Chapter 54: Drugs Acting on the Upper Respiratory Tract

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame? a)30 minutes b)15 minutes c)45 minutes d)60 minutes

a)30 minutes

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

a)Mucolytic

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

a)Retention of secretions

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage? a)decreased sedation b)once-weekly dosing c)absence of adverse effects d)lower cost

a)decreased sedation

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

b)"Consult with your primary care provider."

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? a)"We need to read the label carefully to see how often and how much to give." b)"We can use the adult brand, but we just have to decrease the amount." c)"We can use over-the-counter products for our 5-year-old but not for our 18-monthold." d)"We should use the cup that comes with the drug to measure it out."

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

After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching? a)"I can use some lozenges for comfort." b)"I need to increase the amount of fluids I drink." c)"I'll keep the room warm and toasty." d)"I'll get a humidifier for my bedroom."

c)"I'll keep the room warm and toasty."

While using a decongestant, a client should be instructed to call the health care provider if which occur? (Select all that apply.) a)If sedation occurs. b)Transient nasal stinging or burning occurs. c)A high fever develops. d)If symptoms improve in three days. e)Symptoms do not improve in seven days.

c)A high fever develops. e)Symptoms do not improve in seven days.

Which agent would the nurse identify as providing local anesthesia to the respiratory passages? a)Dextromethorphan b)Hydrocodone c)Benzonatate d)Ephedrine

c)Benzonatate

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased? a)Hypersensitivity b)Dry mouth c)Sedation d)Gastrointestinal upset

c)Sedation

A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? a)Take an antacid before the tablet. b)Take the tablet one hour before food. c)Take the tablet with food. d)Drink ample water before taking the tablet.

c)Take the tablet with food.

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

d)Antidote for acetaminophen poisoning

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

d)Dry mouth

What medication would be administered to counteract the effect of acetaminophen? a)oxymetazoline hydrochloride b)daptomycin c)darbepoetin alfa d)acetylcysteine

d)acetylcysteine

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

a)Pseudoephedrine

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

c)They come into direct contact with nasal mucosa.

A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? a)Antitussives kill cold viruses while expectorants liquefy bronchial secretions. b)Antitussives suppress coughing while expectorants loosen bronchial secretions. c)Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. d)Both drug types loosen bronchial secretions for ease of removal.

b)Antitussives suppress coughing while expectorants loosen bronchial secretions.

A client, having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which body effect is occurring? a)decreased secretion of the mucous glands b)decreased permeability of the veins and capillaries c)contraction of smooth muscle in the bronchi d)suppression of the vagus nerve endings producing tachycardia

c)contraction of smooth muscle in the bronchi

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? a)Acetylcysteine b)Dextromethorphan c)Benzonatate d)Guaifenesin

d)Guaifenesin

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.) a)Benzonatate can cause GI upset and sedation. b)Benzonatate can be taken more frequently than prescribed if needed. c)Benzonatate capsules should be sucked on like a lozenge. d)The client should drink plenty fluids. e)Consumption of alcohol is okay while taking benzonatate.

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

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

a)ineffective airway clearance

A nurse is teaching a 55-year-old client about fexofenadine prescribed to treat allergic symptoms. Which client statement suggests an understanding of this teaching? a)"Taking this medication shouldn't stop me from having my after-dinner drink." b)"I should avoid driving after taking this medication." c)"It's safe to take this medication with the nighttime sinus medication that I've been using." d)"This medication has no serious side effects."

b)"I should avoid driving after taking this medication."

An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine? a)promethazine b)diphenhydramine c)olopatadine d)loratadine

b)diphenhydramine

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

a)Decongestants

Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis. a)True b)False

a)True

Which condition would contraindicate the use of or oxymetazoline? a)skin rash b)cough c)hypertension d)nasal congestion

c)hypertension

The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification? a)"I will blow my nose before using the nasal spray." b)"I can take over-the-counter pseudoephedrine, too." c)"The drug is used no longer than 3 days." d)"I will rinse the spray tip off after each use."

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

A female client presents at the clinic with a dry, nonproductive cough. The client 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 will be prescribed for the client? a)Dextromethophan b)Guaifenesin c)Aspirin d)Codeine

b)Guaifenesin

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? a)Nasal burning b)Nonproductive cough c)Dry mouth d)Drowsiness

d)Drowsiness

A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis? a)Risk for deficient fluid volume related to diuresis b)Risk for impaired skin integrity related to urticaria c)Risk for infection related to adverse effects of antihistamines d)Risk for falls related to sedation

d)Risk for falls related to sedation

Katie, 14 years old, is seen by the health care provider due to increased nasal congestion and a sore throat lasting 2 days. Katie reports to the provider that every fall at this time she has increased nasal congestion and pressure. Upon examination, the provider notes enlarged turbinates with excessive mucus in the nose and at the back of the throat and a reddened throat. The provider prescribes pseudoephedrine. Why is Katie being prescribed this medication? a)To relieve the throat pain and nasal pressure b)To decrease mucus production from the sinus cavities c)To decrease the size of the turbinates by vasoconstriction d)To provide relief of the nasal congestion

d)To provide relief of the nasal congestion

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism? a)Anesthetizing stretch receptors in the respiratory passages b)Nonselectively binding to central and peripheral H1 receptors c)Selectively binding to peripheral H1 receptors d)Vasoconstriction of small blood vessels of the nasal membranes

d)Vasoconstriction of small blood vessels of the nasal membranes

A client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells? a)CD4 T cells b)lymphocytes c)platelets d)basophils

d)basophils

To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure? a)reducing salt intake b)deep breathing and exercises c)gargling with normal saline d)increasing fluid intake

d)increasing fluid intake

A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.) a)Using adult formulation with smaller doses b)Need to follow the directions for how often to give the drug c)Importance of reading the label for ingredients and dosage d)Using household measuring devices for dosage measurements e)Avoidance of use in children under age 2

b)Need to follow the directions for how often to give the drug c)Importance of reading the label for ingredients and dosage e)Avoidance of use in children under age 2

What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies? a)"If you didn't have allergies as a child, you won't develop allergies later in life." b)"The additives that are in drugs can also cause allergic reactions." c)"All drugs have the potential to cause an allergic reaction." d)"Virtually any drug may induce an immunologic response in a susceptible person."

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

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

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

A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason? a)Misuse could result in overdose. b)The medication is not effective for croup. c)The medication is contraindicated for the child's symptoms. d)The medication is contraindicated for viral infections.

a)Misuse could result in overdose.

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

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

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

c)The client has a history of cataracts