Chapter 39 Drugs for Allergic Rhinitis and the Common Cold
1) A client with nasal congestion tells the nurse that his symptoms have worsened since he has been using oxymetazoline (Afrin). Which question should the nurse ask the client?
1. "Have you checke
Answer: 4
Explanation:
1. While it is possible that the client is using an outdated prescription, this is most likely not the reason the client is experiencing rebound congestion.
2. A recent fever is not associated with rebound congestion.
3. The use of
2) Which assessment finding should the nurse be most concerned about for a client receiving pseudoephedrine (Sudafed)?
1. Temperature of 100�F
2. Respiratory rate of 22
3. Heart rate 82 and irregular
4. Complaints of a dry mouth
Answer: 3
Explanation:
1. A high temperature is possible with pseudoephedrine but is not the primary concern.
2. A respiratory rate of 22 is possible with pseudoephedrine but is not the primary concern.
3. Pseudoephedrine may cause dysrhythmias.
4. A dry
3) The nurse has completed the education for a client prescribed diphenhydramine (Benadryl) for allergies. Which statement made by the client indicates an understanding of the teaching?
1. "Drowsiness is common but should lessen over time."
2. "If this me
Answer: 1
Explanation:
1. Drowsiness is a common adverse effect of antihistamines and will diminish with long-term use.
2. Antihistamines dry the nasal secretions, not increase them.
3. The use of antihistamines does not require sodium restriction.
4. Pse
4) The nurse has completed the education for a client prescribed an antihistamine. Which statement made by the client indicates an understanding of the information?
1. "I can still have my after-dinner drink."
2. "I may experience diarrhea while taking th
Answer: 4
Explanation:
1. Alcohol will increase the sedative effects of antihistamines, so the client should not consume alcohol while taking antihistamines.
2. Antihistamines can produce constipation.
3. Just because a prescription is sold OTC does not m
5) The nurse is reviewing the major functions of the upper respiratory tract with a client. Which information should the nurse include?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1.
Answer: 2, 3, 5
Explanation:
1. The trachea and bronchi are part of the lower respiratory tract.
2. The nose warms the air before it reaches the lungs.
3. The nasal mucosa is the first line of immunological defense.
4. Activation of the sympathetic nervou
6) A client asks the nurse what has caused her allergic rhinitis. Which statements should the nurse include in the discussion?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "Allergi
Answer: 1, 2, 3, 5
Explanation:
1. One of the causative factors of allergic rhinitis is animal dander.
2. Tobacco smoke can cause allergic rhinitis in some people.
3. Allergic response to pollen can cause allergic rhinitis in some people.
4. Although asso
7) The educator has reviewed the role of histamine receptors associated with allergic symptoms with a nurse. Which statement made by the nurse indicates further instruction is needed?
1. "H1 receptors are found in the stomach."
2. "H1 receptors are respon
Answer: 1
Explanation:
1. H2 receptors are found in the stomach.
2. The histamine receptors responsible for allergic symptoms are called H1 receptors.
3. H2 receptors increase mucus secretion in the stomach.
4. H2 receptors are responsible for peptic ulce
8) Which symptom should the nurse instruct the client prescribed diphenhydramine (Benadryl) to report to the healthcare provider?
1. Sedation
2. Diarrhea
3. Weight gain
4. Urinary hesitancy
Answer: 4
Explanation:
1. Sedation is a common side effect that does not need to be reported.
2. Diarrhea is not associated with the use of diphenhydramine.
3. Weight gain is not associated with the use of diphenhydramine.
4. Urinary hesitancy is an antic
9) A client prescribed beclomethasone (Beconase) intranasally asks the nurse whether the prescription is safe. Which response should the nurse provide the client?
1. "Intranasal glucocorticoids produce almost no serious adverse effects."
2. "Intranasal gl
Answer: 1
Explanation:
1. Intranasal glucocorticoids produce almost no serious adverse effects.
2. Intranasal glucocorticoids have a delayed effect.
3. There is no maximum time frame for the use of intranasal glucocorticoids; they produce almost no seriou
10) The nurse teaches a client about the difference between oral and nasal decongestants. The nurse evaluates that learning has been effective when the client makes which statement?
1. "Oral decongestants can cause hypertension."
2. "Intranasal decongesta
Answer: 1
Explanation:
1. One of the side effects of oral decongestants is hypertension.
2. Intranasal decongestants should not be used for longer than 3 to 5 days.
3. Oral decongestants do not cause rebound congestion; nasal decongestants can cause rebou
11) A client asks the nurse when she should use an antitussive. Which response should the nurse provide the client?
1. "When you are coughing up secretions."
2. "When your temperature is 101.2�F."
3. "When you have been diagnosed with a respiratory infect
Answer: 4
Explanation:
1. An antitussive is not used to dry up lung secretions.
2. The client should be assessed if she is febrile prior to taking any prescription.
3. It is not desirable to suppress the cough reflex in a client with a respiratory infecti
12) Which condition should the nurse be concerned about for a client prescribed fluticasone (Flonase)?
1. Diabetes mellitus
2. Pregnancy
3. Glaucoma
4. Hypertension
Answer: 2
Explanation:
1. There is no contraindication for use of fluticasone for a client with diabetes mellitus.
2. Fluticasone is a pregnancy category C drug, which means the effects on pregnancy are not known. A pregnant client should not receive this
13) Which information should the nurse include in the teaching for a client prescribed dextromethorphan (Delsym)?
1. Avoid grapefruit juice.
2. Dextromethorphan can be used with a chronic cough.
3. The prescription may have a slow onset of action.
4. Decr
Answer: 1
Explanation:
1. Grapefruit juice can raise serum levels of dextromethorphan and cause toxicity.
2. Dextromethorphan should be avoided in clients in the treatment of chronic cough with excessive bronchial secretions that need to be expelled.
3. T
14) A client asks the nurse why he cannot take his monoamine oxidase inhibitor (MAOI) with diphenhydramine (Benadryl). Which response should the nurse provide?
1. "The diphenhydramine (Benadryl) interferes with the therapeutic effect of the MAOI."
2. "You
Answer: 4
Explanation:
1. The combination of prescriptions does not decrease the therapeutic effect of MAOI.
2. The combination of prescriptions does not place the client at risk for seizures.
3. The combination of prescriptions does not decrease the ther
15) Which prescription is used to prevent allergic rhinitis?
1. Oral corticosteroids
2. Oral decongestants
3. Intranasal corticosteroids
4. Intranasal decongestants
Answer: 3
Explanation:
1. Oral corticosteroids are not used in the treatment of allergic rhinitis.
2. Oral decongestants are used as a reliever of the symptoms associated with allergic rhinitis.
3. Intranasal corticosteroids are used as a preventer in the
16) Which histamine receptor is blocked by the action of an antihistamine?
1. H1 receptor site
2. B1 receptor site
3. B2 receptor site
4. H2 receptor site
Answer: 1
Explanation:
1. Antihistamines block the H1 receptor site.
2. Antihistamines do not block B1 receptor sites.
3. Antihistamines do not block B2 receptor sites.
4. Antihistamines do not block H2 receptor sites.
Page Ref: 603
Cognitive Level: Remem
17) Which information should the nurse include in the client education for the administration of an intranasal decongestant?
1. "Wait 15 minutes in between additional nasal sprays."
2. "Spit out any excess intranasal decongestant that drains in the mouth.
Answer: 2
Explanation:
1. The client should be instructed to wait 5 to 10 minutes prior to following with additional nasal sprays as prescribed. Allowing the first of two sprays time to constrict local vessels and mucosa will allow the spray to reach high
18) Which over-the-counter (OTC) antihistamine combination contains an analgesic property?
1. Sudafed PE Sinus and Allergy
2. Triaminic Cold/Allergy
3. Tavist Allergy 12-hour
4. Actifed Plus
Answer: 4
Explanation:
1. Sudafed PE Sinus and Allergy contains chlorpheniramine and phenylephrine.
2. Triaminic Cold/Allergy contains chlorpheniramine and phenylephrine.
3. Tavist Allergy 12-hour contains clemastine.
4. Actifed Plus contains acetaminophe
19) Which describes the purpose for the use of an opioid antitussive?
1. Decrease nasal congestion
2. Break down mucus
3. Relieve severe cough
4. Relieve mild cough
Answer: 3
Explanation:
1. Decongestants decrease congestion.
2. Expectorants break down mucus.
3. Opioid antitussives are used to relieve severe cough.
4. Mild coughs do not require an antitussive.
Page Ref: 608
Cognitive Level: Remembering
Client Need/Su
20) Which information should the nurse include in the teaching for a client with allergic symptoms prescribed an antihistamine?
1. "Antihistamines are most effective when taken prophylactically."
2. "Antihistamines are useful in reversing allergic symptom
Answer: 1
Explanation:
1. Antihistamines are most effective when taken prophylactically to prevent allergic symptoms.
2. Antihistamines are not useful in reversing allergic symptoms.
3. Antihistamines are not effective for long-term therapy.
4. Antihistam
21) For which should the nurse monitor a client suspected of abusing dextromethorphan (Delsym)?
1. Nephrotoxicity
2. Cardiotoxicity
3. CNS toxicity
4. Hepatoxicity
Answer: 3
Explanation:
1. Abuse of dextromethorphan is not associated with nephrotoxicity.
2. Abuse of dextromethorphan is not associated with cardiotoxicity.
3. Abuse of dextromethorphan is associated with CNS toxicity with a wide variety of symptoms, in
22) Which information should the nurse include in the teaching of a client with chronic bronchitis prescribed breathing treatments with acetylcysteine (Mucomyst)?
1. "Stop the treatment if you start to cough."
2. "Do not use the prescription if you notice
Answer: 4
Explanation:
1. The prescription is used to thin mucus to make it easier to remove by coughing. Coughing is a desired effect.
2. Acetylcysteine has an offensive odor resembling rotten eggs.
3. This prescription is not used to decrease bronchospa
23) Which information should the nurse include when discussing the appropriate dosing and administration needs for self-administering prescriptive therapy?
1. "Drink water when you take cough syrup."
2. "Avoid drinking liquids with expectorants."
3. "Take
Answer: 3
Explanation:
1. Cough syrups should be swallowed without water and allowed to coat the throat for soothing effects, followed by increased fluid intake 30 to 60 minutes later.
2. Expectorants should be taken with a full glass of liquid, and fluid
24) Which assessment findings should the nurse anticipate for a client experiencing allergic rhinitis?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Tearing eyes
2. Itching throat
3
Answer: 1, 2, 3, 4
Explanation:
1. Tearing eyes are a symptom of allergic rhinitis.
2. Itching throat is a symptom of allergic rhinitis.
3. Nasal congestion is a symptom of allergic rhinitis.
4. Sneezing is a symptom of allergic rhinitis.
5. Coughing is n
25) Which information should the nurse include in the education for a client prescribed an intranasal corticosteroid?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "You may feel a b
Answer: 1, 4, 5
Explanation:
1. The most frequently reported adverse effect of this drug is an intense burning sensation in the nose occurring immediately after spraying.
2. The drug often takes 1 to 3 weeks to achieve peak response and should be started
26) Which condition should the nurse be concerned about for a client prescribed an antitussive with codeine?
1. Asthma
2. Diabetes mellitus
3. Chronic kidney disease
4. Coronary artery disease
Answer: 1
Explanation:
1. Care must be taken when using an antitussive with codeine in clients with asthma because bronchoconstriction may occur.
2. An antitussive with codeine does not place a client with diabetes mellitus at risk for an adverse effect.
27) A client asks the nurse how benzonatate (Tessalon) works to suppress her cough. Which response should the nurse provide the client?
1. "Anesthetizes the receptor sites of the lungs"
2. "Raises the cough threshold in the CNS"
3. "Reduces the viscosity
Answer: 1
Explanation:
1. Chemically related to the local anesthetic tetracaine (Pontocaine), benzonatate suppresses the cough reflex by anesthetizing stretch receptors in the lungs.
2. Opioids raise the cough threshold in the CNS.
3. Expectorants reduce
28) Which disorders are antihistamines used to treat?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. Insomnia
2. Vertigo
3. Cystic fibrosis
4. Parkinson's disease
5. Nasal congestion
Answer: 1, 2, 4
Explanation:
1. Antihistamines can be used to treat insomnia.
2. Antihistamines can be used to treat vertigo.
3. Mucolytics are used to help treat cystic fibrosis.
4. Antihistamines can be used to treat Parkinson's disease.
5. Decongestant
29) A client asks the nurse, "Is there anything that I can take for my seasonal allergies?" Which information should the nurse provide to the client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all
Answer: 1, 2, 3
Explanation:
1. Antihistamines are preventers of allergies.
2. Intranasal corticosteroids are preventers of allergies.
3. Mast cell stabilizers are preventers of allergies.
4. Oral decongestants are relievers of allergic symptoms.
5. Nasal
30) A patient has been prescribed benzonatate (Tessalon). What medication education should the nurse provide?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.
1. "This medication should h
Answer: 1, 2, 4, 5
Explanation:
1. Benzonatate is used as an antitussive.
2. If chewed, this drug can cause the side effect of numbing the mouth and pharynx.
3. Hypertension is not an effect of this medication.
4. Nausea is a possible effect of this medic