Claytons Basic Pharmacology For Nurse Ch 29

Question 1

1. Which is a serious adverse effect of decongestants?
   a. Hypotension
   b. Hypertension
   c. Orbital edema
   d. Facial flushing

Answer 1

B Hypertension

Question 2

2. Which time should antihistamines be administered?
   a. PRN throughout the day
   b. After contact with an allergen
   c. 45 minutes before exposure to an allergen
   d. Once nasal congestion begins

Answer 2

c. 45 minutes before exposure to an allergen

Question 3

3. Which effect can result if a patient overuses topical decongestants?
   a. Hypertensive crisis
   b. Allergic reaction
   c. Secondary congestion
   d. Permanent olfactory damage

Answer 3

c. Secondary congestion

Question 4

4. A patient at sports camp is complaining of itchy and watery eyes, coughing, and sneezing
   when outdoors. the patient‘s chart states that he has an allergy to grasses. Which medication
   will the nurse administer?
   a. Antitussive
   b. Expectorant
   c. Antihistamine
   d. Decongestant

Answer 4

c. Antihistamine

Question 5

5. Which medication may be given to patients with allergic seasonal rhinitis who do not respond
   to antihistamines and sympathomimetics?
   a. Leukotrienes
   b. Mineralocorticoids
   c. Corticosteroids
   d. Cortisol

Answer 5

c. Corticosteroids

Question 6

6. Which physiologic rationale explains what initiates the sneeze reflex?
   a. Stimulation of the vagus nerve
   b. Irritation of the nasal mucosa by foreign particulate matter
   c. Stimulation of the tonsils
   d. Enervation of the olfactory cranial nerve

Answer 6

b. Irritation of the nasal mucosa by foreign particulate matter

Question 7

7. Which reaction occurs in the nasal structures when cholinergic fibers are stimulated?
   a. Dryness of mucous membranes in the nostrils
   b. Bleeding in the mucous membranes in the nostrils
   c. Production of serous and mucous secretions in the nostrils
   d. Enhanced olfactory perception in the mucous membranes of the nostrils

Answer 7

c. Production of serous and mucous secretions in the nostrils

Question 8

8. Which process in the antigen-antibody reaction causes the symptoms of allergies?
   a. Release of antihistamines
   b. Production of antibodies
   c. Suppression of histamine
   d. Release of histamine

Answer 8

d. Release of histamine

Question 9

9. Which instruction will the nurse include when teaching a patient with seasonal rhinitis and
   blocked nasal passages about intranasal corticosteroid therapy?
   a. ―Clear your nasal passage after administration.‖
   b. ―Anticipate a therapeutic benefit within 24 hours.‖
   c. ―Use a decongestant prior to administration.‖
   d. ―Report nasal burning to your healthcare provider.‖

Answer 9

c. ―Use a decongestant prior to administration
Use of a decongestant just before intranasal corticosteroid administration ensures adequate
penetration. the therapeutic benefit occurs after 24 hours.

Question 10

10. Which symptom should the nurse prioritize as the most important when assessing a patient
    being seen for a severe allergic reaction to environmental allergens?
    a. Hypotension
    b. Urticaria
    c. Dyspnea
    d. Rhinorrhea

Answer 10

c. Dyspnea

Question 11

11. A college student is being seen at an outpatient clinic with reports of allergic rhinitis and
    conjunctivitis. Which information will be provided when the health care provider orders
    fexofenadine (Allegra)?
    a. Fexofenadine (Allegra) is one of the least sedating antihistamines.
    b. Tolerance will not develop.
    c. Antihistamines are more effective if taken after histamine is released.
    d. Histamine release will be prevented by this medication.

Answer 11

a. Fexofenadine (Allegra) is one of the least sedating antihistamines

Question 12

1. Which rationale explains when allergic rhinitis occurs? (Select all that apply.)
   a. Nasal mucosa become inflamed.
   b. Exposure as a result of an allergen produces inflammation.
   c. Histamine is released following allergen exposure.
   d. The weather is cold during the winter.
   e. A person has an initial exposure to an antigen.

Answer 12

A, B, C
a. Nasal mucosa become inflamed.
b. Exposure as a result of an allergen produces inflammation.
c. Histamine is released following allergen exposure.

Question 13

2. Which action(s) is/are true of antihistamines? (Select all that apply.)
   a. Reduce inflammation locally.
   b. Antagonize H1 receptors.
   c. May be administered orally.
   d. Are systemically distributed.
   e. Reduce nasal congestion.

Answer 13

A, B, C, D
a. Reduce inflammation locally.
b. Antagonize H1 receptors.
c. May be administered orally.
d. Are systemically distributed.

Question 14

3. Which information will thenurse include when preparing education for a patient who has
   developed rebound nasal congestion resulting from use of topical decongestants? (Select all
   that apply.)
   a. For future topical decongestant use, follow the dosage directions daily. Do not
   overuse.
   b. Stop the topical decongestant at once.
   c. A decrease in congestion will occur immediately.
   d. Nasal steroid solutions can be used but may take several days to reduce
   inflammation and congestion.
   e. Use nasal saline spray to moisturize irritated mucosa

Answer 14

A, B, D, E
a. For future topical decongestant use, follow the dosage directions daily. Do not
overuse.
b. Stop the topical decongestant at once.
d. Nasal steroid solutions can be used but may take several days to reduce
inflammation and congestion.
e. Use nasal saline spray to moisturize irritated mucosa.

Question 15

4. Which patient(s) would be able to take an alpha-adrenergic decongestant safely? (Select all
   that apply.)
   a. 24-year-old woman with allergic rhinitis
   b. 18-year-old man with cold symptoms
   c. 64-year-old woman with a history of heart disease
   d. 70-year-old woman with glaucoma
   e. 56-year-old man with prostatic hypertrophy

Answer 15

A,B
a. 24-year-old woman with allergic rhinitis
b. 18-year-old man with cold symptoms

Question 16

5. Which principle(s) will the nurse include in a teaching plan for antihistamine therapy? (Select
   all that apply.)
   a. It is typical to experience an increase in energy.
   b. Dietary fiber and fluids should be increased.
   c. Do not take with prescription medications unless approved by a physician.
   d. Blurred vision is an expected adverse effect.
   e. Over-the-counter (OTC) medications are safe to use with any currently prescribed
   prescription medications.

Answer 16

B,C,D
b. Dietary fiber and fluids should be increased.
c. Do not take with prescription medications unless approved by a physician.
d. Blurred vision is an expected adverse effect

Question 17

6. Which topically active aerosol steroids are highly effective for reducing sneezing, nasal
   itching, stuffiness, and rhinorrhea? (Select all that apply.)
   a. Beclomethasone (Beconase AQ)
   b. Prednisone (Deltasone)
   c. Fluticasone (Flonase)
   d. Flunisolide (Nasarel)
   e. Budesonide (Rhinocort Aqua)

Answer 17

A,C,D,E
a. Beclomethasone (Beconase AQ)
c. Fluticasone (Flonase)
d. Flunisolide (Nasarel)
e. Budesonide (Rhinocort Aqua)

Question 18

7. Which information should be relayed to the patient when providing counseling on cromolyn
   sodium (Nasalcrom) nasal spray? (Select all that apply.)
   a. Cromolyn must be taken immediately following exposure to the stimulus.
   b. The patient should blow the nose before nasal instillation.
   c. Therapeutic effects are immediate.
   d. Inhalation will cause coughing.
   e. The maximum is six sprays in each nostril daily

Answer 18

B,E
b. The patient should blow the nose before nasal instillation.
e. The maximum is six sprays in each nostril daily