Unit 5: ATI The Respiratory System

You are instructing a client about using cromolyn via inhalation to treat exercise-induced bronchospasm. You advise the client to take the drug... A. 15 minutes before exercising B. If needed to stop bronchospasm C. After strenuous activity D. Once in the evening at bedtime

A

You should advise a client who is using a beclomethasone oral inhaler to watch for which of the following possible indication of an adverse effect of this drug? A. White coating in the mouth B. Abdominal pain C. Muscle twitching D. Papitations

A

You should instruct a client using phenylephrine spray for nasal congestion to do which of the following to avoid rebound congestion? A. Limit the drug's use to 3-5 days B. Add an intranasal glucocorticoid C. Taper the dose before discontinuation D. Restrict the drug's use to one nostril at a time

A

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 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.

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin which combination over-the-counter 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 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 are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

Which of the following information should you include when teaching a client about the use of an albuterol inhaler for asthma management? A. Use it every 12 hours B. Use it periodically to prevent exercise-induced asthma C. Store the drug canister in the refrigerator D. Watch for an oral yeast infection

B

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 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.

You are obtaining a health history from a client who is to start using a new ipratropium inhaler. Which of the following information from the client's history alerts you to take further action? (Select all that apply) A. Seizure disorder B. Urinary retention C. Depression treated with a monoamine oxidase inhibitor (MAOI) D. Hypothyroidism treated with synthetic thyroid hormone E. Glaucoma

B and E

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

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 Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

Which of the following information indicates that a client who is taking theophylline needs further instruction? A. The client drives a school bus everyday B. The client drinks 8oz of wine with dinner C. The client exercises 1 hour each day D. The client drinks 2 cups of coffee each morning

D

You are instructing a client who has a new prescription for cetirizine. Which of the following information should you be sure to include? A. Restrict fluids to minimize the drug's adverse effects. B. Take the drug on an empty stomach to increase absorption C. Take the drug in the morning to reduce adverse effects. D. Administer the drug prophylactical during allergy seasons.

D

You should recognize which of the following is a contraindication for taking codeine? A. Emphysema B. Cataracts C. Hyperthyroidism D. Nonproductive cough

A

Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? A. Respiratory depression B. Drug abuse C. Drug tolerance D. Rebound congestion

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

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

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

You should instruct a client who is taking zileuton to report which of the following possible indications of a serious adverse effect of this drug? A. Abdominal pain B. Dysphagia C. Blurred vision D. Bradycardia

A

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 A spacer increases the amount of drug that reaches the lungs.

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, C, and E Restlessness is correct. Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. Bradycardia is incorrect. Pseudoephedrine is more likely to cause tachycardia, not bradycardia. Insomnia is correct. Insomnia is an adverse effect of pseudoephedrine. Muscle pain is incorrect. Muscle pain is not an adverse effect of pseudoephedrine. The drug is more likely to cause numbness of the extremities. Anxiety is correct. Anxiety is an adverse effect of pseudoephedrine.

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

You should monitor a client taking dextromethorphan because of the potential for which of the following? A. Tachycardia B. Fluid retention C. Blurred vision D. Drug abuse

D