The Respiratory System

A nurse is caring for a client who is taking codeine. The nurse should identify which of the following assessments is priority to make? Blood pressure Apical heart rate Respirations Level of consciousness

Respirations Rationale: The greatest risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? Albuterol will increase the absorption of the fluticasone Albuterol will decrease the inflammation Albuterol will reduce nasal secretions Fluticasone will reduce the adverse effects of albuterol

Albuterol will increase the absorption of the fluticasone Rationale: Albuterol, an inhaled, short acting beta 2 agonist causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? Start at a low dose and gradually increase it Take the drug as needed for nasal congestion Allow at least 2 weeks for the full therapeutic effect Use the drug prior to exercise

Allow at least 2 weeks for the full therapeutic effect Rationale: It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? Thins mucus Relaxes bronchial smooth muscle Decreases inflammation Increases the cough threshold

Decreases inflammation Rationale: Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? Muscle tremors Drowsiness Excitation Insomnia

Drowsiness Rationale: The most common adverse effect of diphenhydramine, a first-generation antihistamine, is drowsiness.

A nurse is teaching a client who had a prescription for zileuton. Which of the following instructions should the nurse include? Check the apical pulse before taking the drug Take the drug only as needed before exercise Rinse the mouth after using the drug Have laboratory tests performed at regular intervals

Have laboratory tests performed at regular intervals Rationale: Zileuton, a leukotriene modifier, can cause liver injury. The nurse should monitor liver function once a month for 3 months, then every 2-3 months during the first year of treatment

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? Headache Sleepiness Hypotension Constipation

Headache Rationale: Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision and tremors.

A nurse is teaching a client about albuterol. the nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? Fever Bruising Polyuria Palpitations

Palpitations Rationale: Although not common at therapeutic doses, beta2 agonists can cause cardiac stimulation, resulting in chest pain, palpitations, hypertension, and arrhythmias.

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? Reduces antitussive effect of dextromethorphan Potentiation of depression of CNS actions Increased renal reabsorption of the dextromethorphan Delayed analgesic effect of the opioid

Potentiation of depression of CNS actions Rationale: Potentiation of depression of VNS actions

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? Decrease viscosity of nasal secretions Block H2 receptors Prevent histamine from binding to receptors Reduce nasal congestion

Prevent histamine from binding to receptors Rationale: Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? Select all that apply Restlessness Bradycardia Insomnia Muscle Pain Anxiety

Restlessness Insomnia Anxiety Rationale: Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. Insomnia is an adverse effect of pseudoephedrine. Anxiety is an adverse effect of pseudoephedrine.

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? Use a spacer to improve inhalation Take the drug at the onset of bronchospasm Rinse mouth to prevent oral fungal infection Take the drug once a day in the evening

Take the drug once a day in the evening Rationale: Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

For which of the following reasons should a client attach a spacer to a metered dose inhaler? To increase the amount of drug delivered to the lungs To increase the amount of drug delivered to the oropharynx To increase the amount of drug delivered on exhalation To increase the speed of the drug delivery into the mouth

To increase the amount of drug delivered to the lungs Rationale: A spacer increases the amount of drug that reaches the lungs.

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? Suppresses the cough stimulus Reduces inflammation Thins and Loosens mucus Dries secretions

Thins and loosens mucous Rationale: Mucolytics make mucus less viscous to increase a cough's productivity.

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? Suppresses the cough stimulus Reduces surface tension Reduces inflammation Dries mucous membranes

Reduces surface tension Rationale: Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? Peptic Ulcer disease A Seizure Disorder Anemia Coronary artery disease

Coronary artery disease Rationale: Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with clients who have severe hypertension or coronary artery disease.

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products? Over the counter cold products can also contain guaifenesin Blood glucose levels are increased Rebound congestion is likely Drug intolerance is likely

Over the counter cold products can also contain guaifenesin Many combinations over-the-counter cold products contain guaifenesin. A client taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, some of which the client might not have. All drugs have potential adverse effects, so the client should use only those drugs required to treat existing symptoms and only in the recommended amounts

A nurse is monitoring plasma drug levels in a client taking theophylline. Which of the following findings should the nurse expect to see if the clients drug level indicates toxicity? Seizures Constipation Normal Sinus Rhythm Somnolence

Seizures Rationale: Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? (Select All that apply) Muscle Tremors Urinary retention Dry Mouth Insomnia Tachycardia

Urinary Retention Dry Mouth Rationale: Muscle tremors can occur with beta2 agonists, not with inhaled anticholinergics such as ipratropium. Methylxanthines, not inhaled anticholinergics such as ipratropium can cause insomnia, tachycardia can occur with beta2agonsits, not with inhaled anticholinergics

A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instructions should the nurse include? Avoid taking nonsteroidal anti-inflammatory drugs Rinse your mouth after taking to prevent a yeast infection Stop taking the medication if you become nauseas Change positions slowly when standing up

Avoid taking non-steroidal anti-inflammatory drugs Rationale: Gastric protective measures are essential for clients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so clients should not take them concurrently with prednisone

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks? Respiratory depression Drug Abuse Drug Intolerance Rebound congestion

Drug Abuse Rationale: Because it is possible to alter pseudoephedrine and epinephrine into methamphetamine, a commonly abused drug, the law restricts the drugs' purchase.

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? Take the drug as needed for acute asthma Follow a low sodium diet Use an alternate day dosing schedule Increase weight bearing activity

Increase weight bearing activity Rationale: Weight-bearing activity can help minimize bone loss, which is an adverse effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid and inhaled long-acting beta2 agonist (LABA) combination medication.

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? Increases leukocyte activity Blocks muscarinic receptors Causes bronchodilation Reduces Inflammation

Reduces inflammation Rationale: Cromolyn Sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? Do not drink anything 30minutes after using the drug Wait 5 min between using the drug and another inhaled drug This drug is used to thin respiratory secretions Check pulse rate after inhaling the drug

Wait 5 min between using the drug and another inhaled drug Rationale: Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.