Mastery EAQ Ch. 36

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Question #1

For which condition is goldenseal contraindicated?

A Genitourinary disease, Respiratory tract infection

B Nasal congestion, Genitourinary disease

C Pregnancy, Chronic gastrointestinal disorder

D Respiratory tract infection, Nasal congestion

Question #2

Which adverse drug effect is the nurse alert for assessing in an older adult patient taking diphenhydramine?

A Hypertension

B Insomnia

C Urinary retention

D Hay fever

Question #3

Which information would the nurse teach to a patient who is switching allergy medications from diphenhydramine to loratadine?

A Loratadine causes less gastrointestinal upset.

B Loratadine has fewer sedative effects.

C Loratadine can potentially cause dysrhythmias.

D Loratadine has increased bronchodilating effects.

Question #4

Which antihistamine would the nurse expect to be included in the treatment plan for a patient who is a taxi driver who is diagnosed with allergic rhinitis?

A Promethazine

B Clemastine

C Fexofenadine

D Diphenhydramine

Question #5

A patient will begin taking diphenhydramine to treat motion sickness. Which instruction would the nurse give the patient to prevent gastrointestinal (GI) upset?

A “Increase fluid intake to up to 3000 mL.”

B “Sleep with your head in an elevated position.”

C “Take the medication with food.”

D “Use a humidifier while sleeping.”

Question #6

The nurse makes a home visit to a middle-aged patient who has a history of asthma. The patient’s spouse purchased an over-the-counter antihistamine. However, the nurse instructs the spouse not to administer the drug to the patient. Which complication is the nurse trying to prevent?

A Paradoxical reactions

B Decrease in respiratory rate

C Allergic reactions to the drug

D Collapse of lung alveoli

Question #7

A patient who has allergic rhinitis comes to the clinic for a scheduled allergy test. After performing a health history, the nurse informs the patient that the allergy test will have to be rescheduled. Which statement explains the reason for this?

A The patient is being treated with oral antibiotic drugs.

B The patient is being treated with antihistamine drugs.

C The patient has severe symptoms of rhinitis.

D The patient is afraid of injections.

Question #8

Which instruction would the nurse include for a patient prescribed an antitussive medication?

A “Watch for diarrhea and abdominal cramping.”

B “Headache and hypertension are common side effects.”

C “This medication may cause drowsiness and dizziness.”

D “This medication may cause tremors and anxiety.”

Question #9

Which instruction would the nurse include for a patient who will be using an expectorant?

A “Restrict your fluids to decrease mucus production.”

B “Take the medication once a day only, at bedtime.”

C “Increase your fiber and fluid intake to prevent constipation.”

D “Increase your fluid intake to decrease viscosity of secretions.”

Question #10

If a patient is experiencing an allergic reaction to a medication, which change noted during this reaction would be inhibited by the administration of antihistamines?

A Vasoconstriction, Smooth muscle constriction, Diminished capillary permeability, Decreased production of secretions

B Vasoconstriction, Increased blood pressure, Diminished capillary permeability, Smooth muscle constriction

C Smooth muscle constriction, Increased blood pressure, Diminished capillary permeability, Decreased production of secretions

D Vasoconstriction, Increased blood pressure, Diminished capillary permeability, Decreased production of secretions

Question #11

The nurse is providing care for multiple patients who are prescribed nasal decongestants. For which group of patients would the nurse need to obtain a change of prescription?

A Patients with hyperthyroidism, Patients with skin disease, Patients with genitourinary disease

B Patients with narrow-angle glaucoma, Patients with skin disease, Patients with genitourinary disease

C Patients with skin disease, Patients with genitourinary disease, Patients with hypertension

D Patients with hypertension, Patients with hyperthyroidism, Patients with narrow-angle glaucoma

Question #12

Which information would the nurse provide to a patient taking over-the-counter guaifenesin who informs the nurse that the drug does not last very long?

A Use oxymetolazine nasal spray twice daily.

B Add an antihistamine once a day.

C Contact health care provider for prescription.

D Switch to sustained-release form of drug.

Question #13

After reviewing the health record of a patient with pneumonia who asks for a codeine-containing cough suppressant to alleviate the cough, which medical diagnosis would make the administration of codeine contraindicated? Select all that apply. One, some, or all responses may be correct.
Past Medical History
o Hypertension
o Diabetes mellitus
o Seizure disorder
o Seasonal allergies
o Depression

A Seizure disorder

B Diabetes mellitus

C Seasonal allergies

D Depression

E Hypertension

Question #14

If a patient asks about using echinacea to treat cold symptoms, which cue in the patient’s health history would make the use of this drug contraindicated?

A Enlarged prostate

B Emphysema

C Multiple sclerosis

D Hypertension

Question #15

A patient who underwent coronary artery bypass surgery 2 months ago has an acute upper respiratory infection (URI) and is losing sleep because of a cough. Which instruction would the nurse give to manage the URI if the patient is using codeine as an antitussive?

A “Take a decongestant.”, “Take an antihistamine.”, “Maintain hydration.”

B “Take a decongestant.”, “Productively cough.”, “Take an antihistamine.”

C “Take an expectorant.”, “Take a decongestant.”, “Take an antihistamine.”

D “Maintain hydration.”, “Take an expectorant.”, “Productively cough.”

Question #16

An older adult with pneumonia is experiencing a cough that is disrupting rest and sleep. Which type of medication would the nurse expect to administer to this patient to promote sleep and rest?

A Fexofenadine, Fluticasone

B Fexofenadine, Pseudoephedrine

C Fluticasone, Pseudoephedrine

D Codeine, Guaifenesin

Question #17

A patient who presents with cough and difficulty breathing is prescribed decongestants and antitussives. Which assessment finding in the follow-up visit would the nurse immediately report to the health care provider?

A Temperature of 100.8° F, Change in color of the sputum, Respiratory rate of 30 breaths/min

B Temperature of 100.8° F, Increased expectoration of mucus, Clear breath sounds on auscultation

C Increased expectoration of mucus, Respiratory rate of 30 breaths/min, Clear breath sounds on auscultation

D Increased expectoration of mucus, Clear breath sounds on auscultation, Change in color of the sputum

Question #18

Which antitussive would be administered to a patient with peripheral arterial disease (PAD)?

A Diphenhydramine

B Codeine

C Benzonatate

D Dextromethorphan

Question #19

A patient is prescribed guaifenesin for treatment of productive cough. Which instruction would the nurse give to the patient for maximum therapeutic effect?

A “Increase your carbohydrate intake.”

B “Increase your protein intake.”

C “Increase your fiber intake.”

D “Increase your fluid intake.”

Question #20

The nurse is planning care for a patient receiving decongestants. Which parameter would the nurse assess prior to giving the dose of medication?

A Oral cavity, Mental status, Cough

B Secretions, Oral cavity, Mental status

C Cough, Secretions, Breath sounds

D Breath sounds, Oral cavity, Mental status

Question #21

Which medication would the nurse instruct a patient scheduled to undergo allergy testing to hold at least 4 days prior to the test?

A Dextromethorphan

B Benzonatate

C Guaifenesin

D Fexofenadine

Question #22

Which frequency would the nurse instruct a patient to take Robitussin with dextromethorphan 30 mg PO to suppress a cough due to influenza?

A Every 6 hours

B Every hour

C Every 3 hours

D Every 2 hours

Question #23

After reviewing the health records of four patients who present with cold symptoms, which patient would it be contraindicated to give oxymetolazine?

A 70-year-old patient with bilateral cataracts

B 40-year-old patient with depression

C 60-year-old patient with rheumatoid arthritis

D 50-year-old patient with hyperthyroidism

Question #24

Based on the medication administration record for a patient who reports using goldenseal to treat allergies, which action would the nurse perform due to a possible drug interaction?
Medication Administration Record
o Atenolol 25 mg PO daily
o Atorvastatin 10 mg PO every night
o Venlafaxine ER 75 mg PO daily
o Goldenseal 500 mg PO TID
o Finasteride 5 mg PO daily

A Monitor urine output

B Auscultate breath sounds

C Assess oral cavity

D Obtain blood pressure

Question #25

Which information would the nurse provide as to the adverse effects when teaching a patient about the use of diphenhydramine in the treatment of seasonal allergies?

A Change positions slowly, Causes nausea and vomiting

B Avoid driving after use, Use hard candy for dry mouth

C Change positions slowly, Can trigger urticaria

D Can trigger urticaria, Causes nausea and vomiting

Question #26

Which treatment is best to manage a cough associated with allergic rhinitis for the patient who takes several other medications?

A Guaifenesin

B Dextromethorphan

C Benzonatate

D Loratadine

Question #27

For which possible reason would an older adult who presents with a cough be instructed not to use diphenhydramine?

A Diphenhydramine causes lightheadedness.

B Diphenhydramine causes constipation.

C Diphenhydramine causes a “hangover” effect.

D Diphenhydramine causes seizures.

Question #28

Which type of drug would the nurse expect to be prescribed for a patient in the emergency department with urticaria after contact with shrubs?

A Decongestant

B Antihistamine

C Antitussive

D Expectorant

Question #29

The nurse observes that a patient who is taking phenylephrine and vitamin C tablets has developed rebound congestion. Which reason is the probable cause for the rebound congestion?

A Drug-drug interaction

B Phenylephrine tolerance

C Allergic reaction to vitamin C

D Frequent use of phenylephrine

Question #30

A patient complains that symptoms of allergic rhinitis are persistent even after taking fexofenadine. After checking the patient’s history, the nurse finds that the patient is taking phenytoin for the treatment of seizures. The nurse would interpret which reason as the cause for this?

A Drug tolerance

B Drug-drug interaction

C Paradoxical reaction

D Dystonic reaction

Question #31

During a patient assessment the nurse finds symptoms of dizziness, confusion, sedation, and hypotension. After reviewing the patient’s medical history, the nurse finds that the patient is taking diphenhydramine for treatment of nighttime insomnia. Which condition would the nurse interpret from the assessment?

A Allergic reaction

B Paradoxical reaction

C Rebound congestion

D Dystonic reaction

Question #32

Which instruction would the nurse give to a patient who is prescribed dextromethorphan for treatment of a cough?

A “Use a humidifier while sleeping.”

B “Elevate your bed while sleeping.”

C “Restrict activities that require mental alertness.”

D “Increase your fluid intake to 3000 mL per day.”

Question #33

A patient who reports nasal congestion is prescribed oxymetazoline, two sprays in each nostril for 3 days. The patient reports increased nasal congestion after 10 days. On assessment the nurse learns that the patient had increased the drug frequency to four sprays in each nostril for 5 days. Which statement describes what the nurse would interpret from this information?

A The patient has developed an allergic reaction.

B The patient has developed paradoxical reaction.

C The patient has developed rebound congestion.

D The patient has experienced a side effect of the drug.

Question #34

Which condition is an adverse effect of echinacea?

A Dermatitis, Emotional instability, Mucosal ulceration

B Dizziness, Headache, Dermatitis

C Mucosal ulceration, Dizziness, Emotional instability

D Headache, Mucosal ulceration, Emotional instability

Question #35

Which side effect of a histamine (H1) antagonist is used therapeutically for patients with allergic rhinitis?

A Dryness

B Constipation

C Drowsiness

D Palpitations

Question #36

Which response is appropriate when a patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 hours?

A “You are probably displaying an unexpected reaction to oxymetazoline.”

B “Oxymetazoline is not an effective nasal decongestant.”

C “Overuse of nasal decongestants results in rebound congestion.”

D “Oxymetazoline should be administered every hour for severe congestion.”

Question #37

Which instruction would the nurse provide a patient who reports feeling drowsy after beginning drug therapy with diphenhydramine?

A “Use caution when driving.”

B “Stop taking the drug immediately.”

C “Take a stimulant to combat fatigue.”

D “This may worsen over time.”

Question #38

Which information would the nurse give a patient who mentions being afraid to take antihistamines because they are a truck driver?

A “Take a lower dose than normal when you have to drive.”

B “Take the medication only when you are not driving.”

C “You are correct; you should not take antihistamines.”

D “You may be able to safely take a nonsedating antihistamine.”

Question #39

The primary health care provider prescribes oxymetazoline to a patient with sinusitis who complains of nasal congestion and difficulty breathing. Which possible adverse effect would the nurse teach to the patient?

A Constipation

B Palpitations

C Dry mouth

D Gastrointestinal irritation

Question #40

Which patients are candidates to receive antitussive cough medication?

A Patients with chronic paranasal sinusitis

B Patients who have undergone hernia surgery

C Patients with pharyngitis and rhinitis

D Patients with bronchitis with productive cough

Question #41

The nurse observes a mild cough in a patient after hernia repair. Which medication would the nurse expect the provider to prescribe for this patient?

A Decongestant

B Antitussive

C Expectorant

D Antihistamine

Question #42

Which drug interaction could occur when taking diphenhydramine and consuming alcohol?

A Motion sickness

B Nighttime insomnia

C Central nervous system (CNS) depression

D Allergic rhinitis

Question #43

Which statement by the patient indicates an understanding of the teaching regarding beclomethasone dipropionate?

A “This medication will help prevent the inflammatory response of my allergies.”

B “I will need to taper off the medication to prevent acute adrenal crisis.”

C “I need to take this medication only when my symptoms get bad.”

D “I will need to monitor my blood sugar more closely because it may increase.”

Question #44

The use of fexofenadine is contraindicated in patients with which condition?

A Skin rashes

B Renal impairment

C Vitamin C deficiency

D Vitamin A deficiency

Question #45

Which drug will the primary health care provider prescribe for a patient who has nighttime insomnia and motion sickness?

A Fexofenadine

B Cetirizine

C Loratadine

D Diphenhydramine

Question #46

A patient is prescribed disulfiram for alcohol abuse. During the assessment, the nurse finds that the patient is also taking echinacea for wound healing. Which instruction would the nurse provide to the patient?

A “Increase carbohydrate intake.”

B “Increase the dose of disulfiram.”

C “Take both drugs simultaneously.”

D “Stop using echinacea.”

Question #47

Which antihistamine causes sedation as an adverse drug effect?

A Loratadine

B Fexofenadine

C Diphenhydramine

D Desloratadine

Question #48

A patient is prescribed diphenhydramine for the treatment of an allergic disorder. After reviewing the patient’s history, the nurse finds that the patient drinks alcohol. Why would the nurse instruct the patient to stop alcohol consumption?

A Alcohol diminishes the action of diphenhydramine.

B Alcohol increases central nervous system depression.

C The interaction of alcohol and diphenhydramine produces skin rashes.

D Alcohol increases diphenhydramine levels in the body.

Question #49

Which symptom of allergic rhinitis is treated with fluticasone?

A Nasal congestion

B Bronchospasm

C Fluid retention

D Increased blood pressure

Question #50

The health care provider indicates that the patient will be prescribed an expectorant. Which medication does the nurse anticipate the provider will prescribe?

A Brompheniramine maleate

B Guaifenesin

C Dexchlorpheniramine maleate

D Chlorpheniramine maleate

Question #51

Which clinical finding is seen in a patient with nasal congestion caused by allergic rhinitis?

A Increase in capillary permeability

B Inhibition of histamine production

C Increase in bodily secretions

D Release of inflammatory mediators

Question #52

Which medication can cause paradoxical reactions in children?

A Antihistamine

B Antitussive

C Antacid

D Decongestant

Question #53

The health care provider indicates that a patient will be prescribed an opioid antitussive. Which medication would the nurse anticipate the provider will order?

A Levocetirizine

B Codeine

C Benzonatate

D Promethazine with dextromethorphan

Question #54

Which first-generation histamine (H1) antagonist is less likely than diphenhydramine to induce sleep?

A Hydroxyzine

B Dimenhydrinate

C Promethazine

D Chlorpheniramine

Question #55

A patient with bronchitis asks about medications to suppress the dry cough that is keeping the patient awake at night. After reviewing the health record, which medication would be safe to administer to this patient?
Medication Administration Record
o Lisinopril 10 mg PO daily
o Selegiline 1.25 mg PO every morning
Past Medical History
o Hypertension
o Bipolar disorder
o Renal insufficiency

A Benzonatate

B Dextromethorphan

C Promethazine

D Codeine with hydrocodone

Question #56

Which information is important for the nurse to provide a patient prescribed an over-the-counter nasal spray with oxymetazoline to relieve nasal congestion due to a cold?

A Do not take the drug more than 3 days.

B Use two sprays four times a day.

C Monitor blood pressure.

D Medication cures the cold.

Question #57

Which information would the nurse provide to a patient taking over-the-counter guaifenesin who informs the nurse that the drug does not last very long?

A Add an antihistamine once a day.

B Switch to sustained-release form of drug.

C Contact health care provider for prescription.

D Use oxymetolazine nasal spray twice daily.

Question #58

Which side effect would the nurse watch for in a patient with motion sickness who has been prescribed diphenhydramine?

A Pruritus

B Dry mouth

C Headache

D Lightheadedness

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