Pharmacology Respiratory NCLEX Questions (Ch 40 - 41, 47 - 50) | Complete Solutions

Pharmacology Respiratory NCLEX Questions (Ch 40 - 41, 47 - 50) | Complete Solutions A client tells the nurse that he has started to take an OTC antihistamine, diphenhydramine. In teaching him about side effects, what is most important for the nurse to tell the client? a. Do not to take this drug at bedtime to avoid insomnia. b. Avoid driving a motor vehicle until stabilized on the drug. c. Nightmares and nervousness are more likely in an adult. d. Limit use to 1 to 2 puffs/sprays 4 to 6 times per day to avoid rebound congestion. The client complains of a sore throat and has been told it is due to beta-hemolytic streptococcal infection. The nurse realizes this condition is called what? a. Acute rhinitis. b. Acute sinusitis. c. Acute pharyngitis. d. Acute rhinorrhea. A client is prescribed the decongestant oxymetazoline (Afrin) nasal spray. What should the nurse teach the client? a. Take this drug at bedtime as a sleep aid. b. Directly spray away from the nasal septum and gently sniff. c. This drug may be used in maintenance treatment for asthma. d. Limit the drug to 5 days of use to prevent rebound nasal congestion. A client has been prescribed guaifenesin (Robitussin). The nurse realizes that the purpose of the drug is to accomplish what? a. To treat allergic rhinitis and prevent motion sickness b. To loosen bronchial secretions so they can be eliminated by coughing c. To compete with histamine for receptor sites, thus preventing a histamine response d. To stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa Beclomethasone (Beconase) has been prescribed for a client with allergic rhinitis. The nurse teaches the client that which is the most common side effect from continuous use? a. Dizziness b. Rhinorrhea c. Hallucinations d. Dry nasal mucosa The nurse is teaching a client about diphenhydramine (Benadryl). Which are topics to include? (Select all that apply.) a. Take medication with food to decrease gastric distress. b. Avoid alcohol and other central nervous system depressants. c. Notify the health care provider if confusion or hypotension occurs. d. Take sugarless candy, gum, or ice chips for temporary relief of dry mouth. e. Avoid handling dangerous equipment or performing dangerous activities until stabilized on the drug. The nurse is caring for a client who is taking a first-generation antihistamine. What is the most important fact for the nurse to teach the client? a. "Do not drive after taking this medication." b. "Make sure you drink a lot of liquids while on this medication." c. "Take this medication on an empty stomach." d. "Do not take this medication for more than 2 days." The nurse is caring for a client in the clinic who states that he is afraid of taking antihistamines because he is a truck driver. What is the best information for the nurse to give this client? a. "Take the medication only when you are not driving." b. "Take a lower dose than normal when you have to drive." c. "You are correct, you should not take antihistamines." d. "You may be able to safely take a second-generation antihistamine." The client tells the nurse that she has a bad cold, is coughing, and feels like she has "stuff" in her lungs. What should the nurse do? a. Administer dextromethorphan. b. Administer guaifenesin. c. Encourage the client to drink fluids hourly. d. Administer fluticasone (Flonase). What is the most important thing for the nurse to teach a client who is switching allergy medications from diphenhydramine (Benadryl) to loratadine (Claritin)? a. This medication can potentially cause dysrhythmias. b. This medication has fewer sedative effects. c. This medication has increased bronchodilating effects. d. This medication causes less gastrointestinal upset. A client complains of worsening nasal congestion despite the use of oxymetazoline (Afrin) nasal spray every 2 hours. What is the nurse's best response? a. "Oxymetazoline is not an effective nasal decongestant." b. "Overuse of nasal decongestants results in rebound congestion." c. "Oxymetazoline should be administered every hour for severe congestion." d. "You are probably displaying an idiosyncratic reaction to oxymetazoline." Which statement indicates that the client understands the teaching about beclomethasone diproprionate (Beconase)? a. "I will need to taper off the medication to prevent acute adrenal crisis." b. "This medication will help prevent the inflammatory response of my allergies." c. "I will need to monitor my blood sugar more closely because it may increase." d. "I need to take this medication only when my symptoms get bad." A client is prescribed an antitussive medication. What is the most important thing for the nurse to teach the client? a. "This medication may cause drowsiness and dizziness." b. "Watch out for diarrhea and abdominal cramping." c. "This may cause tremors and anxiety." d. "Headache and hypertension are common side effects." Which is the best instruction for the nurse to include when teaching a client about the use of expectorants? a. Restrict fluids in order to decrease mucus production. b. Take the medication once a day only, at bedtime. c. Increase fluid intake in order to decrease viscosity of secretions. d. Increase fiber and fluid intake to prevent constipation. A client is diagnosed with a pulmonary disorder that causes COPD. Lungs tissue changes are normally reversible with this condition. The nurse understands that which is the client's most likely diagnosis? a. Asthma b. Emphysema c. Bronchiectasis d. Chronic bronchitis A client with COPD has an acute bronchospasm. The nurse knows that which is the best medication for this emergency situation? a. zafirlukast (Accolate) b. epinephrine (Adrenalin) c. dexamethasone (Decadron) d. oxtriphylline-theophyllinate (Choledyl) A client is taking aminophylline-theophylline ethylenediamine (Somophyllin). For what should the nurse monitor the client? a. Drowsiness b. Hypoglycemia c. Increased heart rate d. Decreased white blood cell count A client is prescribed theophylline to relax the smooth muscles of the bronchi. The nurse monitors the client's theophylline serum levels to maintain which therapeutic range? a. 1 to 10 mcg/mL b. 10 to 20 mcg/mL c. 20 to 30 mcg/mL d. 30 to 40 mcg/mL A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? a. Maintenance treatment of asthma b. Treatment of an acute asthma attack c. Reversing bronchospasm associated with COPD d. Treatment of inflammation in chronic bronchitis The nurse is caring for a client with a theophylline level of 14 mcg/mL. What is the priority nursing intervention? a. Increase the IV drip rate. b. Monitor the client for toxicity. c. Continue to assess the client's oxygenation. d. Stop the IV for an hour then restart at lower rate. Discharge teaching to a client receiving a beta-agonist bronchodilator should emphasize reporting which side effect? a. Hypoglycemia b. Nonproductive cough c. Sedation d. Tachycardia The nurse instructs the client to avoid which over-the-counter products when taking theophylline (Theo-Dur)? a. acetaminophen (Tylenol) b. echinacea c. diphenhydramine (Benadryl) d. St. John's wort A nurse reviews a client's medication history and notes that the client is taking a nonselective adrenergic agonist bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention? a. Monitor client for potential chest pain. b. Monitor blood pressure continuously. c. Assess daily for hyperkalemia. d. Assess 12-lead ECG each shift. The nurse is instructing a client about the advantages of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil). How will the nurse explain to the client the difference in these two medications? a. Salmeterol has a shorter onset of action. b. Salmeterol does not have any side effects. c. Albuterol has a longer onset of action. d. Salmeterol has a longer duration of action. Client teaching regarding the use of antileukotriene agents such as zafirlukast (Accolate) should include which statement? a. "Take the medication as soon as you begin wheezing." b. "It will take about 3 weeks before you notice a therapeutic effect." c. "This medication will prevent the inflammation that causes your asthma attack." d. "Increase fiber and fluid in your diet to prevent the side effect of constipation." A client with a history of asthma is short of breath and says, "I feel like I'm having an asthmatic attack." What is the nurse's best action? a. Call a code. b. Ask the client to describe the symptoms. c. Administer a beta2 adrenergic agonist. d. Administer a long-acting glucocorticoid. A client has taken metaproterenol. What is the nurse's priority action? a. Monitor for heart rate 100 beats/min. b. Tell the client not to drive for 2 hours. c. Monitor for sedation. d. Assess for elevated blood pressure. A client demonstrates understanding of flunisolide (AeroBid) by saying that he will do what? a. Take two puffs to treat an acute asthma attack. b. Rinse his mouth with water after each use. c. Immediately stop taking his oral prednisone when he starts using AeroBid. d. Not use his albuterol inhaler while he is taking AeroBid. The nurse is caring for a young child who has been prescribed an inhaler for control of her asthma. The child is having difficulty using the inhaler. What is the nurse's best action? a. Tell the parent to hold the inhaler for the child. b. Ask the health care provider to switch to oral medications. c. Tell the parent that young children should not use inhalers. d. Teach the child to use a spacer. The nurse is caring for clients on the pulmonary unit. Which client should not receive epinephrine if ordered? a. The client with a history of emphysema b. The client with a history of type 2 diabetes c. The client who is 16 years old d. The client with atrial fibrillation with a rate of 100 The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a client. What is the nurse's best action? a. Question the order; three inhalers should not be given at one time. b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later. c. Administer each inhaler at 30-minute intervals. d. Administer beclomethasone first, wait 2 minutes, and administer ipratropium bromide, followed by the albuterol several minutes later. Which instruction will the nurse include when teaching a client about the proper use of metered-dose inhalers? a. "After you inhale the medication once, repeat until you obtain relief." b. "Make sure that you puff out air repeatedly after you inhale the medication." c. "Hold your breath for 10 seconds if you can after you inhale the medication." d. "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler." What will the nurse expect to find that would indicate a therapeutic effect of acetylcysteine (Mucomyst)? a. Decreased cough reflex b. Decreased nasal secretions c. Liquefying and loosening of bronchial secretions d. Relief of bronchospasms What is the most important thing for the nurse to teach the client with a history of diabetes and asthma who has started on albuterol PRN? a. Take Tylenol for headaches when taking albuterol. b. Monitor for orthostatic hypotension every 2 hours when taking albuterol. c. Monitor blood glucose levels every 4 hours when taking albuterol. d. An antianxiety agent may be prescribed to help with nervousness. A client is prescribed ipratropium and cromolyn sodium. What will the nurse teach the client? a. "Do not take these medications within 4 hours of each other." b. "Take the ipratropium at least 5 minutes before the cromolyn." c. "Administer both medications together in a metered-dose inhaler." d. "Take the ipratropium only in the mornings." A client taking an oral theophylline preparation is due for her next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110. The client is irritable. What is the best action for the nurse to take? a. Continue to monitor the client. b. Call the health care provider. c. Hold the next dose of theophylline. d. Administer oxygen 2 lpm via nasal cannula. A client complains of constipation and requires a laxative. In providing teaching to the client, the nurse reviews the common causes of constipation, including which cause? a. Motion sickness b. Lack of exercise c. Food intolerance d. Bacteria (Escherichia coli) A client has nausea and is taking ondansetron (Zofran). The nurse explains that the action of this drug is what? a. Stimulate the CTZ b. Block serotonin receptors in the CTZ c. Block dopamine receptors in the CTZ d. Coat the wall of the GI tract and absorb bacteria A client who has constipation is prescribed a bisacodyl suppository. The nurse explains that bisacodyl does what? a. Acts on smooth intestinal muscle to gently increase peristalsis b. Absorbs water into the intestines to increase bulk and peristalsis c. Lowers surface tension and increases water accumulation in the intestines d. Pulls hyperosmolar salts into the colon and increases water in the feces to increase bulk A client is using the scopolamine patch to prevent motion sickness. The nurse teaches the client that which is a common side effect of this drug? a. Diarrhea b. Vomiting c. Insomnia d. Dry mouth When metoclopramide (Raglan) is given for nausea, the client is cautioned to avoid which substance? a. Milk b. MAOIs c. Alcohol d. Carbonated beverages The nurse is administering opium tincture (paregoric) to a client. Which should be included in the client teaching regarding this medication? (Select all that apply.) a. Warn the client to avoid laxative abuse. b. Record the frequency of bowel movements. c. Warn the client against taking sedatives concurrently. d. Encourage the client to increase fluids. e. Instruct the client to avoid this drug if he or she has narrow-angle glaucoma. f. Teach the client that the drug acts by drawing water into the intestine. Which assessment finding will need intervention and is related to the client's use of aluminum hydroxide (Amphojel)? a. Client has not had a bowel movement in 3 days. b. Client has had one loose stool this week. c. Client is complaining of gastric upset. d. Client has trace edema in feet. Which client needs immediate intervention? a. Client taking aluminum-containing antacids with complaints of reflux. b. Client taking calcium-containing antacids who is hypocalcemic. c. Client taking magnesium-containing antacids who has renal failure. d. Client taking antacids who is older than 70 years. What assessment has the highest priority for a client using sodium bicarbonate to treat gastric hyperacidity? a. Assess for metabolic alkalosis. b. Assess for fluid volume deficit. c. Assess for hyperkalemia. d. Assess for hypercalcemia. Which nursing diagnoses is appropriate for a client receiving famotidine (Pepcid)? a. Increased risk for infection related to immunosuppression b. Potential risk for bleeding related to thrombocytopenia c. Alteration in urinary elimination related to retention d. Alteration in tissue perfusion related to hypertension Which statement demonstrates to the nurse that the client understands instructions regarding the use of histamine2-receptor antagonists? a. "Since I am taking this medication, it is all right for me to eat spicy foods." b. "Smoking decreases the effects of this medication, so I should look into cessation programs." c. "I should take this medication 1 hour after each meal in order to decrease gastric acidity." d. "I should decrease bulk and fluids in my diet to prevent diarrhea." A client is prescribed Lorazepam (Ativan) and a glucocorticoid during chemotherapy treatments. What is the nurse's best action? a. Call the health care provider and question the order. b. Only administer the Ativan if the client seems anxious. c. Administer the two medications at least 12 hours apart. d. Administer the medications and assess the client for relief. A nurse is caring for a client who is unable to tolerate oral medications. The nurse anticipates that the client may be prescribed which proton pump inhibitor to be administered intravenously? a. esomeprazole (Nexium) b. lansoprazole (Prevacid) c. omeprazole (Prilosec) d. pantoprazole (Protonix) Which client statement indicates that further teaching is needed? a. "I will not drive while I am taking these medications because they may cause drowsiness." b. "I may take Tylenol to treat the headache caused by ondansetron (Zofran)." c. "I will apply the scopolamine patches to rotating sites on my arms." d. "I should take my prescribed antiemetic before receiving my chemotherapy dose and continue afterwards." The nurse is administering loperamide (Imodium) to a client with diarrhea. What assessment is essential for this client? a. Vascular assessment b. Gastric assessment c. Hourly blood pressure measurements d. White blood count Which outcome assessment is essential to monitor for the client taking diphenoxylate (Lomotil)? a. Increase in bowel sounds b. Increase in number of bowel movements c. Decrease in gastric motility d. Decrease in urination The nurse is planning to administer metoclopramide (Reglan). What is a primary intervention? a. Administer with food to decrease gastrointestinal upset. b. Administer every 6 hours around the clock. c. Administer 30 minutes before meals and at bedtime. d. Give with a full glass of water first thing in the morning. What will the nurse teach the client about the reason for administering multiple medications for relief of nausea and vomiting? a. Combination therapy decreases the risk of constipation. b. Combination therapy is more cost-effective. c. Combination therapy blocks different vomiting pathways. d. Combination therapy decreases side effects due to lower doses of each drug. In developing a plan of care for a client receiving an antihistamine antiemetic agent, which nursing diagnosis would be of highest priority?