Deck 45: Pharmacotherapy of Allergic Rhinitis and the Common Cold

Question 1

The nurse is teaching a group of grade-school children about body functions.A student asks,"Why do I sneeze?" The nurse's best response is:

A)"A sneeze is caused by a contraction of your throat and lungs."
B)"The back part of your brain is in charge of sneezes and coughs."
C)"A sneeze is your body's way of getting rid of something irritating."
D)"You sneeze because your body needs to take a really deep breath."

Answer 1

"A sneeze is your body's way of getting rid of something irritating."

Question 2

A client is being treated in the emergency department for an anaphylactic reaction to an antibiotic.The client will be receiving an antihistamine in addition to other preparations.Which drug would the nurse anticipate administering?

A)Fexofenadine (Allegra)
B)Azelastine (Astelin)
C)Loratadine (Claritin)
D)Diphenhydramine (Benadryl)

Answer 2

Diphenhydramine (Benadryl)

Question 3

An older male client with several chronic conditions is using pseudoephedrine (Sudafed)for cold symptoms.Which adverse effect does the nurse teach the client to report to the physician?

A)Increased coughing
B)Irritated,crusty nares
C)Thickening and color change of nasal drainage
D)Decreased urinary stream

Answer 3

Decreased urinary stream

Question 4

The nurse is teaching a client about the actions of an intranasal inhaler containing ipratropium (Atrovent).Which statement by the nurse is most accurate?

A)"You will notice a decrease in nasal secretions."
B)"You will notice you are not sneezing as much."
C)"You will not have as much postnasal drip."
D)"Your throat won't feel so scratchy."

Question 5

A mother is asking the nurse about relief of cold symptoms in her 4-year-old.Which preparation should the nurse advise the mother to avoid?

A)Loratadine (Claritin)
B)Acetaminophen (Tylenol)
C)Ibuprofen (Advil)
D)Dextromethorphan (Robitussin)

Question 6

The nurse is advising a client who been using diphenhydramine (Benadryl)over-the-counter (OTC)to induce sleep.The client complains about a dry mouth.The nurse explains that:

A)Diphenhydramine causes less dryness if taken in the liquid form.
B)Drying of the mouth membranes is common after taking diphenhydramine.
C)Drowsiness caused by the diphenhydramine caused the client to reduce fluid intake.
D)Diphenhydramine has a muscle relaxant effect,so the client is likely sleeping with the mouth open.

Question 7

Which assessment data would provide the nurse with the best evidence of allergic rhinitis?

A)Copious thick,green nasal drainage and postnasal drip
B)Productive cough,sneezing,and low-grade fever
C)Coughing,sneezing,and watery eyes
D)Severe frontal headache and pressure along both sides of the nose

Question 8

The nurse is evaluating outcomes for a client who has been using a nasal steroid consistently for several months.Which is the desired outcome?

A)The client reports decreased nasal congestion.
B)The client's upper respiratory system is free of infection.
C)The client is free of wheezing.
D)The client's tonsils are pink and free of swelling and exudate.

Question 9

The nurse is teaching a group about the use of cough medications.Which preparation should be used for nonproductive coughs?

A)Guaifenesin (Robitussin GF)
B)Acetylcysteine (Mucomyst)
C)Dextromethorphan (Delsym)
D)Guaifenesin (Mucinex)

Question 10

The nurse is administering a drug that antagonizes H-1 histamine receptors.Which is the most likely expected outcome of this therapy?

A)The client will report that headache is improved.
B)The client will cough less.
C)The client will report less sneezing and tearing.
D)The client will report less wheezing and more energy.

Question 11

The nurse recognizes that respiratory depression is a risk with some cough suppressants.Which preparation has the least risk of causing respiratory depression?

A)Codeine-based
B)Codeine with bromodiphenhydramine (Ambenyl)
C)Hydrocodone with homatropine (Hycodan)
D)Dextromethorphan (Delsym)

Question 12

A client is receiving a phenylephrine (Afrin)nasal spray for the symptoms of a cold.Which assessment parameter would the nurse expect to see improved?

A)A decrease in nasal stuffiness
B)Improved energy level
C)Less coughing
D)Fewer nasal secretions

Question 13

The nurse is planning care for a client with allergies who has an order for a sympathomimetic drug.The nurse is aware that the desired effect for this client is:

A)relief of nasal dryness.
B)relief of nasal stuffiness.
C)calming of a wet cough.
D)increased blood flow to the nose.

Question 14

A student needs to take an antihistamine for chronic rhinitis.Which preparation is least likely to make the student sleepy in class?

A)Hydroxyzine (Atarax)
B)Cetirizine (Zyrtec)
C)Diphenhydramine (Benadryl)
D)Fexofenadine (Allegra)

Question 15

The nurse is teaching a client about beclomethasone (Beconase)nasal spray prior to discharge.Which side effects will the nurse prepare the client to manage?

A)Salt sensitivity and elevation of blood pressure
B)Nasal irritation and nosebleed
C)Bone demineralization and increased risk of fracture
D)Dyspepsia and gastric irritation

Question 16

The nurse is instructing a client on the proper use of an intranasal decongestant.The nurse's caution about rebound effect will center primarily on:

A)concerns about chest pain with repeated use.
B)the need to minimize the drug's systemic effects.
C)the need to count the number of sprays of medication at each application.
D)the need to stop the medication after three to five days of use.

Question 17

A middle-aged male is taking pseudoephedrine (Sudafed)for nasal congestion.What adverse effect is most likely if he also has benign prostatic hypertrophy?

A)Elevated uric acid level
B)Urinary retention
C)Incontinence of urine
D)Elevated creatine level

Question 18

The nurse is teaching a client about the use of antihistamines for allergic rhinitis.Which pointer is appropriate for increasing effectiveness?

A)"Take this drug at the same time every day."
B)"Take this drug with the largest meal of the day."
C)"Take this drug when your symptoms are the worst."
D)"Take this drug before you are exposed to your allergens."

Question 19

The nurse is administering an antihistamine to a client with nasal allergies.The nurse is aware that antihistamines have which distinct limitation?

A)They have potent cholinergic side effects.
B)They block both H-1 and H-2 receptors.
C)They are most effective when taken prophylactically.
D)They are useful only during acute attacks.

Question 20

Which point should the nurse include when instructing a client in the use of a budesonide (Rhinocort)nasal preparation?

A)"Use this preparation before your nasal decongestant."
B)"Avoid the use of ultrasonic humidifiers with this preparation."
C)"You should see improvement in your symptoms in about a week."
D)"You could experience nosebleeds."

Question 21

A client asks the nurse why the physician prescribed an oral rather than an intranasal decongestant.The nurse responds:
Select all that apply.

A)Intranasal decongestants can worsen congestion once the effects of the drug wear off."
B)You will need medication for the length of the allergy season,but intranasal decongestants shouldn't be taken for longer than 5 days."
C)Oral decongestants take less time to alleviate symptoms."
D)Oral decongestants are more effective at relieving severe congestion."
E)Oral decongestants carry a lower risk of systemic adverse effects."

Question 22

The nurse is planning care for an older adult taking fexofenadine (Allegra)for seasonal allergies.Which nursing diagnoses would take priority?
Select all that apply.

A)Injury,Risk for
B)Knowledge,Deficient
C)Falls,Risk for
D)Airway Clearance,Ineffective
E)Breathing Pattern,Ineffective

Question 23

A pediatric nurse is triaging a 6-year-old in an urgent care facility and suspects the child is experiencing complications from allergic rhinitis.Which symptoms did the nurse assess?
Select all that apply.

A)Loss of smell and taste
B)Hoarseness
C)Plugged ears
D)Red,swollen,itchy eyes
E)Scratchy throat

Question 24

The nurse instructing a client with allergic rhinitis would recommend which actions to decrease exposure to allergens?
Select all that apply.

A)Remove pets from the home or limit exposure.
B)Routinely clean moldy surfaces.
C)Clean frequently to remove dust mites from bedding,carpets,and furniture.
D)Remove all carpeting and replace with wood floors.
E)Buy new mattresses every 2 years.

Question 25

The nurse is assessing a client who regularly takes an oral first-generation antihistamine for nasal allergies.Which medication order would trigger concerns about drug interaction with the antihistamine?

A)Hydrochlorothiazide,a diuretic
B)Tylenol with codeine,an opiate analgesic
C)Enoxaparin (Lovenox),an anticoagulant
D)Atenolol,an antihypertensive

Question 26

The nurse is caring for a client who is taking benzonatate (Tessalon)for a cough.The client accidentally bites into one of the gelcaps prior to swallowing it.What should the nurse do next?

A)Call the physician and complete a variance report.
B)Explain that the client might experience numbness of the tongue.
C)Assess blood pressure frequently for the next hour.
D)Explain that the client is likely to become very nauseated.

Question 27

A client is being treated with dornase alfa (Pulmozyme).The nurse anticipates that the client is most likely to experience which cluster of adverse effects?

A)Headache,nasal stuffiness,and earaches
B)Nausea,vomiting,and diarrhea
C)Epigastric pain,belching,and flatulence
D)Sore throat,conjunctivitis,and hoarseness

Question 28

A client has been receiving a cough medicine with guaifenesin for 48 hours.Which nursing diagnosis would this medication best address?

A)Airway Clearance,Ineffective related to large amount of tenacious mucus
B)Perfusion: Gastrointestinal,Risk for Ineffective related to abdominal distension from gas buildup in stomach.
C)Gas Exchange,Impaired related to inability to discharge carbon dioxide
D)Pain,Acute related to swollen tonsils and discomfort rated at 7 on 0-10 VAS

Question 29

Rebound congestion is occasionally a problem after use of some drugs for allergic rhinitis.Which preparation is mostly likely to cause this concern?

A)Intranasal decongestants
B)Intranasal steroids
C)Oral decongestants
D)Oral antihistamines

Question 30

The nurse is teaching a client about the side effects of intranasal beclomethasone (Beconase),including:

A)nuchal rigidity and headache.
B)burning and nosebleed.
C)muscle aches and conjunctivitis.
D)frequent sneezing and hiccups.

Question 31

The nurse is teaching a group of teens with asthma how the structures of the upper respiratory tract protect against infections.Which statement by a teen demonstrates that teaching has been successful?
Select all that apply.

A)The passages of the nose and throat filter,warm,and humidify air when I inhale."
B)The structures of the upper respiratory tract trap particulate matter and pathogens,preventing them from going down into my lungs."
C)The upper respiratory tract is lined with tiny hairs that move back and forth,pushing foreign matter away from the lungs."
D)Mucous membranes inside the nose produce allergens that neutralize pathogens."
E)The saliva in my mouth contains cells that can eat bacteria."

Question 32

A 12-year-old with allergies has been prescribed desloratadine (Clarinex).The nurse instructs the client and the mother about possible adverse effects,including:
Select all that apply.

A)insomnia.
B)nervousness.
C)dizziness.
D)confusion.
E)urinary hesitancy.

Question 33

The nurse would expect to see an order for a drug that blocks H₂ receptors in a client with:
Select all that apply.

A)excess gastric acid production.
B)peptic ulcer disease.
C)gastroesophageal reflux disease.
D)allergic rhinitis.
E)seasonal allergies.

Question 34

A client asks the nurse why the physician has ordered an antihistamine for insomnia that is the same one a neighbor takes for seasonal allergies.The nurse explains that antihistamines are effective in treating a number of problems,including:
Select all that apply.

A)Parkinson disease.
B)motion sickness.
C)hives.
D)bronchoconstriction.
E)hypotension.

Question 35

It has been determined that a client's rhinitis is not the result of previous exposure to an allergen.The nurse explains that a nonallergic response can occur with:
Select all that apply.

A)x-ray dye.
B)certain drugs.
C)plasma expanders.
D)pollens.
E)animal dander.

Question 36

Which assessment is most relevant to the care of a client with a new order for an inhaled nasal steroid?

A)History of chronic bronchitis
B)History of emphysema
C)History of allergic rhinitis
D)History of asthma

Question 37

What is an expected outcome of antihistamine therapy for allergic rhinitis?

A)The nasal airway opens wider.
B)The sinuses drain more effectively.
C)Coughing becomes productive.
D)Sneezing and tearing decrease.

Question 38

A client with a severe cough has a new order for a hydrocodone-based antitussive.Which history assessment would result in changing the prescription?

A)The client has been unable to sleep for 4 nights due to coughing.
B)The client has a history of lung cancer.
C)Hydrocodone makes the client drowsy.
D)The client has a history of persistent intermittent asthma.

Question 39

The nurse is assisting with the administration of an acetylcysteine (Mucomyst)nebulizer treatment by mask.What warning to the client is essential prior to the start of the treatment?

A)"Tell us right away if your fingers start to tingle."
B)"This treatment does not smell very good."
C)"This treatment may make you feel dizzy."
D)"Tell us right away if you develop chest pain."

Question 40

The nurse keeps which therapeutic goals in mind when teaching a client with allergic rhinitis about prescribed medications?
Select all that apply.

A)Prevent its occurrence.
B)Relieve symptoms.
C)Decrease the risk of infection.
D)Treat evidence of infection.
E)Avoid the use of medications that cause drowsiness.

Question 41

The nurse teaches the client with seasonal allergies that the most effective way to prevent allergy symptoms is to:

A)take allergy medication before allergy season begins.
B)take allergy medication as soon as symptoms begin.
C)take as little allergy medication as possible so the body will not become sensitized to the medication.
D)take supplemental nonpharmacologic measures.

Question 42

The community nurse explains to a group of clients that taking combination drugs for a cold can be dangerous and cites several examples,such as:
Select all that apply.

A)an older male taking a cold medication with chlorpheniramine and phenylephrine (Actifed Cold and Allergy)for congestion.
B)a client with chronic obstructive pulmonary disease (COPD)taking a cold medication containing triprolidine and pseudoephedrine (Actifed Plus)for seasonal allergies.
C)a client with liver disease taking a medication containing diphenhydramine and acetaminophen (Tylenol PM).
D)a young adult with sinusitis taking a medication containing chlorpheniramine and phenylephrine (Sudafed Sinus and Allergy).
E)a middle-aged client with a cough taking a medication containing diphenhydramine and phenylephrine (Benadryl Allergy and Cold caplets).

Question 43

Which outcomes would be most appropriate for a client who is receiving pharmacotherapy for cough and cold relief?
Select all that apply.

A)The client will experience decreased congestion and drainage.
B)The client will easily expectorate excess mucus.
C)The client will report dry mouth and drowsiness to the provider.
D)The client will reduce fluid intake to assist in liquefying mucus.
E)The client will contact the health care provider if the cough becomes productive.

Question 44

Allergy testing is most likely to be useful in directing therapy for a client with which allergy profile?
Select all that apply.

A)Multiple indoor allergens
B)Single outdoor allergen
C)Possible allergy to animal dander
D)Possible allergy to mold
E)Possible allergy to a medication

Question 45

A pediatric nurse,teaching new parents about the body's structural defenses against respiratory infections,explains that pathogens are swept" away from the lungs by the:

A)cilia.
B)mucous membranes.
C)vestibule.
D)internal nares.