so you should see mild toxic symptoms such as nausea and vomiting. Dysrhythmia and seizures will be seen at higher levels. The normal theophylline level is 10-20 mcg/ml, so it is above normal.
The nurse is teaching a client about diphenhydramine (Benadryl). Which are topics to include? (Select all that apply.) A. Take medication with food to decrease gastric distress. B. Avoid alcohol and other central nervous system depressants. C. Notify the health care provider if confusion or hypotension occurs. D. Take sugarless candy, gum, or ice chips for temporary relief of dry mouth. E. Avoid handling dangerous equipment or performing dangerous activities until stabilized on the drug.
ABCDE
A client complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 hours. What is the nurse's best response? A. "Oxymetazoline is not an effective nasal decongestant." B. "Overuse of nasal decongestants results in rebound congestion." C. "Oxymetazoline should be administered every hour for severe congestion." D. "You are probably displaying an idiosyncratic reaction to oxymetazoline."
B
A client has been prescribed guaifenesin (Robitussin). The nurse realizes that the purpose of the drug is to accomplish what? A. To treat allergic rhinitis and prevent motion sickness B. To loosen bronchial secretions so they can be eliminated by coughing C. To compete with histamine for receptor sites, thus preventing a histamine response D. To stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa
B
A client is prescribed theophylline to relax the smooth muscles of the bronchi. The nurse monitors the client's theophylline serum levels to maintain which therapeutic range? A. 1 to 10 mcg/mL B. 10 to 20 mcg/mL C. 20 to 30 mcg/mL D. 30 to 40 mcg/mL
B
A client tells the nurse that he has started to take an OTC antihistamine, diphenhydramine. In teaching him about side effects, what is most important for the nurse to tell the client? A. Do not to take this drug at bedtime to avoid insomnia. B. Avoid driving a motor vehicle until stabilized on the drug. C. Nightmares and nervousness are more likely in an adult. D. Limit use to 1 to 2 puffs/sprays 4 to 6 times per day to avoid rebound congestion.
B
A client with COPD has an acute bronchospasm. The nurse knows that which is the best medication for this emergency situation? A. zafirlukast (Accolate) B. epinephrine (Adrenalin) C. dexamethasone (Decadron) D. oxtriphylline-theophyllinate (Choledyl)
B
A patient complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 to 4 hours for the past 5 days. The nurse's response is based on knowledge that: A. Oxymetazoline should be administered in an hourly regimen for severe congestion. B. Sustained use of nasal decongestants over several days may result in rebound congestion. C. Oxymetazoline is not an effective nasal decongestant. D. The patient is probably displaying an idiosyncratic reaction to oxymetazoline.
B
The client tells the nurse that she has a bad cold, is coughing, and feels like she has "stuff" in her lungs. What should the nurse do? A. Administer dextromethorphan. B. Administer guaifenesin. C. Encourage the client to drink fluids hourly. D. Administer fluticasone (Flonase).
B
The nurse is administering loperamide (Imodium) to a client with diarrhea. What assessment is essential for this client? A. Vascular assessment B. Gastric assessment C. Hourly blood pressure measurements D. White blood count
B
The nurse is caring for a client who is taking sucralfate (Carafate, Sulcrate) for treatment of a duodenal ulcer. Which assessment requires action by the nurse? A. Sodium level 140 mEq/L B. Absent bowel sounds, hard abdomen C. Urinary output 30 mL/hr D. Calcium level 8.5 mg/dL
B
The nurse receives laboratory values for a client with a theophylline level of 14 mcg/mL. How does the nurse interpret this theophylline level? A. Toxic B. Therapeutic C. Subtherapeutic D. Life threatening
B
What is the most important thing for the nurse to teach a client who is switching allergy medications from diphenhydramine (Benadryl) to loratadine (Claritin)? A. This medication can potentially cause dysrhythmias. B. This medication has fewer sedative effects. C. This medication has increased bronchodilating effects. D. This medication causes less gastrointestinal upset.
B
Which complaint indicates that a patient is experiencing an adverse effect of beclomethasone (Beconase AQ) nasal spray? A. Sneezing B. Sore throat C. Runny nose D. Rebound congestion
B
A nurse monitors a patient who has peptic ulcer disease and is taking antibacterial medications. The patient's breath test should reveal the absence of which of these if the treatment has been effective? A. Bicarbonate B. H. pylori C. Histamine2 D. Prostaglandins
B (Antibacterial medications should be given to patients who have confirmed infection with H. pylori, a cause of ulcers. A breath test is a noninvasive test to measure H. pylori. Patients are given radiolabeled urea, and the urea converts to carbon dioxide and ammonia when H. pylori is present. Radiolabeled carbon dioxide can then be detected in the breath. Bicarbonate, histamine2, and prostaglandins are not affected by the actions of antibacterial medications for peptic ulcers.
A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. which of the following instructions should the nurse include in the teaching? A. Take the albuterol at the same time each day. B. Administer the albuterol inhaler prior to using the beclomethasone inhaler. C. Use beclomethasone if experiencing an acute episode. D. Avoid shaking the beclomethasone before use.
B (When a client is prescribed an inhaled beta 2-agonist (such as albuterol) and an inhaled glucocorticoid (such as betomethasone) the client should take the beta 2-agonist first, it promotes bronchodilation and enhances absorption of the glucocorticoid.)
After administering a dose of promethazine (Phenergan) to a patient with nausea and vomiting, what common temporary adverse effect of the medication does the nurse explain may be experienced? A. Tinnitus B. Drowsiness C. Reduced hearing D. Sensation of falling
B -Although being given to this patient as an antiemetic, promethazine also has sedative and amnesic properties. For this reason, the patient is likely to experience drowsiness as an adverse effect of the medication. Tinnitus, reduced hearing, and loss of balance are not side effects of
The nurse will question an order for misoprostol (Cytotec) in which patient? A. A 21-year-old man with Zollinger-Ellison syndrome B. A 32-year-old pregnant woman with a urinary tract infection C. A 45-year-old woman with GERD D. A 64-year-old man with hypertension
B -Misoprostol (Cytotec) is a prostaglandin E analogue and is believed to inhibit gastric acid secretion and protect the gastric mucosa from injury by enhancing the local production of mucus. However, it is also an abortifacient and therefore is contraindicated in pregnancy. The drug may be useful in treating patients with Zollinger-Ellison syndrome (a hypersecretory syndrome) and GERD. Hypertension is not a contraindication for its use
A client has been taking omeprazole (Prilosec) for 4 weeks. The nurse determines that the client is receiving the optimal intended effect of the medication if the client reports absence of which of the following symptoms? A. Diarrhea B. Heartburn C. Flatulence D. Constipation
B -omeprazole (Prilosec) is used for GERD
After administering a dose of promethazine (Phenergan) to a patient with nausea and vomiting, what common temporary adverse effect of the medication does the nurse explain may be experienced? A. Tinnitus B. Drowsiness C. Reduced hearing D. Sensation of falling
B Although being given to this patient as an antiemetic, promethazine also has sedative and amnesic properties. For this reason, the patient is likely to experience drowsiness as an adverse effect of the medication. Tinnitus, reduced hearing, and loss of balance are not side effects of
Which statement by a patient indicates understanding of a nurse's teaching about fluticasone nasal spray (Flonase)? A. "I'll gradually stop taking this so I don't have any problems with withdrawal." B. "This drug will help prevent the inflammation and irritation from my allergies." C. "I'll have to be more careful about not falling, because my bones may break more easily." D. "I realize that I only need to take this when my symptoms are really bad."
B Fluticasone nasal spray is a steroid drug used to prevent the symptoms of allergy. Its effect is localized; therefore, the patient does not have systemic adverse effects with normal use and does not have to wean down the medication, as with oral corticosteroids. Intranasal glucocorticoids are most effective for preventing and treating allergic rhinitis
The client is using a H1 receptor antagonist. Which of the following statements indicates that the client understands drug therapy? A. "This is the only drug I will need to treat my asthma attacks." B. "I will report fever, blurred vision, or eye pain." C. "I will use this drug only when I feel an attack coming on." D. "I will use my bronchodilator if my wheezing increases."
B Objective: Use the nursing process to care for clients who are receiving pharmacotherapy for allergic rhinitis and the common cold.Rationale: Clients should be informed about their adverse effects such as fever, blurred vision and eye pain. H1 receptor antagonists are not used for wheezing and asthma attacks.
A patient develops hypotension, laryngeal edema, and bronchospasm after eating peanuts. Which medication should the nurse prepare to administer? A. Promethazine [Phenergan] B. Epinephrine C. Diphenhydramine [Benadryl] D. Hydroxyzine [Vistaril]
B The patient is showing signs of anaphylaxis caused by a peanut allergy. Histamine1 activation plays a minor role in anaphylaxis; other substances are the principal mediators. Therefore, the drug of choice for anaphylaxis is epinephrine. The antihistamines promethazine, diphenhydramine, and hydroxyzine are effective only for symptoms of mild allergy; they may be used as adjuncts in the treatment of anaphylaxis, but they will have only limited benefit.
The patient tells the nurse that she has a cold, is coughing, and feels like she has fluid in her lungs. What action will the nurse anticipate performing next? A. Administer dextromethorphan. B. Administer guaifenesin. C. Encourage the patient to drink fluids hourly. D. Administer fluticasone (Flonase).
B The patient needs an expectorant. This medication will help the patient cough the fluid out of her lungs. Dextromethorphan and fluticasone will not help the patient expectorate. There is no information about the patient's fluid intake, so hourly fluids may be too much.
The LPN is giving instructions to a patient who has been prescribed a beclomethasone inhaler. Which statement indicates a need for further instruction? A. "I will rinse my mouth after I use my inhaler." B. "I will use my inhaler when I have an acute asthmatic attack." C. "I will use my inhaler just like I was shown." D. "I will call my healthcare provider if I notice white patches or redness in my mouth."
B Warn patients that inhaled corticosteroids are not be used to treat an acute asthma attack because they are not bronchodilators. Teach patients to use these drugs daily as prescribed even when no symptoms are present because they are long-term controller drugs. Instruct patients to rinse their mouths after each use to minimize fungal infection of the mouth from immunosuppressive effects. Advise patients to notify their healthcare professional if white patches in mouth or throat, or soreness and redness in mouth or throat appear because these are indications of infection. Teach patients how to properly use the MDI and DPI inhalers because improper use reduces drug effectiveness.
A client presents to the ED with anaphylaxis. Which medication would the nurse anticipate administering? A: salmeterol B: epinephrine C: montelukast D: benzonatate
B-epinephrine is the drug of choice for anaphylaxis. Salmeterol is a bronchodilator used for maintenance for asthma, montelukast is an oral leukotriene used for asthma maintenance, and benzonatate is an oral cough medication.
A client is prescribed ipratropium. Which part of the medical history would be concerning? A.Hypertension B.Glaucoma C.Obesity D.Heart failure
B: because ipratropium is an anticholinergic it increases intraocular pressure. People with glaucoma already have increase intraocular pressure, so if ipratropium is administered, it can increase the pressure in the eye even more.
A 74 y.o. female pt w/ GERD takes over-the-counter meds. For which med, if taken long-term, should the nurse teach about increased risk of fractures? A. Sucralfate (Carafate) B. Cimetidine (Tagamet) C. Omeprazole (Prilosec) D. Metoclopramide (Reglan)
C
A client is prescribed the over-the-counter laxative of magnesium hydroxide (Milk of Magnesia). Which condition in the client's history would alert the nurse to discuss this medication with the client and the health care provider? A. Hypertension B. Liver dysfunction C. Renal insufficiency D. Chronic constipation
C
A client with a history of asthma is short of breath and says, "I feel like I'm having an asthmatic attack." What is the nurse's best action? A. Call a code. B. Ask the client to describe the symptoms. C. Administer a beta2 adrenergic agonist. D. Administer a long-acting glucocorticoid.
C
A nurse is caring for a caring for a client who is receiving esomeprazole (Nexium) to manage GERD. Which of the following best indicates the desired therapeutic effect? A. " I don't pass gas a often" B. "my abdomen is no longer firm" C. "I don't have pain in my stomach" D. " I have regular BM's"
C
The nurse performs discharge teaching with a client who is prescribed the anticholinergic inhaler ipratropium bromide (Atrovent). Which statement by the client indicates to the nurse that teaching has been successful? A. "I will not drink grapefruit juice while taking this drug." B. "I may gain weight as a result of taking this medication." C. "This inhaler is not to be used alone to treat an acute asthma attack." D. "Nausea and vomiting are common adverse effects of this medication."
C
The patient asks how stool softeners relieve constipation. Which of the following would be the best response by the nurse? A. By stimulating the walls of the intestine. B. By promoting the retention of sodium in the fecal mass. C. By promoting the retention of water in the fecal mass. D. By lubricating the intestinal walls
C
What information should the nurse include in a teaching plan for the client who is prescribed sucralfate (Carafate)? A. "This medication will neutralize gastric acid." B. "This medication will enhance gastric absorption of meals." C. "This medication will form a protective barrier over the gastric mucosa." D. "Your gastric acid will be inhibited."
C
What will the nurse expect to find that would indicate a therapeutic effect of acetylcysteine (Mucomyst)? A. Decreased cough reflex B. Decreased nasal secretions C. Liquefying and loosening of bronchial secretions D. Relief of bronchospasms
C
Which assessment is most important for the client who is taking stimulant laxatives? A. Monitor bowel elimination daily. B. Monitor intake and output. C. Monitor signs and symptoms of fluid and electrolyte imbalance. D. Monitor heart rate and blood pressure every 4 hours.
C
Which client needs immediate intervention? A. Client taking aluminum-containing antacids with complaints of reflux. B. Client taking calcium-containing antacids who is hypocalcemic. C. Client taking magnesium-containing antacids who has renal failure. D. Client taking antacids who is older than 70 years.
C
Which is the best instruction for the nurse to include when teaching a client about the use of expectorants? A. Restrict fluids in order to decrease mucus production. B. Take the medication once a day only, at bedtime. C. Increase fluid intake in order to decrease viscosity of secretions. D. Increase fiber and fluid intake to prevent constipation.
C
A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has: A. Constipation B. Abdominal pain C. Episode of diarrhea D. Hematest-positive nasogastric tube drainage
C (Loperamide (Imodium) is an antidiarrheal.)
Which outcome would be most appropriate for a nurse to establish for a patient with a cough who takes an antitussive with codeine? A. Warm, dry, pink skin B. Oriented to time, place, and person C. Respiratory rate of 12 to 24 breaths per minute D. Effective productive cough
C Codeine, an opioid analgesic that acts through the CNS, effectively suppresses the frequency and intensity of cough. However, it also can suppress respiration, and overdose can be fatal. Doses are small (one-tenth those needed to relieve pain), so orientation and peripheral effects are minimal.
The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved? A. Nausea B. Belching C. Epigastric pain D. Difficulty swallowing
C Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric pain. Famotidine is not indicated for nausea, belching, and dysphagia
The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved? A. Nausea B. Belching C. Epigastric pain D. Difficulty swallowing
C Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric pain. Famotidine is not indicated for nausea, belching, and dysphagia.
A 74-year-old female patient with gastroesophageal reflux disease (GERD) takes over-the-counter medications. For which medication, if taken long-term, should the nurse teach about an increased risk of fractures? A. Sucralfate (Carafate) B. Cimetidine (Tagamet) C. Omeprazole (Prilosec) D. Metoclopramide (Reglan)
C There is a potential link between proton pump inhibitors (PPIs) (e.g., omeprazole) use and bone metabolism. Long-term use or high doses of PPIs may increase the risk of fractures of the hip, wrist, and spine. Lower doses or shorter duration of therapy should be considered.
Which instruction should be included in the teaching for a patient being started on the antihistamine azelastine [Astelin]? A. "Take the pill in the morning before breakfast." B. "Headache may be a side effect of the medication." C. "You may experience an unpleasant taste in your mouth when using azelastine." D. "You will experience a decrease in nasal congestion if the medication is working.
C With both formulations of azelastine [Astelin and Astepro], patients often complain of an unpleasant taste. Azelastine is administered as an intranasal metered spray. Headache is a side effect of the intranasal antihistamine olopatadine. Antihistamines do not reduce nasal congestion.
A woman begins using an albuterol inhaler and a beclomethasone inhaler for her asthma. Which statement by the client indicates further teaching is necessary? A. I use the albuterol inhaler first. After 5-10 minutes I use my beclomethasone inhaler. B. I should rinse my mouth with warm tap water after using my inhalers. C. I use my albuterol inhaler first then immediately use my beclomethasone inhaler. D. I can only use my albuterol inhaler when I am having an acute asthma attack.
C the client should wait 5-10 mins after using albuterol to allow for it to open the constricted airways so the corticosteroid inhaler can be effective.)
A 24 year old man with asthma has just been prescribed an albuterol inhaler as needed. The nurse reviewing the chart is concerned about this prescription noting the patient has a diagnosis of what condition? A. Cushing's B. Hypotension C. cardiac dysrhythmia D. sleep apnea
C. ( Albuterol is contraindicated with the presence of an abnormal heart beat because it increases the heart rate.)
A client is prescribed the decongestant oxymetazoline (Afrin) nasal spray. What should the nurse teach the client?A. Take this drug at bedtime as a sleep aid. B. Directly spray away from the nasal septum and gently sniff. C. This drug may be used in maintenance treatment for asthma. D. Limit the drug to 5 days of use to prevent rebound nasal congestion.
D
A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? A. Abdominal pain B. Reduction in steatorrhea C. Hematest-negative stools D. Regular bowel movements
D
A nurse is providing education to a client taking two different bronchodilator medications. The nurse identifies which characteristic as the advantage of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil)? A. Quicker peak action B. Shorter onset of action C. Extended time of action D. Longer duration of action
D
Beclomethasone (Beconase) has been prescribed for a client with allergic rhinitis. The nurse teaches the client that which is the most common side effect from continuous use? A. Dizziness B. Rhinorrhea C. Hallucinations D. Dry nasal mucosa
D
Discharge teaching to a client receiving a beta-agonist bronchodilator should emphasize reporting which side effect? A. Hypoglycemia B. Nonproductive cough C. Sedation D. Tachycardia
D
The nurse is caring for a client in the clinic who states that he is afraid of taking antihistamines because he is a truck driver. What is the best information for the nurse to give this client? A. "Take the medication only when you are not driving." B. "Take a lower dose than normal when you have to drive." C. "You are correct, you should not take antihistamines." D. "You may be able to safely take a second-generation antihistamine."
D
The nurse is instructing a client about the advantages of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil). How will the nurse explain to the client the difference in these two medications? A. Salmeterol has a shorter onset of action. B. Salmeterol does not have any side effects. C. Albuterol has a longer onset of action. D. Salmeterol has a longer duration of action
D
When a client complains of pain accompanying a peptic ulcer, why should an antacid be given? A. Antacids decrease GI motility. B. Antacids decrease gastric acid secretion. C. Aluminum hydroxide is a systemic antacid. D. Antacids neutralize HCl and reduce pepsin activity.
D
A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which of these substances to prevent a complication? A. Echinacea B. Cimetidine (Tagamet) C. Sunscreen products D. Caffeine
D (Theophylline is a methylxanthine whose benefits are from bronchodilation. It is used to decrease the frequency and severity of asthma attacks, especially those occurring at night. Caffeine is a methylxanthine whose pharmacologic actions may intensify the adverse effects of theophylline on the central nervous system and heart. Sources of caffeine should be avoided. It is not necessary to avoid taking cimetidine, echinacea, or sunscreen products while talking theophylline.)
A patient reports having a dry mouth and asks for something to drink. The nurse recognizes that this symptom can most likely be attributed to a common adverse effect of which medication that the patient is taking? A. Digoxin (Lanoxin) B. Cefotetan (Cefotan) C. Famotidine (Pepcid) D. Promethazine (Phenergan)
D A common adverse effect of promethazine, an antihistamine/antiemetic agent, is dry mouth; another is blurred vision. Common side effects of digoxin are yellow halos and bradycardia. Common side effects of cefotetan are nausea, vomiting, stomach pain, and diarrhea. Common side effects of famotidine are headache, abdominal pain, constipation, or diarrhea.
The patient is using a beta-adrenergic agonist for treatment of asthma. The nurse teaches that the action of this drug is: A. Reducing mucus production. B. Liquefying mucus. C. Reducing cough. D. Relaxing smooth muscle, causing bronchodilation.
D Beta-adrenergic agonists (sympathomimetics) act by relaxing bronchial smooth muscle, resulting in a bronchodilation that lowers airway resistance and makes breathing easier for the patient.
What should the nurse instruct the patient to do to best enhance the effectiveness of a daily dose of docusate sodium (Colace)? A. Take a dose of mineral oil at the same time. B. Add extra salt to food on at least one meal tray. C. Ensure dietary intake of 10 g of fiber each day. D. Take each dose with a full glass of water or other liquid
D Docusate lowers the surface tension of stool, permitting water and fats to penetrate and soften the stool for easier passage. The patient should take the dose with a full glass of water and should increase overall fluid intake, if able, to enhance effectiveness of the medication. Dietary fiber intake should be a minimum of 20 g daily to prevent constipation. Mineral oil and extra salt are not recommended.
A patient is taking a first-generation H1 blocker for the treatment of allergic rhinitis. It is most important for the nurse to assess for which adverse effect? A. Skin flushing B. Wheezing C. Insomnia D. Dry mouth
D First-generation H1 blockers produce adverse effects that include atropine-like properties (ie, drying of mucous membranes) and gastrointestinal effects (eg, nausea). Sedation is a pronounced side effect. H1 blockade results in the inhibition of dilator action of histamine in the periphery, which reduces flushing. Wheezing is not an adverse effect.
For a client with chronic renal failure, the nurse MOST likely will question a prescription for which type of antacid? A. Aluminum-containing antacids B. Calcium-containing antacids C. Sodium-containing antacids D. Magnesium-containing antacids
D Magnesium-containing antacids can cause hypermagnesemia in clients with chronic renal failure. Aluminum-containing antacids may be used as a phosphate binder in clients with chronic renal failure. Sodium- and aluminum-containing antacids are chemically more easily excreted in clients with renal compromise. Although calcium-containing antacids may accumulate in the bloodstream of clients with renal failure, they may also be appropriate because these patients may be hypocalcemic.
Which drug works by blocking serotonin in the gastrointestinal tract, vomiting center, and chemoreceptor trigger zone (CTZ)? A. metoclopramide (Reglan) B. meclizine (Antivert) C. droperidol (Inapsine) D. ondansetron (Zofran)
D R: Ondansetron is a serotonin blocker. Metoclopramide is a prokinetic drug, meclizine is an antihistamine, and droperidol is an antidopaminergic drug
An elderly male patient is prescribed ipratropium (Atrovent) for the treatment of asthma. Appropriate nursing intervention includes: A. Assessing for enlarged liver. B. Monitoring for development of diarrhea. C. Teaching the patient to avoid caffeine in the diet. D. Teaching the patient to report inability to urinate.
D Rationale: Anticholinergic bronchodilators should be used cautiously in elderly men with benign prostatic hypertrophy and in all patients with glaucoma.
The patient is receiving theophylline (Theo-Dur) for treatment of asthma. Nursing intervention is required if the patient makes which of the following statements? A. "I will notify my doctor if my vision changes." B. "I will use my inhaler if I am wheezing." C. "I will check my heart rate each day." D. "I will take my medicine with my coffee each morning."
D Rationale: The methylxanthines comprise a group of bronchodilators chemically related to caffeine. Because of the drugs' chemical similarities, patients should avoid foods and beverages containing caffeine when taking these drugs.
A client as the nurse how albuterol works. Which is the best response from the nurse? A: mobilize respiratory secretions B: decrease the cough response C: increase the work of breathing D: dilate the larger airways
D-albuterol is a bronchodilator, so the function of this medication is to help with bronchoconstriction and open up the airway.
Minutes after receiving a dose of Albuterol (Proventil) for the first time, the patient complains that "my heart is pounding, and I think I'm having a heart attack." Which response is most appropriate? A. Call for medical assistance and supplies. B. Page the attending healthcare provider immediately. C. Initiate the cardiopulmonary resuscitation protocol. D. Reassure the patient and continue to assess.
DAdverse reactions to sympathetic bronchodilators include dysrhythmias, hypotension, increased heart rate, anxiety, anorexia, headache, insomnia, nausea, pallor, perspiration, polyuria, restlessness, vomiting, weakness, urinary hesitancy, and urinary retention. These reactions are frightening to patients and teaching is essential when the drug is given. Even though the symptoms the patient is experiencing are common with this drug, the nurse should always continue to assess. The nurse does not require medical assistance or supplies at this point in time. Continuing to manage this patient's care is within the realm of nursing. Continued reassurance of the patient and assessment are warranted. The patient does not require initiation of the cardiopulmonary resuscitation protocol.
