NUR 3145 Exam 3 with reference and rationale
k k k k k k k
Chapter 36: Antihistamines, Decongestants, Antitussives, and ExpectorantsLille
k k k k k k k
y: Pharmacology and the Nursing Process, 8th Edition
k k k k k k k
MULTIPLEkCHOICE
1. Whenkgivingkdextromethorphan,ktheknursekunderstandskthatkthiskdrugksuppresseskthekcoughkr
eflexkbykwhichkmechanismkofkaction?
a. Causingkdepressionkofkthekcentralknervousksystem
b. Anesthetizingkthekstretchkreceptors
c. Havingkdirectkactionkonkthekcoughkcenter
d. Decreasingkthekviscositykofkthekbronchialksecretions
ANS:k C
Dextromethorphanksuppresseskthekcoughkreflexkthroughkakdirectkactionkonkthekcoughkcenter.kThek
otherkoptionskarekincorrect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k572kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
2. Duringkakroutinekcheckup,kakpatientkstateskthatkshekiskunablektoktakekthekprescribedkantihista
minekbecausekofkonekofkitskmostkcommonkadversekeffects.kTheknurseksuspectskthatkwhichkad
versekeffectkhaskbeenkbotheringkthiskpatient?
a. Constipation
b. Abdominalkcramps
c. Drowsiness
d. Decreasedklibido
ANS:k C
Drowsinesskiskusuallykthekchiefkcomplaintkofkpeoplekwhoktakekantihistamines.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k567kTOP:k NURSINGkPROCESS:kAssessment
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
3. Akgardenerkneedskakdecongestantkbecausekofkseasonalkallergykproblemskandkasksktheknursek
whetherkhekshouldktakekankoralkformkorkaknasalkspray.kWhichkofkthesekiskakbenefitkofkorallyka
dministeredkdecongestants?
a. Immediatekonset
b. Akmorekpotentkeffect
c. Lackkofkreboundkcongestion
d. Shorterkduration
ANS:k C
Drugskadministeredkbykthekoralkroutekproducekprolongedkdecongestantkeffects,kbutkthekonsetkofka
ctionkiskmorekdelayedkandkthekeffectklesskpotentkthankthosekofkdecongestantskappliedktopically.kH
owever,kthekclinicalkproblemkofkreboundkcongestionkassociatedkwithktopicallykadministeredkdru
gskiskalmostknonexistentkwithkoralkdosagekforms.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k570kTOP:k NURSINGkPROCESS:kPlanning
,NUR 3145 Exam 3 with reference and rationale
k k k k k k k
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
4. Akpatientkisktakingkguaifenesink(Humibid)kaskpartkofktreatmentkforkaksinuskinfection.kWhichki
nstructionkwillktheknursekincludekduringkpatientkteaching?
a. Forcekfluidsktokhelpkloosenkandkliquefyksecretions.
b. Reportkclear-coloredksputumktokthekprescriber.
c. Avoidkdrivingkakcarkorkoperatingkheavykmachinerykbecausekofktheksedatingkeffects.
d. Reportksymptomskthatklastklongerkthank2kdays.
ANS:k A
Forcingkfluidskhelpsktokloosenkandkliquefyksecretions.kThekpatientkmustkbekfullykawarekthatkanykf
ever,kchestktightness,kchangekinksputumkfromkclearktokcolored,kdifficultkorknoisykbreathing,kactiv
itykintolerance,korkweaknesskneedsktokbekreported.kThekpatientkmustkalsokreportktokthekprescriberk
akfeverkofkhigherkthank100.4°kFk(38°kC)korksymptomskthatklastklongerkthank3ktok4kdays.kDeconges
tantskdoknotkcauseksedation,kandkthereforekthekpatientkdoesknotkneedktokavoidkdrivingkakcarkorkope
ratingkheavykmachinery.
DIF: COGNITIVEkLEVEL:kApplyingk(Application)
REF:kp.k575kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kBasickCarekandkComfort
5. Theknursekwillkinstructkpatientskaboutkakpossibleksystemickeffectkthatkmaykoccurkifkexcessiveka
mountskofktopicallykappliedkadrenergicknasalkdecongestantskarekused.kWhichksystemickeffectkm
aykoccur?
a. Heartburn
b. Bradycardia
c. Drowsiness
d. Palpitations
ANS:k D
Althoughkaktopicallykappliedkadrenergicknasalkdecongestantkcankbekabsorbedkintokthekbloodstrea
m,kthekamountkabsorbedkiskusuallyktooksmallktokcauseksystemickeffectskatknormalkdosages.kExces
sivekdosageskofkthesekmedications,khowever,karekmoreklikelyktokcauseksystemickeffectskelsewher
ekinkthekbody.kThesekmaykincludekcardiovascularkeffects,ksuchkaskhypertensionkandkpalpitations,ka
ndkcentralknervousksystemkeffectsksuchkaskheadache,knervousness,kandkdizziness.kThekotherkopti
onskarekincorrect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k571kTOP:k NURSINGkPROCESS:kAssessment
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
6. Akpatientkwithkaktracheostomykhaskdifficultykremovingkexcessive,kthickkmucuskfromkthekrespi
ratoryktract.kTheknursekexpectskthatkwhichkdrugkwillkbekorderedktokaidkinkthekremovalkofkmucus
?
a. Guaifenesink(Humibid)
b. Benzonatatek(TessalonkPerles)
c. Diphenhydraminek(Benadryl)
d. Dextromethorphank(RobitussinkDM)
ANS:k A
,NUR 3145 Exam 3 with reference and rationale
k k k k k k k
Expectorantsksuchkaskguaifenesinkworkktokloosenkandkthinksputumkandkthekbronchialksecretions,kt
herebykindirectlykdiminishingkthektendencyktokcough.kThekotherkdrugsklistedkdoknotkhavekthiskeff
ect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k573kTOP:k NURSINGkPROCESS:kPlanning
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
7. Akpatientkhaskbeenkadvisedktokaddkaknasalksprayk(ankadrenergickdecongestant)ktoktreatkakcold.
Theknursekwillkincludekwhichkinstruction?
a. “Youkwon’tkseekeffectskforkatkleastk1kweek.”
b. “Limitkusekofkthisksprayktok3ktok5kdays.”
c. “Continuekthekspraykuntilknasalkstuffinesskhaskresolved.”
d. “Avoidkusekofkthiskspraykifkakfeverkdevelops.”
ANS:k B
Frequent,klong-
term,korkexcessivekusekofkadrenergicknasalkdecongestantskmaykleadktokreboundkcongestionkifkuse
dkbeyondkthekrecommendedktime.kThekotherkinstructionskarekincorrect.
DIF: COGNITIVEkLEVEL:kApplyingk(Application)
REF:kp.k571kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
8. Akpatientkasksktheknursekaboutkthekuseskofkechinacea.kWhichkusekwillktheknursekincludekinkthekre
sponse?
a. Memorykenhancement
b. Boostingkthekimmuneksystem
c. Improvingkmood
d. Promotingkrelaxation
ANS:k B
Commonkuseskofkechinaceakincludekstimulationkofkthekimmuneksystem,kantisepsis,ktreatmentkofkv
iralkinfectionskandkinfluenza-
likekrespiratoryktractkinfections,kandkpromotionkofkthekhealingkofkwoundskandkchronickulceration
s.kThekotherkoptionskarekincorrect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k566kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
MULTIPLEkRESPONSE
1. Whenkteachingkakpatientkwhokwillkbekreceivingkantihistamines,ktheknursekwillkincludekwhichki
nstructions?k(Selectkallkthatkapply.)
a. “Antihistamineskarekgenerallyksafektoktakekwithkover-the-counterkmedications.”
b. “Takekthekmedicationkonkankemptykstomachktokmaximizekabsorptionkofkthekdrug.”
c. “Takekthekmedicationkwithkfoodktokminimizekgastrointestinalkdistress.”
d. “Drinkkextrakfluidskifkpossible.”
e. “Antihistamineskmaykcausekrestlessnesskandkdisturbedksleep.”
f. “Avoidkactivitieskthatkrequirekalertnesskuntilkyoukknowkhowkadversekeffectskarekt
, NUR 3145 Exam 3 with reference and rationale
k k k k k k k
olerated.”
k k k k k k k
Chapter 36: Antihistamines, Decongestants, Antitussives, and ExpectorantsLille
k k k k k k k
y: Pharmacology and the Nursing Process, 8th Edition
k k k k k k k
MULTIPLEkCHOICE
1. Whenkgivingkdextromethorphan,ktheknursekunderstandskthatkthiskdrugksuppresseskthekcoughkr
eflexkbykwhichkmechanismkofkaction?
a. Causingkdepressionkofkthekcentralknervousksystem
b. Anesthetizingkthekstretchkreceptors
c. Havingkdirectkactionkonkthekcoughkcenter
d. Decreasingkthekviscositykofkthekbronchialksecretions
ANS:k C
Dextromethorphanksuppresseskthekcoughkreflexkthroughkakdirectkactionkonkthekcoughkcenter.kThek
otherkoptionskarekincorrect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k572kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
2. Duringkakroutinekcheckup,kakpatientkstateskthatkshekiskunablektoktakekthekprescribedkantihista
minekbecausekofkonekofkitskmostkcommonkadversekeffects.kTheknurseksuspectskthatkwhichkad
versekeffectkhaskbeenkbotheringkthiskpatient?
a. Constipation
b. Abdominalkcramps
c. Drowsiness
d. Decreasedklibido
ANS:k C
Drowsinesskiskusuallykthekchiefkcomplaintkofkpeoplekwhoktakekantihistamines.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k567kTOP:k NURSINGkPROCESS:kAssessment
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
3. Akgardenerkneedskakdecongestantkbecausekofkseasonalkallergykproblemskandkasksktheknursek
whetherkhekshouldktakekankoralkformkorkaknasalkspray.kWhichkofkthesekiskakbenefitkofkorallyka
dministeredkdecongestants?
a. Immediatekonset
b. Akmorekpotentkeffect
c. Lackkofkreboundkcongestion
d. Shorterkduration
ANS:k C
Drugskadministeredkbykthekoralkroutekproducekprolongedkdecongestantkeffects,kbutkthekonsetkofka
ctionkiskmorekdelayedkandkthekeffectklesskpotentkthankthosekofkdecongestantskappliedktopically.kH
owever,kthekclinicalkproblemkofkreboundkcongestionkassociatedkwithktopicallykadministeredkdru
gskiskalmostknonexistentkwithkoralkdosagekforms.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k570kTOP:k NURSINGkPROCESS:kPlanning
,NUR 3145 Exam 3 with reference and rationale
k k k k k k k
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
4. Akpatientkisktakingkguaifenesink(Humibid)kaskpartkofktreatmentkforkaksinuskinfection.kWhichki
nstructionkwillktheknursekincludekduringkpatientkteaching?
a. Forcekfluidsktokhelpkloosenkandkliquefyksecretions.
b. Reportkclear-coloredksputumktokthekprescriber.
c. Avoidkdrivingkakcarkorkoperatingkheavykmachinerykbecausekofktheksedatingkeffects.
d. Reportksymptomskthatklastklongerkthank2kdays.
ANS:k A
Forcingkfluidskhelpsktokloosenkandkliquefyksecretions.kThekpatientkmustkbekfullykawarekthatkanykf
ever,kchestktightness,kchangekinksputumkfromkclearktokcolored,kdifficultkorknoisykbreathing,kactiv
itykintolerance,korkweaknesskneedsktokbekreported.kThekpatientkmustkalsokreportktokthekprescriberk
akfeverkofkhigherkthank100.4°kFk(38°kC)korksymptomskthatklastklongerkthank3ktok4kdays.kDeconges
tantskdoknotkcauseksedation,kandkthereforekthekpatientkdoesknotkneedktokavoidkdrivingkakcarkorkope
ratingkheavykmachinery.
DIF: COGNITIVEkLEVEL:kApplyingk(Application)
REF:kp.k575kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kBasickCarekandkComfort
5. Theknursekwillkinstructkpatientskaboutkakpossibleksystemickeffectkthatkmaykoccurkifkexcessiveka
mountskofktopicallykappliedkadrenergicknasalkdecongestantskarekused.kWhichksystemickeffectkm
aykoccur?
a. Heartburn
b. Bradycardia
c. Drowsiness
d. Palpitations
ANS:k D
Althoughkaktopicallykappliedkadrenergicknasalkdecongestantkcankbekabsorbedkintokthekbloodstrea
m,kthekamountkabsorbedkiskusuallyktooksmallktokcauseksystemickeffectskatknormalkdosages.kExces
sivekdosageskofkthesekmedications,khowever,karekmoreklikelyktokcauseksystemickeffectskelsewher
ekinkthekbody.kThesekmaykincludekcardiovascularkeffects,ksuchkaskhypertensionkandkpalpitations,ka
ndkcentralknervousksystemkeffectsksuchkaskheadache,knervousness,kandkdizziness.kThekotherkopti
onskarekincorrect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k571kTOP:k NURSINGkPROCESS:kAssessment
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
6. Akpatientkwithkaktracheostomykhaskdifficultykremovingkexcessive,kthickkmucuskfromkthekrespi
ratoryktract.kTheknursekexpectskthatkwhichkdrugkwillkbekorderedktokaidkinkthekremovalkofkmucus
?
a. Guaifenesink(Humibid)
b. Benzonatatek(TessalonkPerles)
c. Diphenhydraminek(Benadryl)
d. Dextromethorphank(RobitussinkDM)
ANS:k A
,NUR 3145 Exam 3 with reference and rationale
k k k k k k k
Expectorantsksuchkaskguaifenesinkworkktokloosenkandkthinksputumkandkthekbronchialksecretions,kt
herebykindirectlykdiminishingkthektendencyktokcough.kThekotherkdrugsklistedkdoknotkhavekthiskeff
ect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k573kTOP:k NURSINGkPROCESS:kPlanning
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
7. Akpatientkhaskbeenkadvisedktokaddkaknasalksprayk(ankadrenergickdecongestant)ktoktreatkakcold.
Theknursekwillkincludekwhichkinstruction?
a. “Youkwon’tkseekeffectskforkatkleastk1kweek.”
b. “Limitkusekofkthisksprayktok3ktok5kdays.”
c. “Continuekthekspraykuntilknasalkstuffinesskhaskresolved.”
d. “Avoidkusekofkthiskspraykifkakfeverkdevelops.”
ANS:k B
Frequent,klong-
term,korkexcessivekusekofkadrenergicknasalkdecongestantskmaykleadktokreboundkcongestionkifkuse
dkbeyondkthekrecommendedktime.kThekotherkinstructionskarekincorrect.
DIF: COGNITIVEkLEVEL:kApplyingk(Application)
REF:kp.k571kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
8. Akpatientkasksktheknursekaboutkthekuseskofkechinacea.kWhichkusekwillktheknursekincludekinkthekre
sponse?
a. Memorykenhancement
b. Boostingkthekimmuneksystem
c. Improvingkmood
d. Promotingkrelaxation
ANS:k B
Commonkuseskofkechinaceakincludekstimulationkofkthekimmuneksystem,kantisepsis,ktreatmentkofkv
iralkinfectionskandkinfluenza-
likekrespiratoryktractkinfections,kandkpromotionkofkthekhealingkofkwoundskandkchronickulceration
s.kThekotherkoptionskarekincorrect.
DIF: COGNITIVEkLEVEL:kUnderstandingk(Comprehension)
REF:kp.k566kTOP:k NURSINGkPROCESS:kImplementation
MSC:k NCLEX:kPhysiologicalkIntegrity:kPharmacologicalkandkParenteralkTherapies
MULTIPLEkRESPONSE
1. Whenkteachingkakpatientkwhokwillkbekreceivingkantihistamines,ktheknursekwillkincludekwhichki
nstructions?k(Selectkallkthatkapply.)
a. “Antihistamineskarekgenerallyksafektoktakekwithkover-the-counterkmedications.”
b. “Takekthekmedicationkonkankemptykstomachktokmaximizekabsorptionkofkthekdrug.”
c. “Takekthekmedicationkwithkfoodktokminimizekgastrointestinalkdistress.”
d. “Drinkkextrakfluidskifkpossible.”
e. “Antihistamineskmaykcausekrestlessnesskandkdisturbedksleep.”
f. “Avoidkactivitieskthatkrequirekalertnesskuntilkyoukknowkhowkadversekeffectskarekt
, NUR 3145 Exam 3 with reference and rationale
k k k k k k k
olerated.”
