RESPIRATORY SYSTEM EXAM1
9. The nurse is providing teaching for a patient who will use intranasal dexamethasone (Decadron) after discharge home from the hospital. What information is important to include when teaching this patient about this drug? a. "Dexamethasone may be used for year-round symptoms." b. "Dexamethasone should be discontinued after 30 days." c. "Dexamethasone should not be taken with antihistamines." d. "Dexamethasone should not cause systemic steroid side effects."
"Dexamethasone should be discontinued after 30 days."
12. A patient who has a nonproductive cough will begin taking guaifenesin to help with secretions. When teaching this patient about the medication, the nurse will provide which instruction? a. "Avoid driving or using heavy machinery." b. "Drink extra water while taking the medication." c. "Monitor urine output closely." d. "Take with an oral antihistamine for better effects."
"Drink extra water while taking the medication."
1. The nurse is caring for a patient recently diagnosed with mild emphysema and provides teaching about the disease and medications for treatment. Which statement by the patient indicates understanding of the medication regimen? a. "I should use albuterol when my symptoms worsen." b. "I will need to take oral prednisone on a daily basis." c. "My provider will prescribe prophylactic antibiotics." d. "My symptoms are reversible with proper medications."
"I should use albuterol when my symptoms worsen."
10. The nurse provides teaching for patient who will begin taking montelukast sodium (Singulair). The patient reports sensitivity to aspirin. Which statement by the patient indicates a need for further teaching? a. "I will need to have periodic laboratory tests while taking this medication." b. "I will not take ibuprofen for pain or fever while taking this drug." c. "I will take one tablet daily at bedtime." d. "I will use this as needed for acute symptoms."
"I will use this as needed for acute symptoms."
10. A patient asks the nurse about using dextromethorphan for cough. What information will the nurse include when teaching this patient about this drug? a. "It does not cause sedation except at high doses." b. "It may be used to treat cough for up to 2 weeks." c. "It is non-narcotic, and it is OK to consume alcohol while taking this drug." d. "It should not be taken by patients who have chronic obstructive pulmonary disease (COPD)."
"It should not be taken by patients who have chronic obstructive pulmonary disease (COPD)."
4. A patient who has seasonal allergies with a runny nose during the daytime reports increasing nighttime symptoms of coughing and sneezing that are interfering with sleep. The provider recommends diphenhydramine (Benadryl) at bedtime. What information will the nurse include when teaching the patient about this medication? a. "Avoid fluids at bedtime to prevent urinary retention." b. "This will help clear your daytime symptoms, too." c. "You should be able to sleep better when you take this medication." d. "You should take this medication on an empty stomach."
"You should be able to sleep better when you take this medication."
26. A student nurse is doing research consisting of chart audits of 25 patients with diagnosed chronic pharyngitis; she is attempting to determine what medication has been prescribed most frequently. What type of medication would this nurse expect to find in most of the chart audits? A) Antitussives B) Nasal sprays C) Oral decongestants D) Mucolytics
A) Antitussives
32. The nurse is caring for a patient who is scheduled to receive acetylcysteine because of an acetaminophen overdose. The nurse would notify the physician before administering the medication if the patient had which condition? (Select all that apply.) A) Bronchospasm B) Hypertension C) Nephrotic syndrome D) Peptic ulcer E) Esophageal varices
A) Bronchospasm D) Peptic ulcer E) Esophageal varices
10. A 71-year-old man with a history of heart disease and diabetes has had an antihistamine prescribed. The nurse is concerned with this prescription because of the risk for what? A) Cardiac arrhythmias B) Increased salivation and choking C) Severe constipation D) Insomnia
A) Cardiac arrhythmias
16. The nurse is giving discharge instructions to the mother of a 3-month-old infant who has an upper respiratory tract infection and has been prescribed a pseudoephedrine nasal solution. What instructions are most important for the nurse to give to this mother? A) Instill the medication 20 to 30 minutes before feeding. B) Keep the baby on clear liquids until the nasal discharge has resolved. C) Start the baby on cereal, because she is having difficulty sucking right now. D) Give the medication immediately after feeding.
A) Instill the medication 20 to 30 minutes before feeding.
23. The nurse is caring for a patient who needs education on his medication therapy for allergic rhinitis. The patient is to take clemastine (Tavist) daily. In providing educational interventions regarding this medication, what is the most important instruction on the action of the medication? A) It blocks the effects of histamine. B) It is used to treat atrial and ventricular dysrhythmias. C) It competitively inhibits the rate-limiting enzyme in the liver. D) It leads to bronchodilation and relaxes smooth muscle in the bronchi
A) It blocks the effects of histamine.
8. A patient presents at the clinic with signs and symptoms of seasonal allergic rhinitis. The patient is prescribed a nasal steroid to relieve symptoms. Two days later, the patient calls the clinic and tells the nurse that he is frustrated and wants a new drug. 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 ordered. B) The drug must not work for you. Let's change to an oral steroid. C) You probably 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.
A) It may take up to 2 weeks to get the full clinical effect. Try to keep using the drug as ordered.
6. Parents who treat their children's cold and flu symptoms at home should be educated concerning the reading and understanding of over-the-counter (OTC) labels. Why is this statement true? A) Many of these preparations contain the same active ingredients so that inadvertent overdose is a common problem. B) Each product is best used for alleviating a particular symptom. C) Some of these products do not contain any drugs. D) Some of these products could interfere with breast-feeding.
A) Many of these preparations contain the same active ingredients so that inadvertent overdose is a common problem.
19. The nurse advises that patient 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
A) Mucosal ulcerations
33. A patient has been using guaifenesin for a cough that accompanied a common cold. The patient 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
A) Nausea B) Rash Headache
30. The family nurse practitioner is caring for a Hispanic woman who is 83 years old. The patient has been noncompliant with the care regimen the nurse practitioner has previously outlined for treatment of sinusitis. What should the nurse practitioner do that can assist the patient in being more compliant with the prescribed treatment regimen? A) Provide instructions in writing. 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.
A) Provide instructions in writing.
34. A patient has been prescribed an antihistamine for treatment of allergic rhinitis. What statements by the patient 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.
A) This medication will work best if I take it before I eat anything. 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.
35. An individual calls the nurse help line and asks what the drug diphenhydramine is used for. The nurse knows that the medication is prescribed for which conditions? (Select all that apply.) A) Urticaria B) Vasomotor rhinitis C) Productive cough D) Motion sickness E) Angioedema
A) Urticaria B) Vasomotor rhinitis D) Motion sickness E) Angioedema
4. A patient will begin using ipratropium bromide (Atrovent), albuterol (Proventil), and an inhaled glucocorticoid medication (steroid) to treat chronic bronchitis. When teaching this patient about disease and medication management, the nurse will instruct the patient to administer these medications in which order? a. Albuterol, ipratropium bromide, steroid b. Albuterol, steroid, ipratropium bromide c. Ipratropium bromide, albuterol, steroid d. Steroid, ipratropium bromide, albuterol
Albuterol, ipratropium bromide, steroid
9. A patient who has been taking theophylline at home reports having palpitations and jitteriness. What action will the nurse take? a. Ask the patient if herbal medications are used. b. Notify the provider to report theophylline toxicity. c. Recommend that the patient increase fluid intake. d. Request an order for renal function studies.
Ask the patient if herbal medications are used.
3. A patient arrives in the emergency department after developing a rash, runny nose, and sneezing after eating strawberries. What action will the nurse expect to take first? a. Administer diphenhydramine. b. Administer epinephrine. c. Assess for urinary retention. d. Assess heart rate, respiratory rate, and lung sounds.
Assess heart rate, respiratory rate, and lung sounds.
6. The nurse is teaching a patient who will begin taking oral theophylline (Theo-Dur) when discharged home from the hospital. What information will the nurse include when teaching the patient about this drug? a. An extra dose should be taken when symptoms worsen. b. Anorexia and gastrointestinal upset are unexpected side effects. c. Avoid caffeine while taking this medication. d. Food will decrease the amount of drug absorbed.
Avoid caffeine while taking this medication.
1. A patient who has narrow-angle glaucoma asks the nurse to recommend a medication to alleviate cold symptoms such as nasal congestion and runny nose. The nurse will suggest the patient talk to the provider about which medication? a. Azelastine (Astelin) b. Cetirizine (Zyrtec) c. Chlorpheniramine maleate (Chlor-Trimeton) d. Diphenhydramine (Benadryl)
Azelastine (Astelin)
7. A patient presents at the clinic with a dry nonproductive cough. The patient 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 physician will prescribe? A) Benzonatate (Tessalon) B) Guaifenesin (Mucinex) C) Dextromethorphan (Benylin) D) Hydrocodone (Hycodan)
B) Guaifenesin (Mucinex)
5. A nurse in a three drops with respiratory problems has received orders for four patients. What medication order will the nurse question? A) Tetrahydrozoline (Tyzine) three drops in each nostril for an 8-year-old child B) Hydrocodone (Hycodan) 10 mg PO for a 5-year-old child C) Pseudoephedrine (Dorcol) 15 mg PO for a 2-year-old child D) Diphenhydramine (Benadryl) 5 mg/kg IM for a 10-year-old child
B) Hydrocodone (Hycodan) 10 mg PO for a 5-year-old child
11. A 29-year-old female patient has sinusitis, so the physician orders a topical nasal decongestant. What instructions should be given? A) Avoid becoming pregnant during decongestant therapy. B) Increase fluids to 2 L/d. C) Restrict fluids to 500 mL/d. D) Take the medication with meals.
B) Increase fluids to 2 L/d.
15. The nurse is caring for a patient who is taking dextromethorphan for cough suppression. The nurse will assess this patient for hypotension if he also takes which other medication? A) Calcium-channel blockers B) Monoamine oxidase (MAO) inhibitors C) Beta-blockers D) Thiazide diuretics
B) Monoamine oxidase (MAO) inhibitors
28. A patient has been prescribed a nasal steroid and asks the nurse what the most common reason that this medication is used to treat. What is the nurse's best response? A) Nasal steroids are only used to treat a sinus infection. B) Nasal steroids are used to treat allergic rhinitis. C) Nasal steroids are used for an infection in the adenoids. D) Nasal steroids are used for all acute upper respiratory infections.
B) Nasal steroids are used to treat allergic rhinitis.
14. The nurse is giving discharge instructions to a patient with an upper respiratory infection who has been advised to take an over-the-counter (OTC) topical nasal decongestant. The nurse advises the patient about what common adverse reaction to these medications? A) Diarrhea B) Rhinitis medicamentosa C) Rash D) Headache
B) Rhinitis medicamentosa
3. The nurse is caring for a patient who is receiving acetylcysteine (Mucomyst) by face mask. What would be an appropriate nursing diagnosis? A) Impaired swallowing B) Risk for impaired skin integrity C) Risk for falls D) Sleep deprivation
B) Risk for impaired skin integrity
29. The nurse is writing a care plan for a patient who has been prescribed a nasal steroid. What would be an appropriate nursing diagnosis for this patient? 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
B) Risk for injury related to suppression of inflammatory reaction
11. A patient with chronic obstructive pulmonary disease (COPD) who has a persistent nonproductive cough asks about a medication that will not cause sedation. The nurse will encourage the patient to discuss which medication with the provider? a. Benzonatate HCl (Tessalon Perles) b. Dextromethorphan hydrobromide (Benylin DM) c. Guaifenesin and codeine d. Promethazine with dextromethorphan
Benzonatate HCl (Tessalon Perles)
17. The nurse is caring for a patient who does not have a respiratory disorder but has been prescribed acetylcysteine. What is an additional indication for acetylcysteine (Mucomyst)? A) Conversion of cardiac dysrhythmias B) Treatment of peptic ulcer disease C) Antidote for acetaminophen poisoning D) Decreased bronchospasm
C) Antidote for acetaminophen poisoning
18. The nursing instructor is teaching the lab students the best position for the administration of nasal sprays. What position would the instructor teach the students? A) Supine B) Semi-Fowler's C) High Fowler's D) Side-lying
C) High Fowler's
31. The nurse is caring for a patient with cystic fibrosis who is receiving dornase alfa by nebulizer to help thin secretions. What statement by the patient 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 solve all of my problems. D) I will continue to use postural drainage and take my enzymes as ordered.
C) I'm glad that this medication will solve all of my problems.
9. A patient has an important presentation to make in 4 hours and he needs relief from the congestion of seasonal rhinitis. The patient calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. Which antihistamine would be a good choice for this patient? A) Diphenhydramine (Benadryl) B) Dexchlorpheniramine (Polaramine) C) Loratadine (Claritin) D) Hydroxyzine (Atarax)
C) Loratadine (Claritin)
21. The pharmacology instructor questions the students as to which classification of drugs is commonly found in over-the-counter (OTC) combination cold medications? A) Stimulants B) Opioids C) Oral decongestants D) Antitussives
C) Oral decongestants
27. The nurse is teaching a group of patients with allergic rhinitis about the use of their medications. What would be the most essential information to give these patients 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 tech for assistance in selecting an OTC medication.
C) Read drug labels before taking OTC medications.
4. A nurse is caring for a 15-year-old patient with cystic fibrosis who has been prescribed dornase alfa (Pulmozyme) to relieve the buildup of secretions and keep airways open and functioning longer. What will the nurse instruct the patient to do concerning the use of this drug? A) Use in home nebulizer up to four times a day if needed. B) Stop all other medications while using the drug. C) Store the drug in the refrigerator, protected from light. D) Expect a severe headache after each use.
C) Store the drug in the refrigerator, protected from light.
2. What would be the nurse's best response if a patient 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 be an indication of an underlying medical problem. D) Drink a lot of fluids and take aspirin, which should reduce the irritation in your throat
C) You should come to the clinic to be evaluated. A cough that lasts that long might be an indication of an underlying medical problem.
2. The nurse is preparing to administer isoproterenol (Isuprel) to a patient who is experiencing an acute bronchospasm. The nurse understands that, because isoproterenol is a nonselective beta-adrenergic agonist, the patient will experience which effects? a. Alpha- and beta-adrenergic agonist effects b. Anticholinergic effects c. A shorter duration of therapeutic effects d. Cardiac and pulmonary effects
Cardiac and pulmonary effects
6. The nurse is caring for a patient who is hospitalized for an asthma exacerbation. The patient reports taking diphenhydramine at home at night to help with symptoms of allergic rhinitis and cough. The nurse will contact the patient's provider to request an order for which medication? a. Benzonatate (Tessalon Perles) b. Cetirizine (Zyrtec) c. Dextromethorphan hydrobromide (Benylin DM) d. Diphenhydramine (Benadryl)
Cetirizine (Zyrtec)
20. What disorders would the pharmacology instructor tell the nursing students may be exacerbated by the use of nasal decongestants? A) Pneumonia B) Rheumatoid arthritis C) Acid reflux D) Hypothyroidism
D) Hypothyroidism
13. What statement by the patient leads the nurse to believe that he needs additional instruction regarding his nasal decongestant? A) I will blow my nose before instilling the nasal spray. B) I will report any dizziness, drowsiness, or rapid pulse. C) I will drink 2,000 to 3,000 mL of fluid daily. D) I will use it only when I have nasal discharge.
D) I will use it only when I have nasal discharge.
24. The nursing instructor is discussing the administration of nasal spray with the nursing students. 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.
D) Overuse of nasal spray may cause rebound congestion.
12. What statement by a 61-year-old patient 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 should call the physician if I develop nausea, diarrhea, or stomach cramps while taking this medication. D) This medication can cause drowsiness, so I will avoid driving or using power equipment while I take it.
D) This medication can cause drowsiness, so I will avoid driving or using power equipment while I take it.
22. A patient visits 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
D) Topical decongestants
1. A patient comes to the clinic with symptoms as seen in a cold. What group of upper respiratory drugs causes local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow? A) Antitussives B) Decongestants C) Expectorants D) Mucolytics
Decongestants
5. The parents of a 3-year-old child tell the nurse that they are planning to give their child diphenhydramine (Benadryl) on a flight to visit the child's grandparents to help the child sleep during the flight. What will the nurse tell the parents about giving this drug? a. Administer 25 mg of diphenhydramine when using to induce sleep. b. Diphenhydramine may have the opposite effect and could cause agitation. c. Give the diphenhydramine about 5 minutes prior to takeoff. d. Loratadine should be used instead of diphenhydramine to minimize side effects.
Diphenhydramine may have the opposite effect and could cause agitation.
15. A patient who is using inhaled cromolyn sodium (Intal) daily calls the clinic to report experiencing cough and a bad taste. The nurse will instruct the patient to perform which action? a. Drink water before and after using the inhaler. b. Schedule an appointment to discuss these effects with the provider. c. Stop taking the medication immediately. d. Use the inhaler only as needed for acute bronchospasms.
Drink water before and after using the inhaler.
2. The nurse is caring for a patient who is receiving diphenhydramine. The nurse notes that the patient has not voided for 12 hours. What action will the nurse take? a. Encourage the patient to drink more fluids. b. Evaluate the bladder to check for distension. c. Request an order for an intravenous fluid bolus. d. Request an order for urinary catheterization.
Evaluate the bladder to check for distension.
25. The clinic nurse is caring for a patient who has been prescribed fexofenadine for hay fever. When the nurse is assessing this patient's medication history, what drug would make the nurse question the order for fexofenadine? A) Tetracycline B) Penicillin C) Gentamicin D) Ketoconazole
Ketoconazole
13. The nurse is performing a medication history on a patient who reports long-term use of montelukast (Singulair) and an albuterol metered-dose inhaler (Proventil). The nurse will contact the provider to discuss an order for which laboratory tests? a. Cardiac enzymes and serum calcium b. Electrolytes and a complete blood count c. Liver function tests and serum glucose d. Urinalysis and serum magnesium
Liver function tests and serum glucose
3. A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication? a. Failure to respond to the medication indicates a need for a higher dose. b. Monitor for hypoglycemia symptoms when using this medication. c. Palpitations are common with this drug even at normal, therapeutic doses. d. Overuse of this medication can result in airway narrowing and bronchospasm.
Overuse of this medication can result in airway narrowing and bronchospasm.
8. The patient who has nasal congestion asks the nurse to recommend a decongestant medication. The nurse performs a medication history and learns that the patient takes a beta blocker to treat hypertension. Which over-the-counter product will the nurse recommend? a. Diphenhydramine (Benadryl) b. Ephedrine HCl (Pretz-D) c. Phenylephrine nasal (NeoSynephrine Nasal) d. Loratadine (Claritin)
Phenylephrine nasal (NeoSynephrine Nasal)
11. A patient who uses an inhaled glucocorticoid medication reports having a sore tongue. The nurse notes white spots on the patient's tongue and oral mucous membranes. After notifying the provider, the nurse will remind the patient to perform which action? a. Avoid using a spacer with the inhaled glucocorticoid medication. b. Clean the inhaler with hot, soapy water after each use. c. Consume yogurt daily while using this medication. d. Rinse the mouth thoroughly with water after each use.
Rinse the mouth thoroughly with water after each use.
5. A provider has prescribed ipratropium bromide/albuterol sulfate (Combivent) for a patient who has chronic obstructive pulmonary disease (COPD). The nurse explains that this combination product is prescribed primarily for which reason? a. To be more convenient for patients who require both medications b. To improve compliance in patients who may forget to take both drugs c. To increase forced expiratory volume, an indicator of symptom improvement d. To minimize the side effects that would occur if the drugs are given separately
To increase forced expiratory volume, an indicator of symptom improvement
14. A patient is brought to the emergency department and reports having taken "a lot" of acetaminophen extra-strength tablets 16 hours prior. The nurse will expect the provider to order a. acetylcysteine (Mucomyst). b. dornase alfa (Pulmozyme). c. gastric lavage. d. renal enzyme tests.
acetylcysteine (Mucomyst).
12. A patient will begin using an albuterol metered-dose inhaler to treat asthma symptoms. The patient asks the nurse about the difference between using an oral form of albuterol and the inhaled form. The nurse will explain that the inhaled form of albuterol a. has a more immediate onset than the oral form. b. may cause more side effects than the oral preparation. c. requires an increased dose in order to have therapeutic effects. d. will not lead to tolerance with increased doses.
has a more immediate onset than the oral form.
8. The nurse is caring for a patient who will begin taking theophylline at home. During the assessment, the nurse learns that the patient smokes. The nurse reports this to the provider and will expect the provider to a. decrease the dose of theophylline. b. increase the dose of theophylline. c. keep the theophylline dose as ordered. d. discontinue the theophylline.
increase the dose of theophylline.
7. The nurse is caring for a patient who is receiving intravenous theophylline. The patient complains of headache and nausea. The nurse will contact the provider to a. change the medication to an oral theophylline. b. obtain an order for a serum theophylline level. c. request an order for an analgesic medication. d. suggest an alternative methylxanthine medication.
obtain an order for a serum theophylline level.
7. A patient is admitted to the hospital after developing pneumonia. During the admission assessment, the patient reports having used a nasal decongestant spray for the past few weeks but thinks the nasal congestion is getting worse. The nurse will a. request an order for a systemic decongestant medication. b. request an order so the patient can continue to use the decongestant spray. c. tell the patient the congestion will clear up after stopping the spray. d. tell the patient to increase oral fluid intake.
tell the patient the congestion will clear up after stopping the spray.
