Test Bank - Focus on Nursing Pharmacology (8th Edition by Karch)
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
Ans: B
Feedback:
Decongestants cause local vasoconstriction that decreases blood flow to irritated and
dilated capillaries of the mucous membranes lining the nasal passages and sinus
cavities. This vasoconstriction leads to a shrinking of swollen membranes and opens
clogged nasal passages promoting drainage of secretions and improved air flow.
Antitussives either work directly on the medullary cough center of the brain or act as
a local anesthetic on the respiratory passages blocking the effectiveness of the stretch
receptors that stimulate a cough reflex. Expectorants liquefy lower respiratory tract
secretions, reducing the viscosity of the secretions and so making it easier to cough
them up. Mucolytics break down mucus to aid a person in coughing up thick
tenacious secretions by separating cells that hold mucous material together.
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.
Ans: C
Feedback:
A cough that has persisted for 2 weeks could be indicative of an underlying medical
condition that should be addressed before treating the cough. The patient should be
asked to come in for an evaluation. Dextromethorphan could help stop the cough, but
, suppressing the cough might not be in the patient’s best interest. Drying the mucosa
with an antihistamine could aggravate the cough. Aspirin would not be indicated for
relieving throat irritation.
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
Ans: B
Feedback:
A patient receiving acetylcysteine by face mask should have the residue wiped off the
face mask and her face with plain water to prevent skin breakdown. The appropriate
nursing diagnosis would be risk for impaired skin integrity. Acetylcysteine does not
cause impaired swallowing, produce any CNS effects that could increase the risk for
falls, or impair the patient’s ability to sleep.
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.
Ans: C
Feedback:
Patients using dornase alfa should be cautioned to store the drug in the refrigerator,
protected from light. Heat and light can cause the drug to break down and can
decrease its therapeutic value. The drug should only be used up to two times a day
and the patient should continue all other medications while using it. Dornase alfa is
only a palliative therapy that improves respiratory symptoms. A severe headache is
not associated with this drug.
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
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
Ans: B
Feedback:
Decongestants cause local vasoconstriction that decreases blood flow to irritated and
dilated capillaries of the mucous membranes lining the nasal passages and sinus
cavities. This vasoconstriction leads to a shrinking of swollen membranes and opens
clogged nasal passages promoting drainage of secretions and improved air flow.
Antitussives either work directly on the medullary cough center of the brain or act as
a local anesthetic on the respiratory passages blocking the effectiveness of the stretch
receptors that stimulate a cough reflex. Expectorants liquefy lower respiratory tract
secretions, reducing the viscosity of the secretions and so making it easier to cough
them up. Mucolytics break down mucus to aid a person in coughing up thick
tenacious secretions by separating cells that hold mucous material together.
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.
Ans: C
Feedback:
A cough that has persisted for 2 weeks could be indicative of an underlying medical
condition that should be addressed before treating the cough. The patient should be
asked to come in for an evaluation. Dextromethorphan could help stop the cough, but
, suppressing the cough might not be in the patient’s best interest. Drying the mucosa
with an antihistamine could aggravate the cough. Aspirin would not be indicated for
relieving throat irritation.
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
Ans: B
Feedback:
A patient receiving acetylcysteine by face mask should have the residue wiped off the
face mask and her face with plain water to prevent skin breakdown. The appropriate
nursing diagnosis would be risk for impaired skin integrity. Acetylcysteine does not
cause impaired swallowing, produce any CNS effects that could increase the risk for
falls, or impair the patient’s ability to sleep.
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.
Ans: C
Feedback:
Patients using dornase alfa should be cautioned to store the drug in the refrigerator,
protected from light. Heat and light can cause the drug to break down and can
decrease its therapeutic value. The drug should only be used up to two times a day
and the patient should continue all other medications while using it. Dornase alfa is
only a palliative therapy that improves respiratory symptoms. A severe headache is
not associated with this drug.
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
