Chapter 54 and 55 Study

A nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching?

"I should avoid driving after taking this medication."

Which of the following would a nurse identify as a surfactant?

Beractant

The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?

Coffee

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage? once-weekly dosing decreased sedation absence of adverse effects lower cost

decreased sedation

A client prescribed albuterol should be educated on identifying and managing which adverse reaction? tachycardia diarrhea hypotension polydipsia

tachycardia

A client is being assessed by the home care nurse on the appropriate use of her metered-dose inhalers. Instructions concerning which intervention will assist a client in the proper administration of the metered-dose inhaler?

using a spacer

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 will blow my nose before using the nasal spray." "The drug is used no longer than 3 days." "I can take over-the-counter pseudoephedrine, too." "I will rinse the spray tip off after each use."

"I can take over-the-counter pseudoephedrine, too."

The nurse is teaching a 61-year-old client about the narcotic antitussive syrup that the health care provider has prescribed. Which client statement suggests understanding of what the nurse has taught?

"This medication might cause drowsiness, so I will avoid driving while I use it."

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame? 15 minutes 30 minutes 45 minutes 60 minutes

30 minutes

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?

Drowsiness

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

Antidote for acetaminophen poisoning

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon?

Antitussives suppress coughing while expectorants loosen bronchial secretions.

A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug?

Blood pressure

The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply: Check peak flow Check blood pressure. Check blood glucose. Check respiratory rate Check pulse.

Check blood pressure. Check respiratory rate Check pulse.

A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by nonselectively binding to central and peripheral H1 receptors? Loratadine Diphenhydramine Fexofenadine Cetirizine

Diphenhydramine

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?

Dry mouth

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? The medication is contraindicated for viral infections. The medication is not effective for croup. The medication is contraindicated for the child's symptoms. Misuse could result in overdose.

Misuse could result in overdose.

Codeine containing antitussives should be used cautiously in clients with which conditions? (Select all that apply.)

Pregnancy Convulsive disorders Prostatic hypertrophy

A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports? Rhinorrhea Rhinitis Chronic nasal swelling Retention of secretions

Retention of secretions

A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea?

There is limited or no support for the use of echinacea to prevent or treat symptoms of the common cold.

Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis.

True

When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.)

Using sugarless candies or lozenges to combat dry mouth Advising the client to avoid alcohol consumption

What is the chemical mediator released in immune and inflammatory response to allergic reactions? histamine epinephrine norepinephrine mast cells

histamine

Which condition would contraindicate the use of or oxymetazoline?

hypertension

An older adult client, diagnosed with chronic obstructive pulmonary disease (COPD), is being considered for corticosteroid therapy. The nurse should anticipate that these drugs may be administered by what routes? Select all that apply.

oral parenteral

Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness? Cyproheptadine Meclizine Clemastine Hydroxyzine

Meclizine

Which agent would the nurse instruct a client to use orally?

Pseudoephedrine

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

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 A 65-year-old female with hepatic disease A 43-year-old male with hypertension An 83-year-old female with cardiac disease

A 65-year-old male with asthma

A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client? Theophylline Asthmacort Omalizumab Albuterol

Albuterol

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)? Arformoterol Salmeterol Formoterol Albuterol

Albuterol

A client is prescribed oxymetazoline. Which assessment data would indicate that the drug is effective?

Breathing pattern is regular and without difficulty.

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following? Cigarette smoking Hyperthyroidism Alcohol intake Gastrointestinal upset

Cigarette smoking

A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?

Inhalation

How do inhaled corticosteroid agents assist in the treatment of asthma?

Inhaled corticosteroid agents will reduce airway inflammation.

A group of students are reviewing information about antihistamines. The students demonstrate understanding of the information when they identify which agent as a second generation antihistamine? Promethazine Brompheniramine Loratadine Meclizine

Loratadine

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?

antihistamines

A client, having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which body effect is occurring?

contraction of smooth muscle in the bronchi

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

To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure?

increasing fluid intake

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

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? Administer the scheduled dose of theophylline with as needed (PRN) dose of a bronchodilator. Withhold the scheduled dose of theophylline pending the next day's blood work results. Inform the care provider that an increase in the client's dose of theophylline may be necessary. Contact the care provider and inform him or her that the client has toxic theophylline levels.

Contact the care provider and inform him or her that the client has toxic theophylline levels.

The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness? acetaminophen eucalyptus advil antihistamine

antihistamine

A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels? Allopurinol Nicotine Cimetidine Corticosteroids

Nicotine

A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response? "Afrin can be used as long as nasal burning and stinging do not occur." "Over-the-counter medications are safe for long-term use." "Use the medication until your symptoms are completely relieved." "Consult with your primary care provider."

"Consult with your primary care provider."

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 wait at least 30 minutes after the first inhalation before taking a second." "I need to shake the inhaler well before taking the medication." "I need to take three short, quick breaths to inhale the medication." "I should take a deep breath, hold it while I administer the medication, and then exhale."

"I need to shake the inhaler well before taking the medication."

What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies? "The additives that are in drugs can also cause allergic reactions." "All drugs have the potential to cause an allergic reaction." "If you didn't have allergies as a child, you won't develop allergies later in life." "Virtually any drug may induce an immunologic response in a susceptible person."

"If you didn't have allergies as a child, you won't develop allergies later in life."

A client is using an inhaled bronchodilator as treatment for exercise-induced asthma. The nurse would instruct the client to use the inhaler at which time?

15 minutes before engaging in exercise

A female client administers diphenhydramine to her 9-year-old male child, who experiences seasonal allergies, before his first baseball game. What may the child experience if he has a paradoxical effect to the medication? Decreased mental alertness Exacerbation of allergic symptoms Hyperactivity Poor reflexes

Decreased mental alertness

A client is prescribed oxymetazoline, a decongestant, for the treatment of hay fever. What should the nurse evaluate to assess the efficacy of therapy?

Maintenance of effective airway clearance

Which would contraindicate the use of a topical nasal decongestant? Nasal ulceration Diabetes Glaucoma Hypertension

Nasal ulceration

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased? Sedation Hypersensitivity Gastrointestinal upset Dry mouth

Sedation

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 Selectively binding to peripheral H1 receptors Anesthetizing stretch receptors in the respiratory passages Nonselectively binding to central and peripheral H1 receptors

Vasoconstriction of small blood vessels of the nasal membranes

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." "It usually takes between 8 and 10 days for a decongestant to cure affect cold symptoms." "Sometimes a decongestant can sometimes mask the effects of your cold, essentially prolonging it." "Most people find that cold medications are essentially ineffective."

"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."

The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic? 30 mcg/mL 15 mcg/mL 5 mcg/mL 25 mcg/mL

15 mcg/mL

During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?

Albuterol

While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium? Peanuts Dairy Eggs Shellfish

Peanuts

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.)

The client should drink plenty fluids. Benzonatate can cause GI upset and sedation.

The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness? They are absorbed systemically. Their effects last for 48 to 72 hours. They treat multiple symptoms in a cost-effective manner. They come into direct contact with nasal mucosa.

They come into direct contact with nasal mucosa.

A client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage? acai juice coffee grapefruit juice green tea

coffee

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? pseudoephedrine epinephrine ipratropium bromide cromolyn

epinephrine

The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations? Acetylcysteine Beclomethasone Albuterol Theophylline

Albuterol

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 decreases vital capacity. Albuterol blocks the stimulation of the beta-2 receptors. Albuterol causes relaxation of the bronchial smooth muscles. Albuterol causes stimulation of the bronchial tissue.

Albuterol causes relaxation of the bronchial smooth muscles.

The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.) Drowsiness Dizziness Bowel obstruction Decrease heart rate Vomiting

Drowsiness Dizziness

What information should the nurse provide a mother of a 3-year-old concerning the safety and efficacy of over-the-counter (OTC) cough and cold products containing pseudoephedrine for young children? Risk can be minimized by using age-specific preparations of cough and cold remedies. Cough and cold remedies are generally safe and effective for children over the age of 2. Media reports about the risks of cough and cold medications in children have greatly exaggerated the fear of risks. There are concerns among health professionals about how safe and effective these medications are.

There are concerns among health professionals about how safe and effective these medications are.

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching? "I'll get a humidifier for my bedroom." "I'll keep the room warm and toasty." "I can use some lozenges for comfort." "I need to increase the amount of fluids I drink."

"I'll keep the room warm and toasty."

The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time? Immediately on beginning to exercise 15 minutes prior to exercising In the morning of the day when exercise is planned One hour before exercise

15 minutes prior to exercising

A 45-year-old female client is being seen in the health care provider's office for a dry, hacking cough that is keeping her up at night. The provider prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? Dextromethorphan works in the medulla to suppress the cough reflex. Dextromethorphan works by inhibiting allergen response. Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works by relaxing the smooth muscles in the bronchioles.

Dextromethorphan works in the medulla to suppress the cough reflex.

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." "I'm a heavy coffee drinker, but I know that I now know I need to cut down on this." "I'll try to make sure that I drink plenty of fluids each day." "I'll make sure I don't take my inhalers more often than they've been prescribed."

I'll keep taking my medications until I'm not experiencing any more symptoms."

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 permanent liver damage. community-acquired pneumonia. severe anticholinergic effects. rebound bronchoconstriction.

rebound bronchoconstriction.