pharmacology 1003: Unit 3- respiratory practice questions

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."

An older adult client has reported "seeing things that aren't there" after starting to take over-the-counter dextromethorphan for a nonproductive cough associated with a cold. What assessment question will provide the most relevant information regarding the possible cause of this adverse effect?

"How much dextromethorphan have you been taking each day?" *At normal doses, dextromethorphan is known to cause nausea, drowsiness, rash, and difficulty breathing but doses exceeding recommendations can produce hallucinations and disassociation. The question concerning dosage is the most relevant regarding the cause of hallucinations.

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."

A client is instructed to take diphenhydramine after an allergic reaction. Which statement by the client indicates successful teaching concerning the safe and effective use of diphenhydramine?

"I should not drive my car after taking this medication."

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching?

"I'll keep the room warm and toasty." *Measures to assist with cough control when using antitussives include cool temperatures, humidification, lozenges, and increased fluids.

The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching?

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

The nurse is teaching a client about the potential for allergic drug reaction. What statement made by a client suggests a need for further teaching?

"If you didn't have allergies as a child, you won't develop allergies later in life." *Drug allergies can develop later in life, though many appear at a young age. All the other options contain accurate statements.

A client is receiving dornase alfa at home. Which would the nurse instruct the client to do?

"Protect the drug from light." *Clients receiving dornase alfa should be cautioned to store the drug in the refrigerator, protected from light. The nurse also needs to review how to administer the drug using a nebulizer.

The client reports a mild stinging sensation after using a nasal spray decongestant. Which response by the nurse would be most appropriate?

"This sensation is common and usually disappears with continued use."

After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching?

"We can use the adult brand, but we just have to decrease the amount."

Which is used as both a respiratory medication and to prevent liver damage in cases of acetaminophen toxicity? -Triprolidine -Cyproheptadine -Dexchlorpheniramine -Acetylcysteine

-Acetylcysteine

Because it acts directly on the medullary cough center of the brain, codeine is classified as which? -Decongestant -Antitussive -Antihistamine -Expectorant

-Antitussive

Which is a common adverse effect of topical nasal decongestants? -sneezing -kidney damage -lethargy -nausea

-nausea

A client is questioning the use of eucalyptus as a decongestant. The nurse should point out that eucalyptus is contraindicated for which clients? Select all that apply. -pregnant females -children younger than 2 years -lactating females -postmenopausal females -men

-pregnant females -children younger than 2 years -lactating females *The use of eucalyptus is contraindicated during pregnancy and lactation, as well as in people who are hypersensitive to eucalyptus and in children younger than 2 years. Eucalyptus is generally considered safe for postmenopausal females and men.

Patients who use decongestants for a prolonged period of time are at risk for: -rhinitis medicamentosa. -hypotension. -infection. -serious cardiac arrhythmia.

-rhinitis medicamentosa

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. *Antitussive agents suppress cough by depressing the cough center in the medulla oblongata or the cough receptors in the throat, trachea, or lungs. Expectorants are agents given orally to liquefy respiratory secretions and allow for their easier removal.

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

Breathing pattern is regular and without difficulty. *A regular breathing pattern without difficulty would indicate that the drug is effective because oxymetazoline is a decongestant drug. Hydration of the skin, heart rate, and urine output are usually not affected by this drug.

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

Contraction of smooth muscle in the bronchi

A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

Decongestants

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

Dry mouth *First-generation antihistamines have substantial anticholinergic effects; therefore, they may cause dry mouth, urinary retention, constipation, and blurred vision.

The nurse is assessing a client suspected of overdose with dextromethorphan. What assessment finding is suggestive of an overdose with the drug?

Hallucinations

Fluticasone (Flovent) is an example of what group of drug that is helpful in decreasing the inflammatory response in the airway? Immune modulators Leukotriene receptor agonists Anticholinergics Inhaled steroids

Inhaled steroids

A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis?

Risk for falls related to sedation *First-generation antihistamines cause drowsiness and impaired cognition that can result in falls. These drugs are not known to cause diuresis, impaired skin integrity, or infection.

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

Theophylline is an example of which group of drug used in patients with asthma and COPD to improve respiratory gas exchange by dilating the airways? Anticholinergics Xanthines Immune modulators Lung surfactants

Xanthines

anticholinergics

affect the vagus nerve to relax bronchial smooth muscle, thereby promoting bronchodilation.

lung surfactants

are naturally occurring compounds that reduce the surface tension in the alveoli, allowing them to expand.

The drug of choice for treating acute bronchospasm in both adults and children is: albuterol. ephedrine. epinephrine. formoterol.

ephedrine.

Patients who become pregnant may safely continue taking montelukast (Singulair) for asthma. TRUE FALSE

false

Pseudoephedrine (Sudafed, Decofed) is used to treat patients with glaucoma because it decreases ocular pressure. true or false

false

Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine?

ineffective airway clearance

Ipratropium (Atrovent) is contraindicated in patients with an allergy to: peanuts and soy products. shellfish. dairy. eggs.

peanuts and soy products.

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

sympathomimetics

replicate the effects of the sympathetic nervous system; they dilate the bronchi and increase the rate and depth of respiration

Patient teaching for someone using a nebulizer should include: -sitting upright while administering the drug. -lying flat for 30 minutes after using the nebulizer. -avoiding any liquids in the mouth for 15 minutes after administration. -priming the device before beginning the treatment.

sitting upright while administering the drug.

Benzonatate (Tessalon) should not be used by pregnant patients because of the potential adverse effects on the fetus. true or false

true

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

true

Oral decongestants may be helpful in patients with otitis media by opening the nasal passage and improving drainage of the eustachian tube. true or false

true

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. *There is limited or no support for the use of dietary or herbal supplements to prevent or treat symptoms of the common cold.

The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification?

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

A nurse is conducting an ongoing assessment and notes the client is experiencing difficulty bringing up mucus. Which nursing diagnosis should the nurse prioritize for this client?

Ineffective Airway Clearance

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

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 *Evaluation of the maintenance of effective airway clearance helps in assessing the efficacy of oxymetazoline, which is a decongestant drug. The hydration of the skin, the heart rate and the urine output are usually not changed in decongestant therapy.

The nurse is preparing a teaching session for a client prescribed dextromethorphan orally. Which instruction should the nurse prioritize?

Swallow the whole tablet and do not chew it. *The nurse should instruct the client to swallow the whole tablet and not to chew it to ensure that the drug is absorbed properly. The nurse need not instruct the client to take the drug with a glass of milk, dissolve the tablet in water and take the drug, or take the drug on an empty stomach.

A client reports to the nurse, "My head is stuffed up and I can't breathe through my nose." Nasal discharge is noted upon examination. The client is diagnosed with a common cold. The nurse should prepare to provide medication instructions related to what classification of medication directed at the client's nasal mucosa?

decongestant

Steroids

decrease the inflammatory response. The inhalable form is associated with many fewer systemic effects than are the other corticosteroid formulations.

Dextromethorphan is helpful in patients with cystic fibrosis to decrease the spasmodic coughing because it moistens the mucous membranes and decreases the viscosity of respiratory secretions. true or false

false

Patient teaching for the use of a nasal decongestion spray should include ensuring that the tip of the bottle is placed fully into the nasal passage and slowly squeezed to ensure that the medication reaches the sinuses. true or false

false

Premature infants are at risk for alveoli collapse because of an overproduction of surfactant, which causes the sacs to stick together. TRUE FALSE

false

Sympathomimetics are drugs that mimic the effects of the sympathetic nervous system and are used for vasoconstriction. TRUE FALSE

false

What is an adverse reaction commonly experienced by people taking nasal decongestants?

rebound congestion *An adverse effect that accompanies frequent or prolonged use of these drugs is a rebound congestion, officially called rhinitis medicamentosa.

Beractant (Survanta) should be instilled directly into the trachea and is indicated for rescue treatment of infants who have developed respiratory distress syndrome. TRUE FALSE

true

The adverse effects of xanthines are directly related to toxic concentrations of theophylline in the blood. TRUE FALSE

true

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

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

The nurse is preparing to administer naphazoline to a client. The nurse will exercise caution if which disorder is noted in the client's history on preadministration assessment? Select all that apply. -diabetes -glaucoma -hypotension -hypothyroidism -arthritis

-diabetes -glaucoma -hypothyroidism

Medications like guaifenesin (Mucinex) that liquefy lower respiratory tract secretions and make them easier to cough up are called: -decongestants. -antihistamines. -expectorants. -antitussives.

-expectorants