Pharm test 4 practice questions

Which information should the nurse include in the teaching for a client with allergic symptoms prescribed an antihistamine? 1. "Antihistamines are most effective when taken prophylactically." 2. "Antihistamines are useful in reversing allergic symptoms." 3. "Antihistamines are effective for long-term therapy." 4. "Antihistamines have minimal side effects."

Answer: 1 Explanation: 1. Antihistamines are most effective when taken prophylactically to prevent allergic symptoms. 2. Antihistamines are not useful in reversing allergic symptoms. 3. Antihistamines are not effective for long-term therapy. 4. Antihistamines do not have minimal side effects; they can produce anticholinergic effects such as increased heart rate, urinary retention, constipation, and blurred vision. Page Ref: 603

Which histamine receptor is blocked by the action of an antihistamine? 1. H1 receptor site 2. B1 receptor site 3. B2 receptor site 4. H2 receptor site

Answer: 1 Explanation: 1. Antihistamines block the H1 receptor site. 2. Antihistamines do not block B1 receptor sites. 3. Antihistamines do not block B2 receptor sites. 4. Antihistamines do not block H2 receptor sites. Page Ref: 603

Which condition should the nurse be concerned about for a client prescribed an antitussive with codeine? 1. Asthma 2. Diabetes mellitus 3. Chronic kidney disease 4. Coronary artery disease

Answer: 1 Explanation: 1. Care must be taken when using an antitussive with codeine in clients with asthma because bronchoconstriction may occur. 2. An antitussive with codeine does not place a client with diabetes mellitus at risk for an adverse effect. 3. An antitussive with codeine does not place a client with chronic kidney disease at risk for an adverse effect. 4. An antitussive with codeine does not place a client with coronary artery disease at risk for an adverse effect. Page Ref: 608

) A client asks the nurse how benzonatate (Tessalon) works to suppress her cough. Which response should the nurse provide the client? 1. "Anesthetizes the receptor sites of the lungs" 2. "Raises the cough threshold in the CNS" 3. "Reduces the viscosity of the mucus" 4. "Anticholinergic effects decrease the cough reflex"

Answer: 1 Explanation: 1. Chemically related to the local anesthetic tetracaine (Pontocaine), benzonatate suppresses the cough reflex by anesthetizing stretch receptors in the lungs. 2. Opioids raise the cough threshold in the CNS. 3. Expectorants reduce the viscosity of the mucus. 4. Benzonatate does not have anticholinergic effects. Page Ref: 609

The nurse has completed the education for a client prescribed diphenhydramine (Benadryl) for allergies. Which statement made by the client indicates an understanding of the teaching? 1. "Drowsiness is common but should lessen over time." 2. "If this medication makes my nose run, I can use a nasal spray." 3. "I need to watch my intake of sodium with this medication." 4. "I cannot take this medication with pseudoephedrine (Sudafed)."

Answer: 1 Explanation: 1. Drowsiness is a common adverse effect of antihistamines and will diminish with longterm use. 2. Antihistamines dry the nasal secretions, not increase them. 3. The use of antihistamines does not require sodium restriction. 4. Pseudoephedrine (Sudafed) is commonly used with antihistamines. Page Ref: 605

Which information should the nurse include in the teaching for a client prescribed dextromethorphan (Delsym)? 1. Avoid grapefruit juice. 2. Dextromethorphan can be used with a chronic cough. 3. The prescription may have a slow onset of action. 4. Decrease your alcohol intake while taking this prescription

Answer: 1 Explanation: 1. Grapefruit juice can raise serum levels of dextromethorphan and cause toxicity. 2. Dextromethorphan should be avoided in clients in the treatment of chronic cough with excessive bronchial secretions that need to be expelled. 3. The prescription has a rapid onset of action, usually within 15 to 30 minutes. 4. The client should not drink any alcohol while taking the prescription as this may result in sedation. Page Ref: 610

The educator has reviewed the role of histamine receptors associated with allergic symptoms with a nurse. Which statement made by the nurse indicates further instruction is needed? 1. "H1 receptors are found in the stomach." 2. "H1 receptors are responsible for allergic symptoms." 3. "H2 receptors increase mucus secretion in the stomach." 4. "H2 receptors are responsible for peptic ulcers."

Answer: 1 Explanation: 1. H2 receptors are found in the stomach. 2. The histamine receptors responsible for allergic symptoms are called H1 receptors. 3. H2 receptors increase mucus secretion in the stomach. 4. H2 receptors are responsible for peptic ulcers. Page Ref: 603

A client prescribed beclomethasone (Beconase) intranasally asks the nurse whether the prescription is safe. Which response should the nurse provide the client? 1. "Intranasal glucocorticoids produce almost no serious adverse effects." 2. "Intranasal glucocorticoids will provide immediate relief." 3. "Intranasal glucocorticoids are safe if they are not used too long." 4. "Intranasal glucocorticoids are safe only if used once a day."

Answer: 1 Explanation: 1. Intranasal glucocorticoids produce almost no serious adverse effects. 2. Intranasal glucocorticoids have a delayed effect. 3. There is no maximum time frame for the use of intranasal glucocorticoids; they produce almost no serious adverse effects. 4. Intranasal glucocorticoids may be used more than once a day; they produce almost no serious adverse effects. Page Ref: 605

The nurse teaches a client about the difference between oral and nasal decongestants. The nurse evaluates that learning has been effective when the client makes which statement? 1. "Oral decongestants can cause hypertension." 2. "Intranasal decongestants are safe to use for a few weeks." 3. "Oral and nasal decongestants can cause rebound congestion." 4. "Oral decongestants are the most effective at relieving severe congestion."

Answer: 1 Explanation: 1. One of the side effects of oral decongestants is hypertension. 2. Intranasal decongestants should not be used for longer than 3 to 5 days. 3. Oral decongestants do not cause rebound congestion; nasal decongestants can cause rebound congestion. 4. Intranasal, not oral, decongestants are the most effective at relieving severe congestion. Page Ref: 606, 608

) A client asks the nurse, "Is there anything that I can take for my seasonal allergies?" Which information should the nurse provide to the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Some antihistamines can help prevent the onset of allergies." 2. "Some patients find that intranasal corticosteroids help prevent their allergies." 3. "Drugs that are mast cell stabilizers may help you avoid your seasonal allergies." 4. "Oral decongestants can help you prevent allergies." 5. "Nasal decongestants are very good at preventing allergic response."

Answer: 1, 2, 3 Explanation: 1. Antihistamines are preventers of allergies. 2. Intranasal corticosteroids are preventers of allergies. 3. Mast cell stabilizers are preventers of allergies. 4. Oral decongestants are relievers of allergic symptoms. 5. Nasal decongestants are relievers of allergic symptoms. Page Ref: 603, 605

Which assessment findings should the nurse anticipate for a client experiencing allergic rhinitis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Tearing eyes 2. Itching throat 3. Nasal congestion 4. Sneezing 5. Coughing

Answer: 1, 2, 3, 4 Explanation: 1. Tearing eyes are a symptom of allergic rhinitis. 2. Itching throat is a symptom of allergic rhinitis. 3. Nasal congestion is a symptom of allergic rhinitis. 4. Sneezing is a symptom of allergic rhinitis. 5. Coughing is not a symptom of allergic rhinitis. Page Ref: 602, 613

A client asks the nurse what has caused her allergic rhinitis. Which statements should the nurse include in the discussion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "Allergic rhinitis can occur after exposure to animal dander." 2. "Tobacco smoke can cause allergic rhinitis." 3. "Exposure to pollens from weeds and grass causes an allergic rhinitis." 4. "Asthma is associated with allergic rhinitis." 5. "There is a strong genetic predisposition for allergic rhinitis."

Answer: 1, 2, 3, 5 Explanation: 1. One of the causative factors of allergic rhinitis is animal dander. 2. Tobacco smoke can cause allergic rhinitis in some people. 3. Allergic response to pollen can cause allergic rhinitis in some people. 4. Although associated with asthma, allergic rhinitis is not caused by asthma. 5. There is a strong genetic predisposition for allergic rhinitis. Page Ref: 602

Which disorders are antihistamines used to treat? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Insomnia 2. Vertigo 3. Cystic fibrosis 4. Parkinson's disease 5. Nasal congestion

Answer: 1, 2, 4 Explanation: 1. Antihistamines can be used to treat insomnia. 2. Antihistamines can be used to treat vertigo. 3. Mucolytics are used to help treat cystic fibrosis. 4. Antihistamines can be used to treat Parkinson's disease. 5. Decongestants are used to treat nasal congestion Page Ref: 604

A patient has been prescribed benzonatate (Tessalon). What medication education should the nurse provide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "This medication should help relieve your cough." 2. "Do not chew this medication." 3. "This medication may increase your blood pressure." 4. "You may be nauseated when taking this medication." 5. "Adverse effects are uncommon, but you may develop a headache."

Answer: 1, 2, 4, 5 Explanation: 1. Benzonatate is used as an antitussive. 2. If chewed, this drug can cause the side effect of numbing the mouth and pharynx. 3. Hypertension is not an effect of this medication. 4. Nausea is a possible effect of this medication. 5. Adverse effects are uncommon, but a headache may develop. Page Ref: 609

) Which information should the nurse include in the education for a client prescribed an intranasal corticosteroid? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. "You may feel a burning sensation when using this drug." 2. "This prescription will be most effective if used only when symptoms are present." 3. "Squeeze the container cautiously so you do not inadvertently administer too much of a dose." 4. "This prescription may dry out your nasal passages enough to cause nosebleed." 5. "Avoid eating licorice while taking this prescription."

Answer: 1, 4, 5 Explanation: 1. The most frequently reported adverse effect of this drug is an intense burning sensation in the nose occurring immediately after spraying. 2. The drug often takes 1 to 3 weeks to achieve peak response and should be started in advance of expected need. 3. The prescription is provided in metered-spray devices. 4. Excessive drying of the nasal mucosa may occur, which leads to epistaxis. 5. Licorice may potentiate the effects of corticosteroids. Page Ref: 606-607

Which information should the nurse include in the client education for the administration of an intranasal decongestant? 1. "Wait 15 minutes in between additional nasal sprays." 2. "Spit out any excess intranasal decongestant that drains in the mouth." 3. "Clear the nasal passage after administering the intranasal decongestant." 4. "Limit the use of the nasal decongestant to 2 weeks.

Answer: 2 Explanation: 1. The client should be instructed to wait 5 to 10 minutes prior to following with additional nasal sprays as prescribed. Allowing the first of two sprays time to constrict local vessels and mucosa will allow the spray to reach higher into passages. 2. The client should be instructed to spit out any excess intranasal decongestant that drains in the mouth. Swallowing additional drug may increase the risk of systemic adverse effects. 3. The nasal passages should be cleared prior to the administration of an intranasal decongestant. Clearing the nasal passages before administering the nasal spray and allowing the first of two sprays time to constrict local vessels and mucosa will allow the spray to reach higher into passages. 4. The client should be taught to limit use of decongestant nasal sprays to 3 to 5 days, unless otherwise advised by the healthcare provider, to avoid rebound congestion. Page Ref: 612

Which condition should the nurse be concerned about for a client prescribed fluticasone (Flonase)? 1. Diabetes mellitus 2. Pregnancy 3. Glaucoma 4. Hypertension

Answer: 2 Explanation: 1. There is no contraindication for use of fluticasone for a client with diabetes mellitus. 2. Fluticasone is a pregnancy category C drug, which means the effects on pregnancy are not known. A pregnant client should not receive this prescription. 3. There is no contraindication for use of fluticasone for a client with glaucoma. 4. There is no contraindication for use of fluticasone for a client with hypertension. Page Ref: 607

The nurse is reviewing the major functions of the upper respiratory tract with a client. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. Inward airflow from the trachea branches off to the two bronchi. 2. The nose warms the air before it reaches the lungs. 3. The nasal mucosa is the first line of immunological defense. 4. Activation of the parasympathetic nervous system constricts arterioles in the nose. 5. Activation of the sympathetic nervous system constricts arterioles in the nose.

Answer: 2, 3, 5 Explanation: 1. The trachea and bronchi are part of the lower respiratory tract. 2. The nose warms the air before it reaches the lungs. 3. The nasal mucosa is the first line of immunological defense. 4. Activation of the sympathetic nervous system, not the parasympathetic nervous system, constricts arterioles in the nose. 5. Activation of the sympathetic nervous system constricts arterioles in the nose. Page Ref: 601

Which assessment finding should the nurse be most concerned about for a client receiving pseudoephedrine (Sudafed)? 1. Temperature of 100°F 2. Respiratory rate of 22 3. Heart rate 82 and irregular 4. Complaints of a dry mouth

Answer: 3 Explanation: 1. A high temperature is possible with pseudoephedrine but is not the primary concern. 2. A respiratory rate of 22 is possible with pseudoephedrine but is not the primary concern. 3. Pseudoephedrine may cause dysrhythmias. 4. A dry mouth is possible with pseudoephedrine but is not the primary concern. Page Ref: 607

For which should the nurse monitor a client suspected of abusing dextromethorphan (Delsym)? 1. Nephrotoxicity 2. Cardiotoxicity 3. CNS toxicity 4. Hepatoxicity

Answer: 3 Explanation: 1. Abuse of dextromethorphan is not associated with nephrotoxicity. 2. Abuse of dextromethorphan is not associated with cardiotoxicity. 3. Abuse of dextromethorphan is associated with CNS toxicity with a wide variety of symptoms, including slurred speech, ataxia, hyperexcitability, stupor, respiratory depression, seizures, coma, and toxic psychosis. 4. Abuse of dextromethorphan is not associated with hepatoxicity. Page Ref: 610

Which information should the nurse include when discussing the appropriate dosing and administration needs for self-administering prescriptive therapy? 1. "Drink water when you take cough syrup." 2. "Avoid drinking liquids with expectorants." 3. "Take your antihistamine as soon as you begin experiencing allergy symptoms." 4. "Clear your nasal passages by blowing prior to using your nasal spray."

Answer: 3 Explanation: 1. Cough syrups should be swallowed without water and allowed to coat the throat for soothing effects, followed by increased fluid intake 30 to 60 minutes later. 2. Expectorants should be taken with a full glass of liquid, and fluid intake throughout the day should be increased to assist in thinning mucus for ease of expectoration. 3. The client should begin taking antihistamines before the allergy season begins or at the earliest possible appearance of symptoms for best results. 4. When using a nasal decongestant, nasal passages should be cleared by blowing, followed by the nasal spray. Page Ref: 612

Which describes the purpose for the use of an opioid antitussive? 1. Decrease nasal congestion 2. Break down mucus 3. Relieve severe cough 4. Relieve mild cough

Answer: 3 Explanation: 1. Decongestants decrease congestion. 2. Expectorants break down mucus. 3. Opioid antitussives are used to relieve severe cough. 4. Mild coughs do not require an antitussive. Page Ref: 608

Which prescription is used to prevent allergic rhinitis? 1. Oral corticosteroids 2. Oral decongestants 3. Intranasal corticosteroids 4. Intranasal decongestants

Answer: 3 Explanation: 1. Oral corticosteroids are not used in the treatment of allergic rhinitis. 2. Oral decongestants are used as a reliever of the symptoms associated with allergic rhinitis. 3. Intranasal corticosteroids are used as a preventer in the treatment of allergic rhinitis. 4. Intranasal decongestants are used as a reliever of the symptoms associated with allergic rhinitis. Page Ref: 602

The nurse has completed the education for a client prescribed an antihistamine. Which statement made by the client indicates an understanding of the information? 1. "I can still have my after-dinner drink." 2. "I may experience diarrhea while taking this prescription." 3. "This prescription is safe because it is sold over-the-counter (OTC)." 4. "This medication could make me very sleepy."

Answer: 4 Explanation: 1. Alcohol will increase the sedative effects of antihistamines, so the client should not consume alcohol while taking antihistamines. 2. Antihistamines can produce constipation. 3. Just because a prescription is sold OTC does not mean it is safe. 4. Sedation is a common side effect of antihistamines. Page Ref: 604, 612

A client asks the nurse when she should use an antitussive. Which response should the nurse provide the client? 1. "When you are coughing up secretions." 2. "When your temperature is 101.2°F." 3. "When you have been diagnosed with a respiratory infection." 4. "When you have a dry cough and cannot rest."

Answer: 4 Explanation: 1. An antitussive is not used to dry up lung secretions. 2. The client should be assessed if she is febrile prior to taking any prescription. 3. It is not desirable to suppress the cough reflex in a client with a respiratory infection. 4. Antitussives can be taken when the client is experiencing a dry, hacking, and nonproductive cough. This type of cough is irritating to the membranes of the throat and deprives the client of much needed rest. Page Ref: 608

Which symptom should the nurse instruct the client prescribed diphenhydramine (Benadryl) to report to the healthcare provider? 1. Sedation 2. Diarrhea 3. Weight gain 4. Urinary hesitancy

Answer: 4 Explanation: 1. Sedation is a common side effect that does not need to be reported. 2. Diarrhea is not associated with the use of diphenhydramine. 3. Weight gain is not associated with the use of diphenhydramine. 4. Urinary hesitancy is an anticholinergic effect of diphenhydramine and should be reported to the healthcare provider. Page Ref: 604, 605, 612

Which over-the-counter (OTC) antihistamine combination contains an analgesic property? 1. Sudafed PE Sinus and Allergy 2. Triaminic Cold/Allergy 3. Tavist Allergy 12-hour 4. Actifed Plus

Answer: 4 Explanation: 1. Sudafed PE Sinus and Allergy contains chlorpheniramine and phenylephrine. 2. Triaminic Cold/Allergy contains chlorpheniramine and phenylephrine. 3. Tavist Allergy 12-hour contains clemastine. 4. Actifed Plus contains acetaminophen. Page Ref: 604

A client asks the nurse why he cannot take his monoamine oxidase inhibitor (MAOI) with diphenhydramine (Benadryl). Which response should the nurse provide? 1. "The diphenhydramine (Benadryl) interferes with the therapeutic effect of the MAOI." 2. "You are at risk for the development of seizures." 3. "The MAOI prescription decreases the effectiveness of diphenhydramine (Benadryl)." 4. "You may develop a hypertensive crisis."

Answer: 4 Explanation: 1. The combination of prescriptions does not decrease the therapeutic effect of MAOI. 2. The combination of prescriptions does not place the client at risk for seizures. 3. The combination of prescriptions does not decrease the therapeutic effect of diphenhydramine. 4. The combination of diphenhydramine and a monoamine oxidase inhibitor drug can result in a hypertensive crisis. Page Ref: 605

Which information should the nurse include in the teaching of a client with chronic bronchitis prescribed breathing treatments with acetylcysteine (Mucomyst)? 1. "Stop the treatment if you start to cough." 2. "Do not use the prescription if you notice it has a foul odor." 3. "This drug is used to decrease bronchospasms." 4. "You may experience nausea while using this drug."

Answer: 4 Explanation: 1. The prescription is used to thin mucus to make it easier to remove by coughing. Coughing is a desired effect. 2. Acetylcysteine has an offensive odor resembling rotten eggs. 3. This prescription is not used to decrease bronchospasms. Acetylcysteine is a mucolytic and is designed to thin mucus by breaking down the chemical structure. 4. One of the adverse effects of acetylcysteine is nausea. Page Ref: 609

A client with nasal congestion tells the nurse that his symptoms have worsened since he has been using oxymetazoline (Afrin). Which question should the nurse ask the client? 1. "Have you checked the expiration date on the prescription?" 2. "Have you experienced a recent fever?" 3. "Are you using any other inhaled prescriptions?" 4. "How long have you been using the prescription?"

Answer: 4 Explanation: 1. While it is possible that the client is using an outdated prescription, this is most likely not the reason the client is experiencing rebound congestion. 2. A recent fever is not associated with rebound congestion. 3. The use of other inhaled prescriptions will not cause or prevent rebound congestion. 4. It is important to assess the length of time the client has been using oxymetazoline. Oxymetazoline can cause rebound congestion if used for a long period of time. Page Ref: 606, 608