Pharmacology: Chapter 54: Drugs Acting on the Upper Respiratory Tract

A 71-year-old man with a history of atrial fibrillation, chronic obstructive pulmonary disease and type 2 diabetes has had an antihistamine prescribed. What assessment should the nurse prioritize? a.Auscultation of apical heart rate and rhythm b.Chest auscultation and assessment of respiratory rate c.Q4h blood glucose checks d.Assessment of orientation and level of consciousness

ANS: A

The nurse is caring for a client who states that he recently been taking dextromethorphan for cough suppression. The nurse should contact the provider promptly if the client also takes which other medication? a.Verapamil b.Phenelzine c.Metoprolol d.Hydrochlorothiazide

ANS: B

The nurse is giving discharge instructions to a client with an upper respiratory infection who has been advised to take an over-the-counter (OTC) topical nasal decongestant. What should the nurse teach the client in order to prevent rhinitis medicamentosa? a.Avoid using nonsteroidal anti-inflammatories concurrently b.Use the medication for as short a time as possible c.Avoid using antihistamines at the same time as the decongestant d.Increase fluid intake for the duration of treatment

ANS: B

The nurse is writing a care plan for a client who has been prescribed a nasal steroid. What would be an appropriate nursing diagnosis for this client? a.Disturbed sensory perception (kinesthetic) related to CNS effects b.Risk for injury related to suppression of inflammatory reaction c.Ineffective airway clearance related to bronchospasm d.Ineffective airway related to nasal obstruction

ANS: B

Which client is most likely to benefit from the administration of a nasal steroid? a.A client with an acute sinus infection b.A client who has chronic allergic rhinitis c.A client who is recovering from a tonsillectomy d.A client who has a deviated nasal septum

ANS: B

A client with seasonal allergies has sought care due to a recent onset of blurred vision and urinary retention. What is the nurse's best action? a.Encourage the client to ask the provider for medication to resolve the problems b.Determine whether the client is taking over-the-counter antitussives c.Assess the client's pattern of antihistamine usage d.Perform a focused respiratory assessment

ANS: C

A client has been diagnosed with chronic pharyngitis. The client is most likely to benefit from what medication category? a.Antitussives b.Nasal sprays c.Oral decongestants d.Mucolytics

ANS: A

A client presents to the clinic with signs and symptoms of seasonal allergic rhinitis. The client is prescribed a nasal steroid to relieve symptoms. Two days later, the client calls the clinic stating that he is not experiencing any relief. What is the most appropriate response by the nurse? a."It may take up to 2 weeks to get the full clinical effect. Try to keep using the drug as prescribed." b."The drug must not work for you. I'll contact your provider to see if you can change to an oral steroid." c."It could be that you are administering the drug incorrectly. Come in and we can review the process." d."You probably need to try a different nasal steroid. This one should be effective by now."

ANS: A

The nurse advises that client to avoid long-term use of nasal decongestants because it may lead to what condition? a.Mucosal ulcerations b.Decreased drainage c.Increased risk of infection d.Asthma

ANS: A

The nurse is caring for a client with allergic rhinitis who takes clemastine daily. What should the nurse teach the client about the action of the medication? a.It blocks the effects of histamine. b.It changes the viscosity of mucus. c.It promotes the development of mast cells. d.It increases the tone of smooth muscle in the bronchi.

ANS: A

The nurse is working with parents who are treating their child's cold and flu symptoms at home using over-the-counter (OTC) medications. What guidance should the nurse provide? a."Read the labels clearly to make sure you're not giving the same drug in two different preparations." b."It's generally safer to give your child herbal preparations rather than OTC drugs." c."Many OTC products do actually not contain any effective drugs." d."OTC medications aren't recommended for anyone who is younger than 12."

ANS: A

A client's drug regimen includes diphenhydramine. What potential indications may this drug be used for? Select all that apply. a. Urticaria b. Vasomotor rhinitis c. Productive cough d. Motion sickness e. Angioedema

ANS: A,B,D,E

A client has been prescribed an antihistamine for treatment of allergic rhinitis. What statements by the client indicate an understanding of this medication? Select all that apply. a."This medication will work best if I take it before I eat anything." b."I need to drink less fluid while I take this medication to help reduce the amount of mucus I have." c."I will use sugarless candies to help with the feelings of a dry mouth." d."I will use a humidifier in the bedroom while I sleep." e."This medication will probably cause my appetite to increase."

ANS: A,C,D

The nurse is caring for a client who is scheduled to receive acetylcysteine. The nurse should notify the prescriber before administering the medication if the client had which condition? Select all that apply. a. Bronchospasm b. Hypertension c. Nephrotic syndrome d. Peptic ulcer e. Esophageal varices

ANS: A,D,E

A client has been using guaifenesin for a cough that accompanied a common cold. The client calls the nurse help line and states that she thinks she is having an adverse reaction to the medication. The nurse knows that which symptoms are adverse effects of this medication? Select all that apply. a. Nausea b. Rash c. Constipation d. Bleeding e. Headache

ANS: A.B.E

A 29-year-old female client has sinusitis and has been prescribed a topical nasal decongestant. What instructions should the nurse provide? a.Use two forms of birth control until treatment is complete. b.Increase fluids to 2 L/day. c.Temporarily avoid high-sodium foods. d.Take the medication with meals

ANS: B

A client presents to the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe? a.Benzonatate b.Guaifenesin c.Dextromethorphan d.Hydrocodone

ANS: B

A nurse in a pediatric clinic is caring for several clients with respiratory problems. What medication prescription should the nurse question? a.Tetrahydrozoline three drops in each nostril for an 8-year-old child b.Hydrocodone 10 mg PO for a 5-year-old child c.Pseudoephedrine 15 mg PO for a 2-year-old child d.Diphenhydramine 5 mg/kg IM for a 10-year-old child

ANS: B

The nurse has taught a client to self-administer a topical decongestant. What statement should the nurse follow up with further education? a."I'll put the tip of the bottle about half an inch into my nostril." b."I'll squeeze the bottle to get the medication up into my sinuses." c."I'll sit upright when I give myself the drug." d."I won't take the drug if I've got a sore inside my nose."

ANS: B

The nurse is caring for a client who is receiving acetylcysteine by facemask. What would be an appropriate nursing diagnosis? a.Impaired swallowing b.Risk for impaired skin integrity c.Risk for falls d.Sleep deprivation

ANS: B

A client has an important presentation to make in four hours and he needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. What medication is most likely to meet this client's needs? a.Diphenhydramine (Benadryl) b.Dexchlorpheniramine (Polaramine) c.Loratadine (Claritin) d.Hydroxyzine (Atarax)

ANS: C

A nurse is caring for a 15-year-old client with cystic fibrosis who has been prescribed dornase alfa. What should the nurse instruct the client and family to do? a.Use in-home nebulizer up to every 4 hours. b.Avoid taking other drugs within 2 hours of dornase alfa. c.Store the drug in the refrigerator, protected from light. d.Expect a headache after each use, due to vasodilation.

ANS: C

The nurse is caring for a client who does not have a respiratory disorder but has been prescribed acetylcysteine. What is an additional indication for acetylcysteine? a.Conversion of cardiac dysrhythmias b.Treatment of peptic ulcer disease c.Antidote for acetaminophen poisoning d.Treatment of bronchospasm

ANS: C

The nurse is caring for a client with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the client indicates a need for further instruction? a."This medication will loosen up the sticky mucus that is in my lungs." b."I will try to cough after I receive this medication." c."I'm glad that this medication will address all of my symptoms." d."I will continue to use postural drainage and take my enzymes as ordered."

ANS: C

The nurse is providing education for a client who has begun taking an over-the-counter (OTC) combination cold medication. What is this medication most likely to contain? a.Stimulants b.Opioids c.Oral decongestants d.Antihistamines

ANS: C

The nurse is teaching a group of clients with allergic rhinitis about the use of their medications. What would be the most essential information to give these clients about preventing possible drug interactions? a.Over-the-counter (OTC) medications are safe to use. b.Use only one pharmacy so the pharmacist can check drug interactions. c.Read drug labels before taking OTC medications. d.Ask the pharmacy technician for assistance in selecting an OTC medication.

ANS: C

What would be the nurse's best response if a client calls the clinic and reports that he has had a persistent cough for 2 weeks and asks the nurse for a recommendation for a cough medicine? a."Look for dextromethorphan as an ingredient in any OTC cough preparation." b."The doctor could order an antihistamine, which might dry up your secretions and stop the cough." c."You should come to the clinic to be evaluated. A cough that lasts that long might indicate a medical problem." d."Drink a lot of fluids and take aspirin, which should reduce the irritation in your throat.

ANS: C

A client presents to the clinic and is diagnosed with acute sinusitis. To promote sinus drainage, what medication might be ordered? a.Topical nasal steroid decongestants b.First-generation antihistamines c.Second-generation antihistamines d.Topical decongestants

ANS: D

The clinic nurse is caring for a client who has been prescribed fexofenadine for hay fever. When the nurse is assessing this client's medication history, what drug would make the nurse question the order for fexofenadine? a.Tetracycline b.Penicillin c.Gentamicin d.Ketoconazole

ANS: D

The nurse is caring for a client who has an upper respiratory infection and who is inquiring about the use of nasal decongestants. What comorbidity would require cautious use of decongestants? a.Reynaud's syndrome b.Rheumatoid arthritis c.Gastroesophageal reflux disease (GERD) d.Hypothyroidism

ANS: D

The nurse is caring for a client who has been taking an OTC cold remedy containing pseudoephedrine for the past 2 days. What assessment finding should the nurse most likely attribute to this medication? a.Nasal congestion and rhinorrhea b.Drowsiness and reports of sleeping for 10 hours the previous day c.Diaphoresis and oral temperature of 37.9°C (100.2°F) d.Heart rate 98 beats/minute and blood pressure 142/93 mm Hg

ANS: D

The nurse is teaching a client about the administration of nasal spray. What information is most important to include in this discussion? a.Finish the bottle of nasal spray to clear the infection effectively. b.Nasal spray can be shared between family members only. c.Administer the nasal spray in a prone position. d.Overuse of nasal spray may cause rebound congestion.

ANS: D

What statement by a 61-year-old client who is to take an antitussive with codeine indicates that the nurse's teaching has been effective? a."I will take this medication anytime I start to cough." b."This medication may make me anxious and nervous." c."I might get diarrhea, so I'll call my provider if that happens." d."This medication can cause drowsiness, so I will avoid driving after taking it."

ANS: D

A client has begun taking an antihistamine for the treatment of seasonal allergies. What dietary guidelines should the nurse provide to the client? a.Avoid drinking alcohol while taking antihistamines. b.Avoid grapefruit juice until at least 48 hours after treatment is complete. c.Increase intake of foods that are high in vitamin C. d.Eat several small meals instead of three larger meals in case of GI upset.

ANS:A

The family nurse practitioner is caring for a client who has been noncompliant with the care regimen the nurse practitioner has previously outlined for treatment of sinusitis. What should the nurse practitioner do to best promote compliance? a.Assess the reasons why the client did not comply with treatment. b.Provide the instructions in large type. c.Give the treatment instructions to a member of her family. d.Give the treatment instructions to the woman's husband.

ANS:A