PHARM chp 29

Question 1: (see full question) 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? You selected: Blood pressure Correct Explanation: As a pre-administration assessment before giving a nasal decongestant, the nurse should assess the patient's blood pressure, pulse, and respiratory rates. Assessments for disturbed ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 2: (see full question) Guaifenesin 200 mg PO every 4 hours as needed is ordered for a patient with a respiratory ailment. The nurse understands that this medication is given for which of the following reasons? You selected: reduction of viscosity of mucus Incorrect Correct response: relief of cough Explanation: Guaifenesin, when given PRN, relieves cough usually associated with a respiratory tract infection. Opioid antitussives are given for relief of cough and mild pain, while mucolytics ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 3: (see full question) Your client complains that he has had difficulty finding OTC nasal decongestants. You know that this is likely because: You selected: Most states have passed laws to restrict sales of these products because they are being used to manufacture methamphetamine. Correct Explanation: The use of OTC products containing pseudoephedrine to manufacture methamphetamine has increased at an alarming rate. Most states have passed laws placing these products behind phar ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 550. Question 4: (see full question) A 76-year-old man with a history of heart disease has been prescribed an oral decongestant. The nurse is concerned with this prescription because of the risk for You selected: serious cardiovascular effects. Correct Explanation: Oral decongestants are contraindicated or (at minimum) used with caution in patients with severe cardiovascular disease or severe hypertension because of the risks for increased he ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 5: (see full question) After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching? You selected: "I'll keep the room warm and toasty." Correct Explanation: Measures to assist with cough control when using antitussives include cool temperatures, humidification, lozenges, and increased fluids. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 6: (see full question) Which of the following statements by your client leads you to believe that he needs additional instruction regarding his nasal decongestant? You selected: "I will use it only when I have nasal discharge." Correct Explanation: Decongestants decrease the overproduction of secretions by causing local vasoconstriction to the upper respiratory tract. This vasoconstriction leads to a shrinking of swollen mucu ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 7: (see full question) Decongestants elicit their effect by which of the following mechanisms? (Choose one) You selected: Vasoconstriction of small blood vessels of the nasal membranes Correct Explanation: Vasoconstriction of small blood vessels of the nasal membrane is the mechanism of action for decongestants. First-generation antihistamines act to nonselectively bind to peripheral ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 8: (see full question) A male client presents to the physician'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? You selected: To be effective, Echinacea must be taken daily regardless of symptoms. Incorrect Correct response: There is limited or no support for the use of Echinacea to prevent or treat symptoms of the common cold. Explanation: There is limited or no support for the use of dietary or herbal supplements to prevent or treat symptoms of the common cold. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 549. Question 9: (see full question) Which drug is classified as an expectorant? You selected: Guaifenesin (Robitussin) Correct Explanation: Robitussin is an expectorant that contains guaifenesin. Mucomyst is a mucolytic that contains acetylcysteine. Delsym is a centrally acting antitussive that contains dextromethorpha ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 10: (see full question) What is an adverse reaction commonly experienced by people taking nasal decongestants? You selected: Rebound congestion Correct Explanation: An adverse effect that accompanies frequent or prolonged use of these drugs is a rebound congestion, officially called rhinitis medicamentosa. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 11: (see full question) A patient is advised to take a decongestant drug to relieve nasal congestion associated with hay fever. The patient is not comfortable with a nasal spray or drops and prefers an oral tablet. Which of the following oral decongestant drugs can be administered to the patient? You selected: Pseudoephedrine Correct Explanation: The patient can take an oral preparation of pseudoephedrine. Xylometazoline, ephedrine, and tetrahydrozoline are usually available only in the form of nasal sprays or drops for top ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 12: (see full question) Which of the following should the client be told about nasal drops? Select all that apply: You selected: • Sniff hard for a few minutes after administration. • Do not share the container with anyone. • Nasal burning or stinging may occur with the use of topical decongestants. Incorrect Correct response: • Recline on a bed and hang your head over the edge. • After using the drops keep head down and rotate it from side to side. • Do not share the container with anyone. • Nasal burning or stinging may occur with the use of topical decongestants. Explanation: A client should be counseled to administer nasal drops while reclined on a bed with their head over the edge and after using the drops to keep the head dose and rotate it from side ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 13: (see full question) A client expresses her belief that the common cold is caused by exposure to very cold air. The nurse would correct the client by stating that the common cold is caused by which type of microorganism? You selected: Virus Correct Explanation: The common cold, a viral infection of the upper respiratory tract, is the most common respiratory tract infection. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 14: (see full question) The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine You selected: an antihistamine, a stimulant, and a decongestant. Incorrect Correct response: a decongestant, an analgesic, and an antihistamine. Explanation: Many over-the-counter cold remedies are combination products that include an antihistamine, a nasal decongestant, and an analgesic. Some may also include an antitussive or an expec ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 15: (see full question) The nursing instructor is teaching the students about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students sometimes can cause drowsiness? You selected: antihistamine Correct Explanation: Antitussives that contain an antihistamine may cause drowsiness. The others are not found in antitussives and therefore do not cause the adverse reaction of drowsiness. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 16: (see full question) 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? You selected: "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." Incorrect Correct response: "We can use the adult brand, but we just have to decrease the amount." Explanation: Parents should use the children's, pediatric, or infant formulations of the drug. Over-the-counter cough and cold preparations should not be used in children under the ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 17: (see full question) A patient 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? You selected: Decongestants Correct Explanation: Decongestants cause local vasoconstriction that decrease blood flow to irritated and dilated capillaries of the mucous membranes lining the nasal passages and sinus cavities. The v ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 18: (see full question) As a student nurse, you are doing research consisting of chart audits of 25 patients with a diagnosis of chronic pharyngitis. You are researching what medication has been prescribed the most. What type of medication would you expect to find in the majority of the chart audits? You selected: Oral decongestants Incorrect Correct response: Antitussives Explanation: Antitussives are drugs that suppress the cough reflex. Many disorders of the respiratory tract, including the common cold, sinusitis, pharyngitis, and pneumonia are accompanied by ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 545. Question 19: (see full question) A male client presents to the physician'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? You selected: Rebound nasal swelling Correct Explanation: Rebound nasal swelling can occur with excessive or extended use of nasal sprays. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 20: (see full question) A 25-year-old female client presents at the clinic with bronchitis. The physician orders guaifenesin. Which of the following instructions should the clinic nurse offer when teaching the client about the medication? You selected: "Drink at least two liters of fluids each day." Correct Explanation: Clients requiring expectorants, antitussives, or decongestants should drink approximately two liters of fluids each day unless contraindicated by cardiovascular or renal disease. J ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547.

Question 1: (see full question) A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? You selected: Dextromethorphan works on the receptors in the throat to prevent a cough. Incorrect Correct response: Dextromethorphan works in the medulla to suppress the cough reflex. Explanation: Dextromethorphan is related chemically to the opiate agonists and can suppress coughing as effectively as narcotics. Cough suppression occurs by several mechanisms, but mainly the ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 545. Question 2: (see full question) A client reports severe nasal congestion for the last 8 days. The client has been using an OTC nasal decongestant spray. The nurse knows that this is indicative of: You selected: rebound nasal congestion. Correct Explanation: With nasal decongestants, topical preparations are often preferred for short-term use. They are rapidly effective because they come into direct contact with nasal mucosa. However, ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 3: (see full question) When describing the action of acetylcysteine in treating cystic fibrosis, which of the following would the nurse need to keep in mind about the drug? You selected: It liquefies secretions to decrease viscosity. Incorrect Correct response: It splits the disulfide bonds that hold mucus together. Explanation: In treating cystic fibrosis, acetylcysteine splits apart the disulfide bonds that are responsible for holding the mucus material together. When used to treat acetaminophen tox ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 548. Question 4: (see full question) A 79-year-old client calls the clinic requesting advice for something that will relieve nasal congestion. The nurse is aware that oral decongestants may cause which adverse effects in older adults? (Select all that apply.) You selected: • Hypertension • Bradycardia • Heart rhythm abnormalities • Nervousness Incorrect Correct response: • Hypertension • Heart rhythm abnormalities • Nervousness Explanation: Older adults may experience hypertension, heart rhythm abnormalities, nervousness, and insomnia when they use oral nasal decongestants. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 5: (see full question) A patient reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects? You selected: Ephedrine Incorrect Correct response: Pseudoephedrine Explanation: The side effects of pseudoephedrine include anxiety, restlessness, nausea and vomiting. The drugs ephedrine, epinephrine, and phenylephrine do not cause these side effects. Their s ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 6: (see full question) A patient with a productive cough should always be treated with an antitussive to relieve the cough. You selected: True Incorrect Correct response: False Explanation: Antitussives are used to relieve a nonproductive cough. When the cough produces sputum, it should be treated by the primary care provider, who, based on results of the physical exa ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 7: (see full question) What medications, if administered with dextromethorphan, could cause hypotension? You selected: Thiazide diuretics Incorrect Correct response: MAO inhibitors Explanation: Dextromethorphan should not be used with MAO inhibitors because hypotension, fever, nausea, myoclonic jerks, and coma could occur. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 8: (see full question) A client is taking pseudoephedrine. The nurse would assess the client for which of the following adverse effects? You selected: Lethargy Incorrect Correct response: Anxiety Explanation: Adverse effects related to the sympathomimetic effects of pseudoephedrine are more likely to occur, including feelings of anxiety, restlessness, hypertension, sweating, tensen ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 9: (see full question) The client asks, "What is the difference between antitussive medications and expectorants?" The best response is: You selected: Antitussives liquefy bronchial secretions, and expectorants assist in the expectoration of those secretions. Incorrect Correct response: Antitussives suppress coughing, and expectorants loosen bronchial secretions. Explanation: 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 ora ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, pp. 545-546. Question 10: (see full question) What home remedies are effective for mouth dryness and cough? (Select all that apply.) You selected: • Adequate fluid intake • Humidification of the environment • Sucking on hard candy or throat lozenges Correct Explanation: An adequate fluid intake, humidification of the environment, and sucking on hard candy or throat lozenges can help relieve mouth dryness and cough. The use of astringent mout ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 11: (see full question) The pharmacology instructor is discussing adverse effects associated with nasal decongestants. Which of the following is an effect of excessive use of these products? You selected: Rebound nasal congestion Correct Explanation: Rebound nasal congestion, chronic rhinitis, and ulceration of nasal mucosa are possible adverse effects of long-term or excessive use of nasal decongestants. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 12: (see full question) Your client states that he is taking medication to liquefy secretions in his respiratory tract. However, he cannot recall the name of the medication. He states that the medication is added to a nebulizer. You suspect he is taking which of the following medications? You selected: Mucomyst Correct Explanation: Mucolytics are administered by inhalation to liquefy mucus in the respiratory tract. Solutions of mucolytic drugs may be nebulized into a face mask or mouthpiece or instilled direc ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 13: (see full question) The nurse is teaching a 61-year-old client about the narcotic antitussive syrup that the physician has prescribed. Which client statement suggests that the client understands what the nurse has taught? You selected: "This medication might cause drowsiness, so I will avoid driving while I use it." Correct Explanation: Although narcotic antitussives include only small doses of narcotics, some of the adverse effects of that drug category (e.g., drowsiness, dizziness) are still possible. To decreas ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 14: (see full question) Acetylcysteine may be used as a mucolytic agent. Which of the following is an additional indication for the drug? You selected: Treatment of bronchospasm Incorrect Correct response: Antidote for acetaminophen poisoning Explanation: Oral acetylcysteine is widely used in the treatment of acetaminophen overdosage. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 548. Question 15: (see full question) A group of students demonstrate understanding of topical decongestants, identifying them as which of the following? You selected: Sympathomimetics Correct Explanation: Topical decongestants are sympathomimetics, imitating the effects of the sympathetic nervous system to cause vasoconstriction. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 16: (see full question) A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to You selected: stop taking the medication and come to the clinic as ordered by the physician. Correct Explanation: Cardiovascular adverse effects such as palpitations, tachycardia, hypertension, and arrhythmias are possible with the administration of pseudoephedrine (Sudafed). If the patient re ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 17: (see full question) A college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student? You selected: "You can probably expect to get relief within the next few days or a week at the longest." Incorrect Correct response: "You might find yourself more congested than ever as your body compensates for your use of these drugs." Explanation: Frequent, long-term, or excessive use of decongestants induces rebound congestion. Rebound congestion occurs when the nasal passages become congested as the drug effect wears off a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 18: (see full question) Expectorants elicit their effect by which of the following mechanisms? (Choose one) You selected: Thinning respiratory secretions Correct Explanation: Thinning respiratory secretions is the mechanism of action for expectorants. Breaking down thick mucus in the lower lungs is the mechanism of action of mucolytics. Depressing the c ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 19: (see full question) A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that You selected: she must be prepared to show identification when buying a drug that contains pseudoephedrine. Incorrect Correct response: drugs containing pseudoephedrine are available without a prescription but are kept off pharmacy shelves. Explanation: Sudafed and any combination drugs that contain pseudoephedrine have been removed from the shelves of drug stores, but they have not been taken off the market. Consumers must purcha ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 550. Question 20: (see full question) Prior to administering a mucolytic to a client what must the nurse document. (Select all that apply) You selected: • Consistency of sputum • Amount of dyspnea • Heart rate • Lung sounds Incorrect Correct response: • Lung sounds • Amount of dyspnea • Consistency of sputum Explanation: Heart rate and temperature are not required documentation prior to the administration of a mucolytic although they may be helpful in diagnosing an infection. Baseline description o ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551.

Question 1: (see full question) A nurse in a healthcare facility is preparing a teaching plan for a patient receiving an antitussive drug. What instructions should the nurse include in the teaching plan? Select all that apply. You selected: • Swallow capsules whole • Suck on sugarless hard candy • Take frequent sips of water Correct Explanation: Taking frequent sips of water, swallowing capsules whole, and sucking on sugarless hard candy are the instructions that the nurse should include in the teaching plan for a patient ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 2: (see full question) What statement by a 61-year-old client who is to take an antitussive with codeine indicates that your teaching has been effective? You selected: "This medication can cause drowsiness, so I will avoid driving while I use it." Correct Explanation: Codeine is a CNS depressant and should not be combined with driving or heavy machinery activities. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 3: (see full question) A patient presents at the clinic with a dry, non-productive cough. The patient is diagnosed with bronchitis, and it is determined that they need help thinning their sputum so their cough can become productive. What does the nurse expect the physician will prescribe? You selected: Guaifenesin (Mucinex) Correct Explanation: Since this patient needs to cough up respiration secretions, they would likely be prescribed guaifenesin. This drug is an expectorant, and it liquefies lower respiratory secretions ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 4: (see full question) A male client presents to the physician'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? You selected: Chronic nasal polyps Incorrect Correct response: Rebound nasal swelling Explanation: Rebound nasal swelling can occur with excessive or extended use of nasal sprays. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 5: (see full question) The nurse demonstrates an understanding of the action of the mucolytic drugs when stating which of the following? You selected: They are used to break down the thickness of secretions. Correct Explanation: Mucolytics are agents that break down the thickness of secretions for easier removal. An antitussive is used to relieve coughing for nonproductive coughs only. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 6: (see full question) Which agent acts directly on the medullary cough center? You selected: Benzonatate Incorrect Correct response: Codeine Explanation: Codeine, a centrally acting antitussive, works directly on the medullary cough center. Benzonatate provides local anesthetic action on the respiratory passages, lungs, and pl ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 454. Question 7: (see full question) You are speaking to a group of clients in a public meeting. They ask you to explain how colds should be treated. You would include which of the following in your explanation? You selected: The tendencies to overmedicate and use antibiotics inappropriately with the common cold are widespread and pose significant risk for complications and drug resistance. Correct Explanation: Common colds are caused by viruses, not bacteria. After the viruses gain entry, the incubation period is generally 5 days, the most contagious period is about 3 days after symptoms ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 8: (see full question) 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? You selected: "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." Incorrect Correct response: "We can use the adult brand, but we just have to decrease the amount." Explanation: Parents should use the children's, pediatric, or infant formulations of the drug. Over-the-counter cough and cold preparations should not be used in children under the ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 9: (see full question) 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 of the following would be most appropriate to include? Select all that apply. You selected: • 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 Correct Explanation: OTC cough and cold preparations should not be used in children under the age of 4 years. Accurate dosing is essential. Following the directions is essential to prevent inadvertent ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 10: (see full question) A patient 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? You selected: Antitussives Incorrect Correct response: Decongestants Explanation: Decongestants cause local vasoconstriction that decrease blood flow to irritated and dilated capillaries of the mucous membranes lining the nasal passages and sinus cavities. The v ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541.

Question 1: (see full question) A client reports severe nasal congestion for the last 8 days. The client has been using an OTC nasal decongestant spray. The nurse knows that this is indicative of: You selected: sinusitis. Incorrect Correct response: rebound nasal congestion. Explanation: With nasal decongestants, topical preparations are often preferred for short-term use. They are rapidly effective because they come into direct contact with nasal mucosa. However, ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 2: (see full question) A nurse is assigned to care for a patient who has to be administered dextromethorphan. From the patient's medical history, the nurse knows that the patient has been taking monoamine oxidase inhibitors. Which of the following effects of interaction of the two drugs should the nurse monitor for in this patient? You selected: Hypokalemia Incorrect Correct response: Hypotension, fever, nausea Explanation: The nurse should monitor for hypotension, fever, nausea jerking motions of the leg, and in severe cases, coma in a patient who has been taking monoamine oxidase inhibitors and is b ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 3: (see full question) A female client's four children, aged 12 through 18, have symptoms of a common cold. She calls the physician's office regarding advice for the most economical over- the-counter cold remedy. The nurse informs the mother that which product is the least expensive to purchase? You selected: Single-drug formulations Correct Explanation: Single-drug formulations allow flexibility and individualization of dosage, whereas combination products may contain unneeded ingredients and are more expensive. However, man ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 550. Question 4: (see full question) The client asks, "What is the difference between antitussive medications and expectorants?" The best response is: You selected: Antitussives liquefy bronchial secretions, and expectorants assist in the expectoration of those secretions. Incorrect Correct response: Antitussives suppress coughing, and expectorants loosen bronchial secretions. Explanation: 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 ora ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, pp. 545-546. Question 5: (see full question) Which agent would the nurse instruct a client to use orally? You selected: Pseudoephedrine Correct Explanation: Pseudoephedrine is the only oral decongestant. Phenylephrine, tetrahydrozoline, and xylometazoline are topical decongestants. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 499. Question 6: (see full question) A patient with a productive cough should always be treated with an antitussive to relieve the cough. You selected: True Incorrect Correct response: False Explanation: Antitussives are used to relieve a nonproductive cough. When the cough produces sputum, it should be treated by the primary care provider, who, based on results of the physical exa ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 7: (see full question) Your client experiences frequent sinus infections. What is a major cause of the infections? You selected: Inflammatory processes Correct Explanation: As in other parts of the respiratory tract, in the sinuses ciliated mucous membranes help move fluid and microorganisms out and into the nasal cavity. This movement becomes impaire ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 8: (see full question) A male client presents to the physician's office with symptoms of a common cold. He asks the nurse to suggest over-the-counter drugs to alleviate his symptoms. Before recommending an over-the-counter medication, what action should the nurse take? You selected: Obtain a complete drug history Correct Explanation: Before recommending a particular product, the nurse needs to assess the intended recipient for conditions or other medications that contraindicate the product's use. ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 9: (see full question) A 29-year-old female client has sinusitis, so the physician orders a topical nasal decongestant. What instructions should be given? You selected: Increase fluids to 2 L per day Correct Explanation: Institute other measures to help relieve the discomfort of congestion (e.g., humidity, increased fluid intake, cool environment, avoidance of smoke-filled areas) as appropriate. Th ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 10: (see full question) What would be the nurse's best response if a patient calls the clinic and reports a persistent cough for 2 weeks and then asks the nurse for a recommendation for a cough medicine? You selected: "You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem." Correct Explanation: A cough that has persisted for 2 weeks could be indicative of an underlying medical condition that should be addressed before treating the cough. The patient should be asked to com ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544.

Question 1: (see full question) Which of the following should the client be told about nasal spray? Select all that apply: You selected: • Nasal burning or stinging may occur with the use of topical decongestants. • Do not share the container with anyone except family members. • Recline on a bed and hang your head over the edge. Incorrect Correct response: • Sniff hard for a few minutes after administration. • Nasal burning or stinging may occur with the use of topical decongestants. Explanation: A client should be counseled to administer a nasal spray while sitting upright, do not allow the tip of the container to touch the nasal mucosa, and to sniff hard for a few minutes ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 2: (see full question) 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 of the following would be most appropriate to include? Select all that apply. You selected: • Importance of reading the label for ingredients and dosage • Using adult formulation with smaller doses • Avoidance of use in children under age 2 • Need to follow the directions for how often to give the drug Incorrect Correct response: • 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 Explanation: OTC cough and cold preparations should not be used in children under the age of 4 years. Accurate dosing is essential. Following the directions is essential to prevent inadvertent ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 3: (see full question) The nursing instructor is teaching students about the administration of nasal sprays. According to the instructor, the correct patient position for administering the sprays is closest to You selected: high Fowler's position. Correct Explanation: The patient should be standing or sitting during administration of nasal sprays. This is closest to high Fowler's position. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 4: (see full question) A patient presents at the clinic with a dry, non-productive cough. The patient is diagnosed with bronchitis, and it is determined that they need help thinning their sputum so their cough can become productive. What does the nurse expect the physician will prescribe? You selected: Guaifenesin (Mucinex) Correct Explanation: Since this patient needs to cough up respiration secretions, they would likely be prescribed guaifenesin. This drug is an expectorant, and it liquefies lower respiratory secretions ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 5: (see full question) A patient presents at the clinic with a dry, nonproductive cough. The patient is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect the physician will prescribe? You selected: Guaifenesin Correct Explanation: Expectorants, such as guaifenesin, are agents given orally to liquefy respiratory secretions and allow for easier removal. Dextromethorphan and codeine are antitussives used to sup ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 6: (see full question) A patient is sent home with a prescription for codeine to suppress a cough and to help with mild discomfort. Which of the following should the nurse tell this patient to avoid while taking this medication? You selected: alcohol Correct Explanation: Other central nervous system depressants and alcohol may cause additive depressant effects when administered with antitussives containing codeine. The other choices are allowed whe ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 7: (see full question) As a student nurse, you are doing research consisting of chart audits of 25 patients with a diagnosis of chronic pharyngitis. You are researching what medication has been prescribed the most. What type of medication would you expect to find in the majority of the chart audits? You selected: Nasal sprays Incorrect Correct response: Antitussives Explanation: Antitussives are drugs that suppress the cough reflex. Many disorders of the respiratory tract, including the common cold, sinusitis, pharyngitis, and pneumonia are accompanied by ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 545. Question 8: (see full question) When teaching a patient who is receiving pseudoephedrine about possible adverse effects, which of the following would the nurse include? Select all that apply. You selected: • Sedation • Hypertension • Anxiety • Restlessness Incorrect Correct response: • Hypertension • Anxiety • Restlessness Explanation: Possible adverse effects associated with pseudoephedrine are related to the sympathomimetic effects and include anxiety, tenseness, restlessness, hypertension, pallor, and sweating ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 9: (see full question) A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? (Choose one) You selected: Expectorant Incorrect Correct response: Mucolytic Explanation: Dornase alfa (Pulmozyme) is a mucolytic use in the treatment of cystic fibrosis. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 10: (see full question) Mr. Johnson is prescribed pseudoephedrine to relieve his nasal congestion. What should the nurse include in patient and family education? (Choose all that apply.) You selected: • Advise him to avoid grapefruit juice. • Advise him not to take other OTC drugs. • Advise him to avoid excessive and frequent use of the drug. Incorrect Correct response: • Advise him to avoid excessive and frequent use of the drug. • Advise him not to take other OTC drugs. Explanation: As there is a possibility of CNS effects, it is important to outline safety measures during administration of pseudoephedrine drug therapy. A serious overdose could occur if patien ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 11: (see full question) While using a decongestant, a client should be instructed to call the physician if which of the following occur? Select all that apply: You selected: • A high fever develops. • Symptoms do not improve in seven days. Correct Explanation: The physician should be contacted before continuing use of a decongestant if symptoms do not improve in seven days, a high fever develops, or severe nasal burning or stinging occur ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, pp. 542-544. Question 12: (see full question) 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 physician advises against the medication, for what reason? You selected: The medication is contraindicated for the child's symptoms. Incorrect Correct response: Misuse could result in overdose. Explanation: Several OTC cough and cold medicines for use in infants have been recalled voluntarily due to concerns about possible misuse that could result in overdoses. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 13: (see full question) Guaifenesin 200 mg PO every 4 hours as needed is ordered for a patient with a respiratory ailment. The nurse understands that this medication is given for which of the following reasons? You selected: reduction of viscosity of mucus Incorrect Correct response: relief of cough Explanation: Guaifenesin, when given PRN, relieves cough usually associated with a respiratory tract infection. Opioid antitussives are given for relief of cough and mild pain, while mucolytics ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 14: (see full question) Which of the following are included in the pre-administration assessment of an antitussive? Select all that apply: You selected: • Temperature • Type of cough • Sputum presence Correct Explanation: Vital signs, type of cough, presence of sputum, color and amount of sputum, home remedies used, and actions taken should be taken prior to initiation of an antitussive. Bowel and h ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 15: (see full question) What information should be obtained from the client by the nurse and documented prior to the administration of antitussive? (Select all that apply) You selected: • Type of cough • Vital signs • Presence of sputum • Color and amount of sputum Incorrect Correct response: • Type of cough • Presence of sputum • Color and amount of sputum • Home remedies used to treat the cough • Vital signs Explanation: All of the answers listed above are important to obtain from the patient and document for the provider to insure optimal and appropriate treatment of the client's cough. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 16: (see full question) The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine You selected: a decongestant, an analgesic, and an antihistamine. Correct Explanation: Many over-the-counter cold remedies are combination products that include an antihistamine, a nasal decongestant, and an analgesic. Some may also include an antitussive or an expec ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 17: (see full question) 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? You selected: "We can use the adult brand, but we just have to decrease the amount." Correct Explanation: Parents should use the children's, pediatric, or infant formulations of the drug. Over-the-counter cough and cold preparations should not be used in children under the ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 18: (see full question) Decongestants should be used cautiously in clients with which of the following? Select all that apply: You selected: • Hypothyroidism • Hypotension • Diabetes Incorrect Correct response: • Diabetes • Glaucoma Explanation: Clients with diabetes, heart disease, hypertension, hyperthyroidism, benign prostatic hypertrophy, and glaucoma should contact their physician before taking over the counter decong ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 19: (see full question) An instructor is describing topical decongestants as belonging to which class? You selected: Sympathomimetics Correct Explanation: Topical decongestants are sympathomimetic, imitating the effects of the sympathetic nervous system to cause vasoconstriction. Pseudoephedrine has adrenergic properties. Topica ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 20: (see full question) When instructing a patient in how to use a topical nasal spray, which of the following would the nurse emphasize to do first? You selected: Spray the medication with the bottle upright Incorrect Correct response: Clear the nasal passages Explanation: Before administering the nasal spray, it would be important to clear the nasal passages to ensure that the medication reaches its intended target thereby promoting effectiveness.

Question 1: (see full question) A college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student? You selected: "You might find yourself more congested than ever as your body compensates for your use of these drugs." Correct Explanation: Frequent, long-term, or excessive use of decongestants induces rebound congestion. Rebound congestion occurs when the nasal passages become congested as the drug effect wears off a ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 551. Question 2: (see full question) Which agent would the nurse instruct a client to use orally? You selected: Pseudoephedrine Correct Explanation: Pseudoephedrine is the only oral decongestant. Phenylephrine, tetrahydrozoline, and xylometazoline are topical decongestants. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 499. Question 3: (see full question) Acetylcysteine may be used as a mucolytic agent. Which of the following is an additional indication for the drug? You selected: Antidote for acetaminophen poisoning Correct Explanation: Oral acetylcysteine is widely used in the treatment of acetaminophen overdosage. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 548. Question 4: (see full question) A patient with a productive cough should always be treated with an antitussive to relieve the cough. You selected: True Incorrect Correct response: False Explanation: Antitussives are used to relieve a nonproductive cough. When the cough produces sputum, it should be treated by the primary care provider, who, based on results of the physical exa ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 5: (see full question) A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? You selected: Dextromethorphan works in the medulla to suppress the cough reflex. Correct Explanation: Dextromethorphan is related chemically to the opiate agonists and can suppress coughing as effectively as narcotics. Cough suppression occurs by several mechanisms, but mainly the ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 545. Question 6: (see full question) A male client presents to the physician's office with symptoms of a common cold. He asks the nurse to suggest over-the-counter drugs to alleviate his symptoms. Before recommending an over-the-counter medication, what action should the nurse take? You selected: Obtain a complete drug history Correct Explanation: Before recommending a particular product, the nurse needs to assess the intended recipient for conditions or other medications that contraindicate the product's use. ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 542. Question 7: (see full question) The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness? You selected: They treat multiple symptoms in a cost-effective manner. Incorrect Correct response: They come into direct contact with nasal mucosa. Explanation: With nasal decongestants, topical preparations (i.e., nasal solutions or sprays) are often preferred for short-term use. They are rapidly effective because they come into dire ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 8: (see full question) Your client experiences frequent sinus infections. What is a major cause of the infections? You selected: Inflammatory processes Correct Explanation: As in other parts of the respiratory tract, in the sinuses ciliated mucous membranes help move fluid and microorganisms out and into the nasal cavity. This movement becomes impaire ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 540. Question 9: (see full question) A 29-year-old female client has sinusitis, so the physician orders a topical nasal decongestant. What instructions should be given? You selected: Increase fluids to 2 L per day Correct Explanation: Institute other measures to help relieve the discomfort of congestion (e.g., humidity, increased fluid intake, cool environment, avoidance of smoke-filled areas) as appropriate. Th ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 544. Question 10: (see full question) Acetylcysteine (Mucomyst) is primarily administered by which of the following routes when being used to thin secretion? Select all that apply: You selected: • Orally • Inhalation Incorrect Correct response: • Instilled into a tracheostomy • Inhalation Explanation: While acetylcysteine (Mucomyst) can be administered orally in the treatment of acetaminophen overdose, it is primarily given by nebulizer or instilled into tracheostomy to thin sec ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 548.

Question 1: (see full question) Which of following is used to evaluate effectiveness of antitussive therapy? Select all that apply: You selected: • Assessment of vital signs • Assessment of therapeutic response • Assessment of airway • Identification of adverse reactions Incorrect Correct response: • Evidence of injury • Assessment of airway • Assessment of therapeutic response • Identification of adverse reactions Explanation: All of the answers are used in determining the effectiveness of antitussive therapy except assessment of vital signs. The other part of evaluating effectiveness of antitussive ther ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 2: (see full question) The nursing instructor is teaching the students about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students sometimes can cause drowsiness? You selected: antihistamine Correct Explanation: Antitussives that contain an antihistamine may cause drowsiness. The others are not found in antitussives and therefore do not cause the adverse reaction of drowsiness. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 546. Question 3: (see full question) Guaifenesin 200 mg PO every 4 hours as needed is ordered for a patient with a respiratory ailment. The nurse understands that this medication is given for which of the following reasons? You selected: reduction of viscosity of mucus Incorrect Correct response: relief of cough Explanation: Guaifenesin, when given PRN, relieves cough usually associated with a respiratory tract infection. Opioid antitussives are given for relief of cough and mild pain, while mucolytics ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 4: (see full question) Your client complains that he has had difficulty finding OTC nasal decongestants. You know that this is likely because: You selected: Most states have passed laws to restrict sales of these products because they are being used to manufacture methamphetamine. Correct Explanation: The use of OTC products containing pseudoephedrine to manufacture methamphetamine has increased at an alarming rate. Most states have passed laws placing these products behind phar ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 550. Question 5: (see full question) A patient 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? You selected: Decongestants Correct Explanation: Decongestants cause local vasoconstriction that decrease blood flow to irritated and dilated capillaries of the mucous membranes lining the nasal passages and sinus cavities. The v ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 6: (see full question) Decongestants elicit their effect by which of the following mechanisms? (Choose one) You selected: Vasoconstriction of small blood vessels of the nasal membranes Correct Explanation: Vasoconstriction of small blood vessels of the nasal membrane is the mechanism of action for decongestants. First-generation antihistamines act to nonselectively bind to peripheral ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 541. Question 7: (see full question) 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 of the following would be most appropriate to include? Select all that apply. You selected: • Importance of reading the label for ingredients and dosage • Need to follow the directions for how often to give the drug • Avoidance of use in children under age 2 Correct Explanation: OTC cough and cold preparations should not be used in children under the age of 4 years. Accurate dosing is essential. Following the directions is essential to prevent inadvertent ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 543. Question 8: (see full question) Which drug is classified as an expectorant? You selected: Guaifenesin (Robitussin) Correct Explanation: Robitussin is an expectorant that contains guaifenesin. Mucomyst is a mucolytic that contains acetylcysteine. Delsym is a centrally acting antitussive that contains dextromethorpha ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 9: (see full question) A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? (Choose one) You selected: Mucolytic Correct Explanation: Dornase alfa (Pulmozyme) is a mucolytic use in the treatment of cystic fibrosis. Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 547. Question 10: (see full question) First-generation antihistamines may be effective against what symptoms? (Select all that apply.) You selected: • Rhinorrhea • Cough • Sneezing Correct Explanation: First-generation antihistamines (e.g., chlorpheniramine, diphenhydramine) have anticholinergic effects that may reduce sneezing, rhinorrhea, and cough. They do not have antip ... (more) Reference: Frandsen, G., & Pennington, S.S. Abrams' Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 29: Drug Therapy for Nasal Congestion, p. 548, 551.

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