CoursePoint Quizzes Exam 2

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the client about this prescription during discharge counseling? (Select all that apply.)

-Benzonatate can cause GI upset and sedation. -The patient should drink plenty of fluids. Rationale: The adverse effects of benzonatate include sedation, headache, dizziness, constipation, nausea, GI upset, pruritus, and nasal congestion. It is recommended that patients with cough drink plenty of fluids (1500 to 2000 mL daily) unless fluids are contraindicate due to another disease state. Benzonatate should not be crushed or chewed due to a local anesthetic effect resulting in possible choking. Consumption of alcohol while taking benzonatate can increase CNS depression and increased sedation. The maximum daily dose of benzonatate is 600 mg daily.

A patient is receiving aminophylline orally. The nurse would expect this drug to begin acting within which time frame?

1-6 hours

The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?

15mcg/ml

A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame?

30 minutes

A client has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?

A 65-year old male with asthma

A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?

A modified dose of aminophylline

What medication would be administered to counteract the effect of acetaminophen?

Acetylcysteine (Mucomyst)

When describing the action of acetylcysteine in treating cystic fibrosis, which would the nurse need to keep in mind about the drug?

Acetylcysteine, in treating CF, splits apart the disulfide bonds that are responsible for holding the mucous material togethe

After reviewing information about drugs used to treat lower respiratory system conditions, a group of nursing students demonstrate understanding of the information when they identify which as an example of a short-acting beta-2 agonist (SABA)?

Albuterol

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is:

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

A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?

Asthma

A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?

Coffee

The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?

Contact the care provider and inform him or her that the client has toxic theophylline levels.

A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?

Cromolyn

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

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

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

"I'll keep my room warm and toasty"

When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?

"When I am short of breath, I will increase the use of my fluticasone." Rationale: Fluticasone is an inhaled steroid and should not be used during acute asthmatic attacks. Washing linens weekly will decrease the incidence of dust mites. When clients can participate in some, but not all of usual activities, they are in the yellow zone. Once medication is inhaled, the client should hold his or her breath for 10 seconds so that medication can reach deep into the lungs.

What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies?

"if you did not have allergies as child you will not have allergies as an adult

Which of the following would be most important to assess before administering calfactant? (Select all that apply.)

Endotracheal tube placement Lung sounds Oxygen saturation levels

After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?

Fluticasone

The client has mild, persistent asthma. The nurse anticipates the healthcare provider prescribing which daily medications?

Fluticasone

The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?

I need to shake the inhaler well before taking the medication

A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?

I'll keep taking my medications until I am not experiencing any more symptoms

A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?

Inhalation

A client, diagnosed with asthma, is prescribed a leukotriene receptorantagonist. The nurse will discuss the importance of which diagnostic lab tests to determine how effectively the medication is being metabolized and excreted? Select all that apply.

Kidney function Liver function

A newborn, experiencing ineffective alveolar expansion, is receiving treatment. What intervention should the nurse implement to assure the administration of the prescribed medication has been effective?

Monitoring respirations for bilateral chest movement

When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply.

Offer ice chips. Take frequent sips of water. Suck on sugarless hard candy.

What elicits their pharmacological effect by reducing swelling in the nasal passages by vasoconstriction? (Select all that apply.)

Phenylephrine Oxymetazoline

A client reports experiencing severe nasal congestion since starting to use an over-the-counter (OTC) nasal decongestant spray a week ago. This symptomology most supports what possible medical condition?

Rebound congestion Rationale: Nasal decongestants are rapidly effective because they come into direct contact with nasal mucosa. However, if used longer than the recommended 3 days or in excessive amounts, these products may produce rebound nasal congestion that result from the irritation and swelling of the nasal mucosa. The other options would present with distinctive symptomology.

A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?

Relaxation of smooth muscle

The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?

SABA

A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?

Salmeterol is contraindicated based on his wife's condition. Rationale: The FDA has issued a black box warning that initiating salmeterol in people with significantly worsening or acutely deteriorating asthma may be life threatening

A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family provider. What effect will the client's smoking status have on the therapeutic use of theophylline?

The client may require higher doses of theophylline than a nonsmoker

A male client presents to the health care provider's office for his annual visit. When questioned about over-the-counter medication use, he states that he uses echinacea to prevent colds. What statement is true about echinacea?

There is limited or no support for the use of Echinacea to prevent or treat symptoms of the common cold.

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

True Rationale: Mucolytics increase or liquefy respiratory secretions to aid the clearing of the airways in high-risk respiratory patients who are coughing up thick, tenacious secretions. Patients may be suffering from conditions such as chronic obstructive pulmonary disease (COPD), cystic fibrosis, pneumonia, or tuberculosis.

What type of cough is best treated with dextromethorphan?

a dry non productive cough

The client states that he/she once needed medication to liquefy secretions in the respiratory tract. However, the client cannot recall the name of the medication but states that the medication is added to a nebulizer. The nurse suspects the client is taking which medication?

actylcysteine

A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client?

albuterol

During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?

albuterol

Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?

albuterol causes relaxation of brachial smooth muscles

Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug?

antidote for acetaminophen poisoning

A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?

antihistamine

The nursing instructor is teaching about antitussives and their side effects. What ingredient found in some antitussives does the instructor tell students can cause drowsiness?

antihistamine

A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?

chocolate

A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?

cigarette smoking

There are two types of antitussives, centrally acting and peripherally acting. Which are centrally acting antitussives? (Select all that apply.)

codedine dextromethorphan

A client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage?

coffee

The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?

coffee

A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response?

consult with your primary care provider

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

contraction of smooth muscle in the Bronchi

When describing the benefits of second-generation H1 receptor antagonists to those of first-generation H1 receptor antagonists, the nurse should cite what advantage?

decreased sedation

A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients?

drowsiness

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

dry mouth

A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?

epinephrine

The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects?

excessive salivation

What is considered a possible trigger for an asthma attack? Select all that apply.

exercise cigarette smoke allergens pollutants

A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example?

guaifenesin (Robitussin)

A client diagnosed with asthma is being prescribed a leukotriene receptor antagonist as part of their mediation therapy. The nurse should encourage the client to report incidence of what events as possible adverse effects of the new medication? Select all that apply.

headache fever muscle aches diarrhea

What is the chemical mediator released in immune and inflammatory response to allergic reactions?

histamine

Which condition would contraindicate the use of or oxymetazoline?

hypertension

To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure?

increasing fluid intake

The triage nurse in the emergency department has a 42-year-old client with asthma present for treatment. The client's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this client?

ineffective breathing pattern

How do inhaled corticosteroid agents assist in the treatment of asthma?

inhaled corticosteroid agents will reduce airway inflammation

A neonate is receiving beractant. The nurse understands that this agent is administered by which route?

intratracheal

A client has been suffering from repeated sinus infections. The client is diagnosed with allergic rhinitis. The client is prescribed a daily antihistamine. What is the mechanism of action in the antihistamine medications?

it prevents histamine from working on target tissues

Which agent would a nurse expect the health care provider to prescribe for a client experiencing motion sickness?

meclizine

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

misuse can result in overdose

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

mucolytic

The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?

nausea and vomiting

While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?

peanuts

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 oral decongestant drugs can be administered to the patient?

pseudoephedrine

Which agent would the nurse instruct a client to use orally?

pseudoephedrine

The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?

rinse mouth with water after each use

When describing the effects of second-generation antihistamines, which would the nurse address as being decreased?

sedation

A client prescribed albuterol should be educated on identifying and managing which adverse reaction?

tachycardia

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?

take the tablet with food

A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which common adverse effects of the drug?

throat irritation

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?

to provide the relief of nasal congestion

A client is being assessed by the home care nurse on the appropriate use of her metered-dose inhalers. Instructions concerning which intervention will assist a client in the proper administration of the metered-dose inhaler?

using a spacer

When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism?

vasoconstriction of small blood vessels of the nasal membranes