ATI Pharmacology Made Easy 4.0: The Respiratory System 2

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

A. "Avoid taking nonsteroidal 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.

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 the fluticasone inhaler? A. Albuterol will increase the absorption of fluticasone. B. Albuterol will decrease inflammation. C. Albuterol will reduce nasal secretions. D. Fluticasone will reduce the adverse effects of albuterol.

A. Albuterol will increase the absorption of fluticasone. RATIONALE Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.

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? A. Headache B. Sleepiness C. Hypotension D. Constipation

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

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

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

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

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

B. Potentiation of depression of CNS actions RATIONALE Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.

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? A. Suppresses the cough stimulus B. Reduces surface tension C. Reduces inflammation D. Dries mucous membranes

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

B. 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.

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks? A. respiratory depression B. drug abuse C. drug tolerance D. rebound congestion

B. 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 about using intranasal glucocorticoids. What should they include? A. Start at a low dose and gradually increase it. B. Take the drug as needed for nasal congestion. C. Allow at least 2 weeks for the full therapeutic effect. D. Use the drug prior to exercise.

C. 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? A. Thins mucus B. Relaxes bronchial smooth muscle C. Decreases inflammation D. Increases the cough threshold

C. Decreases inflammation RATIONALE Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

A nurse is caring for a patient who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? A. ipratropium B. beclomethasone C. acetylcysteine D. azelastine

C. acetylcysteine RATIONALE acetylcysteine is a mucolytic that loosens thick respiratory secretions

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? A. decrease viscosity of nasal secretions B. block H2 receptors C. prevent histamine from binding to receptors D. reduce nasal congestion

C. 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 should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? A. Peptic ulcer disease B. A seizure disorder C. Anemia D. Coronary artery disease

D. 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.

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

D. 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 to 3 months during the first year of treatment.

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? A.Increases leukocyte activity B. Blocks muscarinic receptors C. Causes bronchodilation D. Reduces inflammation

D. Reduces inflammation Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.

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

D. 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.

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? A. fever B. bruising C. polyuria D. palpitations

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

A nurse is teaching a client about ipratropium.The nurse would include that this drug has which of the following adverse effects? (Select all that apply) A. muscle tremors B. urinary retention C. dry mouth D. insomnia E. tachycardia

B. urinary retention C. dry mouth RATIONALE Urinary retention can occur with ipratropium, an inhaled anticholinergic. Dry mouth is correct because Ipratropium can dry oral secretions.

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? (Select all that apply) A. Restlessness B. Bradycardia C. Insomnia D. Muscle pain E. Anxiety

A. Restlessness C. Insomnia E. Anxiety RATIONALE Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. Anxiety is an adverse effect of pseudoephedrine. Insomnia is an adverse effect of pseudoephedrine.

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? A. blood pressure B. apical heart rate C. respirations D. level of consciousness

C. respirations RATIONALE: the greatest risk to clients who are taking codeien, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.

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? A. suppress the cough stimulus B. reduces inflammation C. thins and loosens mucus D. dreies secretions

C. thins and loosens mucus RATIONALE mucolytics make mucus less viscous to increase a cough's productivity

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? A. take the drug as needed for acute asthma B. follow a low sodium diet C. use an alternate-day dosing schedule D. increase weight bearing activity

D. 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 LABA combination medication

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

A. Over-the-counter cold products can also contain guaifenesin. RATIONALE Many combination 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 who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? A. Seizures B. Constipation C. Normal sinus rhythm D. Somnolence

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