chapter 55 pharm

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." "Consult with your primary care provider." "Use the medication until your symptoms are completely relieved." "Over-the-counter medications are safe for long-term use."

"Consult with your primary care provider.

A client has hypertension and wants to take a nasal decongestant for cold symptoms. Which statement by the nurse indicates the effect of hypertensive medications on hypertension? "The administration of a nasal decongestant will cause bradycardia and increase peripheral blood pressure gastric reflux." "The administration of nasal decongestant will act on the central nervous system to cause vasodilation of blood vessels." "The administration of a nasal decongestant will decrease the thyroid production and increase blood pressure." "The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

"The administration of a nasal decongestant will increase blood pressure due to vasoconstriction of blood vessels."

A patient receives dextromethorphan. The nurse would expect this drug to begin acting within which time frame? 20 to 25 minutes 25 to 30 minutes 10 to 15 minutes 15 to 20 minutes

25 to 3o min

A client asks the nurse about using dextromethorphan to relieve a cough. What type of cough would the nurse explain is best treated with the drug? A cough that is associated with an allergy to ragweed A dry, nonproductive cough A cough that occurs when the client is exposed to airborne irritants An occasional, productive cough

A dry, nonproductive cough

What home remedies are effective for mouth dryness and cough? (Select all that apply.) Administration of over-the-counter antihistamine Humidification of the environment Swishing the mouth with astringent mouthwash. Adequate fluid intake Sucking on hard candy or throat lozenges

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? Treatment of peptic ulcer disease Conversion of cardiac arrhythmias Antidote for acetaminophen poisoning Treatment of bronchospasm

Antidote for acetaminophen poisoning

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: Antihistamines are not recommended for this issue; only antibiotics are useful. Antihistamines are recommended for extended use, as long as you monitor for adverse effects. Antihistamines are not used for this issue. Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

A client is prescribed an antihistamine. The nurse determines that the drug would be contraindicated if the client had which condition? Select all that apply. Allergic conjunctivitis Cardiovascular shock Nausea and vomiting Anaphylactic shock Angle-closure glaucoma

Cardiovascular shock Angle-closure glaucoma

A client having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which process is occurring? Decreased permeability of the veins and capillaries Suppression of the vagus nerve endings producing tachycardia Contraction of smooth muscle in the bronchi Decreased secretion of the mucous glands

Contraction of smooth muscle in the bronchi

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

Dry mouth

What effect is associated with a first-generation H1 receptor antagonist? It catalyzes the enzymatic oxidation of uric acid. It raises the seizure threshold by impairing vitamin D. It decreases capillary permeability. It depletes norepinephrine and serotonin.

It decreases capillary permeability.

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 Meclizine Brompheniramine Loratadine

Loratadine

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 Maintenance of an effective heart rate Maintenance of effective hydration of the skin Maintenance of an effective urine output;z

Maintenance of effective airway clearance

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

Meclizine

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? Mucolytic Expectorant Peripherally acting antitussive Antihistamine Centrally acting antitussive

Mucolytic

Which agent would the nurse instruct a client to use orally? Tetrahydrozoline Pseudoephedrine Xylometazoline Phenylephrine

Pseudoephedrine

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

Retention of secretions

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

They come into direct contact with nasal mucosa.

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? Antitussives Decongestants Expectorants Mucolytics

decongestants

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

What intervention should be included in the care plan of a client experiencing excessive respiratory tract secretions? administration of guaifenesin deep breathing and coughing exercises administration of pseudoephedrine oxygen by nasal prongs supplemental

deep breathing

What is the chemical mediator released in immune and inflammatory response to allergic reactions? Epinephrine Norepinephrine Mast cells Histamine

histamine

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition? rebound congestion a drug allergy bronchitis sinusitis

rebound congestion

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? "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." "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

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

What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies? "Virtually any drug may induce an immunologic response in a susceptible person." "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." "The additives that are in drugs can also cause allergic reactions."

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

A client is admitted after overdose with acetaminophen. What medication would the nurse expect to be administered? Daptomycin Darbepoetin alfa Acetylcysteine Oxymetazoline hydrochloride

Acetylcysteine

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? Antianginals Antipyretics Antihistamines Antimicrobials

Antihistamines

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.) Consumption of alcohol is okay while taking benzonatate. Benzonatate can cause GI upset and sedation. Benzonatate capsules should be sucked on like a lozenge. Benzonatate can be taken more frequently than prescribed if needed. The client should drink plenty fluids.

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

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.) Consumption of alcohol is okay while taking benzonatate. Benzonatate capsules should be sucked on like a lozenge. Benzonatate can cause GI upset and sedation. Benzonatate can be taken more frequently than prescribed if needed. The client should drink plenty fluids.

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

A critically ill client with a diagnosis of ventilator-associated pneumonia has been administered acetylcysteine. The inhalation of acetylcysteine helps to liquefy secretions in the respiratory tract by what mechanism? Decreasing the osmolality of mucus Drawing increased amounts of water from interstitial spaces into mucus Increasing the osmolality of mucus Breaking the protein bonds that exist in mucu

Breaking the protein bonds that exist in mucus

Which agent acts directly on the medullary cough center? Tetrahydrozoline Codeine Benzonatate Ephedrine

Codeine

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

Consult with your primary care provider."

A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this use of codeine? Desensitization of the cough receptors in the sinuses and trachea Depression of the cough center in the medulla oblongata Vasodilation of the alveolar capillaries Stimulation of the reticular activating system (RAS)

Depression of the cough center in the medulla oblongata

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? Fexofenadine Loratadine Cetirizine Diphenhydramine

Diphenhydramine

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? Loratadine Olopatadine Diphenhydramine Promethazine

Diphenhydramine

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 will rinse the spray tip off after each use." "I can take over-the-counter pseudoephedrine, too."

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

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? "This medication has no serious side effects." "I should avoid driving after taking this medication." "Taking this medication shouldn't stop me from having my after-dinner drink." "It's safe to take this medication with the nighttime sinus medication that I've been using."

I should avoid driving after taking this medication.

What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies? "All drugs have the potential to cause an allergic reaction." "The additives that are in drugs can also cause allergic reactions." "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."

Mr. Zee is prescribed an inhaled nasal steroid to relieve his symptoms associated with seasonal allergies. What is true about inhaled nasal steroids? Inhaled nasal steroids do not have any adverse effects. Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies. Inhaled nasal steroids are used only to treat seasonal allergies. Inhaled nasal steroids produce a significant systemic effect.

Inhaled nasal steroids are more effective than oral medications in treating the global symptoms associated with allergies.

What factor is consistent with a drug reaction? Select all that apply. It follows ingestion of a drug known to produce allergic reactions. It follows a previous exposure to the same or similar drug. It occurs approximately 7 to 10 days after initial exposure to the suspected drug. It occurs after a moderate to large dose of the drug. It is limited to drugs that are based on organic compounds.

It follows a previous exposure to the same or similar drug. It follows ingestion of a drug known to produce allergic reactions. It occurs approximately 7 to 10 days after initial exposure to the suspected drug.

Fexofenadine (Allegra) is prescribed for a client with seasonal allergies. What should the nurse teach the client about the side effects of this medication? "Drink three to four glasses of water a day to loosen the mucus and congestion in your sinuses." "You may experience an increased heart rate or palpitations." "This medication should relieve your cough symptoms within several days." "Less drowsiness occurs with this medication compared to other antihistamines."

Less drowsiness occurs with this medication compared to other antihistamines

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

Meclizine

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

Misuse could result in overdose.

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

Misuse could result in overdose.

Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication? Ask about history of hay fever. Ask about nausea and vomiting. Observe for swelling in nasal passages. Obtain the client's blood pressure.

Obtain the client's blood pressure.

Decongestants are available in which dosage forms? (Select all that apply.) Nasal sprays Suppositories Nasal drops Inhalers Oral tablets

Oral tablets Nasal sprays Nasal drops

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? Chronic nasal polyps Damage of the nasal concha Rebound nasal swelling Burning of the nares secondary to chronic use of nasal sprays

Rebound nasal swelling

The nurse prepares to administer acetylcysteine by nebulization to an adult client diagnosed with chronic bronchitis. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. Instruct client that the drug irritates gastric vagal receptors to stimulate respiratory tract fluid. Provide drug after meals and before bedtime to remove mucous, which causes difficulties in breathing. Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber. Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment. SUBMIT ANSWER

Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber. Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment.

A group of students demonstrate understanding of topical decongestants, identifying them as: Parasympatholytics Parasympathomimetics Sympatholytics Sympathomimetics

Sympathomimetics

A client informs the nurse about taking pseudoephedrine for the relief of nasal congestion due to the common cold. In which situation should the nurse suggest that the client not use this medication since it is a contraindication for this health care concern? The client is being treated for severe hypertension. The client has a history of cataracts. The client has hypothyroidism. The client has had a cold for 3 days.

The client is being treated for severe hypertension

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 Stopping the drug after 3 days if no relief is obtained Encouraging the client to engage in usual activities such as driving Advising the client to avoid alcohol consumption

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

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 Using household measuring devices for dosage measurements Importance of reading the label for ingredients and dosage Using adult formulation with smaller doses Need to follow the directions for how often to give the drug

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 drug

A client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells? Platelets Basophils CD4 T cells Lymphocytes

basophils

What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction? clemastine cetirizine diphenhydramine epinephrine

diphenhydramine

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? impaired tissue perfusion ineffective airway clearance ineffective breathing pattern risk for infection

ineffective airway clearance

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition? Central nervous system depression Joint pain Nausea and vomiting Hypotension

nausea and vomiting