Deck 74: Pharmacotherapy of Allergic Rhinitis and the Common Cold

Question 1

A middle-aged male is taking pseudoephedrine (Sudafed)for nasal congestion.What adverse effect is most likely if the patient also has benign prostatic hypertrophy?
1)Urinary retention
2)Incontinence of urine
3)Elevated uric acid level
4)Elevated creatine level

Answer 1

1

Question 2

Which teaching pointer is appropriate for inclusion in the teaching associated with learning to use a budesonide (Rhinocort)nasal preparation?
1)"Don't blow your nose right after using this drug."
2)"Use this preparation before your nasal decongestant."
3)"Avoid the use of ultrasonic humidifiers with this preparation."
4)"You should see improvement in your symptoms in about a week."

Answer 2

1

Question 3

The nurse is evaluating the outcomes of the use of a nasal steroid the patient has been using consistently for several months.Which is the most appropriate desired outcome?
1)The patient's upper respiratory system is free of infection.
2)The patient's reports minimal, clear nasal drainage.
3)The patient is free of wheezing.
4)The patient's tonsils are pink, and free of swelling and exudates.

Answer 3

2

Question 4

A nurse is planning care for a patient with allergies who has an order for a sympathomimetic drug.The nurse is aware that the desired effect for this patient is:
1)Relief of nasal stuffiness.
2)Increased blood flow to the nose.
3)Relief of nasal dryness.
4)Calming of a wet cough.

Question 5

The nurse is administering an antihistamine to a patient with nasal allergies.The nurse is aware that antihistamines have a distinct limitation, including:
1)They block both H-1 and H-2 receptors.
2)They are useful only during acute attacks.
3)They have potent cholinergic side effects
4)They are useful only for prophylaxis.

Question 6

A mother is asking the nurse about relief of cold symptoms in her 15-month-old baby.Which preparation should the nurse advise the mother it would be wise to avoid?
1)Acetaminophen (Tylenol)
2)Ibuprofen (Advil)
3)Dextromethorphan (Robitussin)
4)Ocean Spray nasal

Question 7

A student needs to take an antihistamine because of chronic rhinitis.The nurse recognizes that drowsiness impedes scholarly activity.The nurse also recognizes that which preparation is least likely to make the student sleepy in class?
1)Diphenhydramine (Benadryl)
2)Loratadine (Claritin)
3)Certirizine (Zyrtec)
4)Fexofenadine (Allegra)

Question 8

Which assessment data would provide the nurse with the best evidence for allergic rhinitis?
1)Coughing, sneezing, watery eyes, and afebrile
2)Productive cough, sneezing, and low-grade fever
3)Copious thick green nasal drainage and post-nasal drip
4)Severe frontal headache, and pressure along both sides of the nose

Question 9

The nurse is teaching a group of grade school children about some body functions.During the discussion, one student asks the nurse, "Why do I sneeze?" The nurse's best response is:
1)"A sneeze is cause by a contraction of your throat and lungs."
2)"A sneeze is your body's way of getting rid of something irritating."
3)"You sneeze because your body needs to take a really deep breath."
4)"The back part of your brain is in charge of sneezes and coughs."

Question 10

The nurse is working with a patient who persists in blowing cigarette smoke through his nose.The nurse knows his protective mechanisms are less effective than they should be because:
1)Smoke inactivates the normal sweeping motion of the cilia.
2)Exhaled smoke promotes excessive vasodilatation of the nasal vessels.
3)Smoking depresses the cough reflex.
4)Cigarette smoke causes excess thin mucus production.

Question 11

A nurse is planning to teach a patient about the proper use of an intranasal decongestant.The nurse's caution about rebound effect will center primarily on the:
1)Need to count the number of sprays of medication at each application.
2)Wisdom of stopping the medication on the fifth day.
3)Concerns about chest pain with repeated use.
4)Need to minimize the drug's systemic effects.

Question 12

The nurse is teaching a patient to use an intranasal inhaler containing ipratropium.Which pointer is relevant?
1)"Do not blow your nose prior to using this preparation."
2)"Exhale at the same time you depress the canister."
3)"Use the inhaler on one or the other nares with each dose."
4)"Direct the inhaler spray to a different area in the nose each time."

Question 13

The nurse is teaching a patient about the use of antihistamines for allergic rhinitis.Which pointer is appropriate for increasing effectiveness?
1)"Take this drug before you are exposed to your allergens."
2)"Take this drug when your symptoms are the worst."
3)"Take this drug at the same time every day."
4)"Take this drug with the largest meal of the day."

Question 14

The nurse is administering a drug that antagonizes H-1 histamine receptors.Which of the following is the most likely expected outcome of this therapy?
1)The patient will report less sneezing and less tearing.
2)The patient will report less wheezing and more energy.
3)The patient will report head discomfort is less than 3 on a 0-10 analog scale.
4)The patient will cough less than once per hour.

Question 15

A patient is being treated in the Emergency Department for an anaphylactic reaction to an antibiotic.The patient will be receiving an antihistamine in addition to other preparations.Which drug would the nurse anticipate?
1)Diphenhydramine (Benadryl)
2)Fexofenadine (Allegra)
3)Loratadine (Claritin)
4)Azelastine (Astelin)

Question 16

Avoidance is commonly recommended, along with drug therapy, for the relief of allergic rhinitis.Teaching a patient to create an avoidance plan is most practical for the relief of:
1)Perennial food allergies.
2)Seasonal tree pollen allergies.
3)Perennial dust mite allergies.
4)Seasonal grass allergies.

Question 17

A nurse is advising a patient who says she has been using diphenhydramine (Benadryl)OTC to induce sleep.The patient complains about a dry mouth.When teaching the patient to manage this side effect, the nurse recognizes that:
1)Drying of the mouth membranes is common after taking diphenhydramine.
2)Diphenhydramine has a muscle relaxant effect, so she is sleeping with her mouth open.
3)Diphenhydramine causes less dryness if taken in the liquid form.
4)Drowsiness caused by the diphenhydramine caused the patient to reduce fluid intake.

Question 18

Allergy testing is most likely to be useful in directing therapy for a patient with which allergy profile?
1)Single outdoor allergen
2)Multiple outdoor allergens
3)Multiple indoor allergens
4)Multiple indoor and outdoor allergens

Question 19

The nurse is teaching a patient about the beclomethasone (Beconase)nasal spray he will be using post-discharge.Which side effects will the nurse prepare the patient to manage?
1)Nasal irritation and nosebleed
2)Salt sensitivity and elevation of blood pressure
3)Dyspepsia and gastric irritation
4)Bone demineralization and increased risk of fracture

Question 20

A patient is receiving a phenylephrine nasal spray for the symptoms of a cold.Which assessment parameter would the nurse expect to see improved?
1)A decrease in nasal stuffiness
2)Less coughing
3)Fewer nasal secretions
4)Improved energy level

Question 21

Which assessment is most relevant to the care of the patient with a new order for an inhaled nasal steroid?
1)History of allergic rhinitis
2)History of asthma
3)History of chronic bronchitis
4)History of emphysema

Question 22

A nurse is teaching a patient about the adverse reactions associated with dornase alfa (Pulmozyme).Which cluster is the patient most likely to experience?
1)Sore throat, sore eyes, and hoarseness
2)Nausea, vomiting, and diarrhea
3)Headache, nasal stuffiness, and earaches
4)Epigastric pain, belching, and flatulence

Question 23

A nurse is assisting with the administration of a Mucomyst nebulizer treatment by mask.What warning to the patient is essential prior to the start of the treatment?
1)"This treatment may make you feel dizzy."
2)"Tell us right away if you develop chest pain."
3)"This treatment does not smell very good."
4)"Tell us right away if your fingers start to tingle."

Question 24

The nurse is caring for a patient who is receiving benzonatate (Tessalon Perles).The patient accidentally bites into one of the perles prior to swallowing it.What should the nurse do next?
1)Call the physician and complete a variance report.
2)Warn the patient that he is likely to become very nauseated.
3)Explain to the patient that he might experience numbness of the tongue.
4)Assess blood pressure frequently for the next hour.

Question 25

Which of the following is the expected outcome of antihistamine therapy in allergic rhinitis?
1)Sneezing and tearing decrease.
2)The nasal airway opens wider.
3)Coughing becomes productive.
4)The sinuses drain more effectively.

Question 26

Rebound congestion is occasionally a problem after use of some drugs for allergic rhinitis.Which preparation is mostly likely to cause this concern?
1)Inhaled decongestants
2)Oral decongestants
3)Inhaled steroids
4)Oral antihistamines

Question 27

A patient has been receiving a cough medicine with guaifenesin for 48 hours.Which nursing diagnosis would this medication best address?
1)Acute Pain related to swollen tonsils and discomfort rated as 7 on 0-10 VAS
2)Impaired Airway Clearance related to large amount of tenacious mucous
3)Impaired Gas Exchange related to inability to discharge carbon dioxide
4)Impaired Perfusion (pulmonary)related to partially blocked subsegmental bronchioles

Question 28

A nurse is teaching a group about the appropriate use of cough medications.Which preparation is appropriate for dry and harsh coughs?
1)Dextromethorphan (Delsym)
2)Guaifenesin (Mucinex)
3)Guaifenesin (Robitussin GF)
4)Acetylcysteine (Mucomyst)

Question 29

A patient with several chronic conditions is using an oral decongestant because of a cold.Which development should prompt the patient to contact his physician?
1)Thickening and color change of nasal drainage
2)Palpitations
3)Increased coughing
4)Irritated, crusty nares

Question 30

The nurse recognizes that respiratory depression is a risk with some cough suppressants.Which preparation would the nurse consider the safest?
1)Codeine-based
2)Hydrocodone with homatropine (Hycodan)
3)Codeine with bromodiphenhydramine (Ambenyl)
4)Dextromethorphan (Delsym)

Question 31

The nurse is assessing a patient who regularly takes an oral first-generation antihistamine for nasal allergies.Which other medication order would trigger concerns about drug interaction with the antihistamine?
1)Tylenol with codeine #3
2)Hydrochlorothiazide
3)Atenolol
4)enoxaparin (Lovenox)

Question 32

The nurse is teaching a patient about the use of intranasal beclomethasone (Beconase).Which side effects should the nurse mention?
1)Muscle aches and conjunctivitis
2)Burning and nosebleed
3)Frequent sneezing and hiccups
4)Nuchal rigidity and headache

Question 33

A patient with a severe cough has a new order for a hydrocodone-based antitussive.Upon collecting the patient's history, the nurse notes what concern, which triggers a call to the health care provider to check the patient's new order?
1)The patient has been unable to sleep for four nights due to coughing.
2)The patient has a history of persistent intermittent asthma.
3)The patient says hydrocodone makes her drowsy.
4)The patient has a history of lung cancer.