Chapter 30 Drugs Used to Treat Upper Respiratory Disease

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Chapter 30  Drugs Used to Treat Upper Respiratory Disease

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

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

ANS: B
Sympathomimetic decongestants cause stimulation of the alpha adrenergic receptors that can increase blood pressure. Excessive use of decongestants when taking a beta adrenergic blocking agent or monoamine oxidase inhibitor can cause significant hypertension. Alpha receptor stimulation does not cause hypotension, orbital edema, or facial flushing.

DIF: Cognitive Level: Knowledge REF: p. 477 OBJ: 3 | 5 | 6
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

2. The nurse is teaching a patient about the administration of antihistamines. The nurse will instruct the patient to take the medication at what time of day?
a.
PRN throughout the day
b.
After contact with an allergen
c.
45 minutes before exposure to an allergen
d.
Once nasal congestion begins

ANS: C
Allergies may be seasonal or perennial. People are commonly allergic to more than one antigen simultaneously, so seasons may overlap or occur more than once per year. Antihistamines do not prevent histamine release, but reduce the symptoms of an allergic reaction by competing with the histamines for receptor sites. Antihistamines are most effective when taken 45 to 60 minutes before anticipated exposure to the allergen or when symptoms first appear. PRN use of antihistamines, waiting until after contact with an allergen, or waiting until nasal congestion begins is not the most effective administration of antihistamines.

DIF: Cognitive Level: Knowledge REF: p. 477 OBJ: 6 | 7
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance

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

ANS: C
Overuse of topical decongestants may lead to a rebound or increase in nasal secretions, causing a secondary congestion (known as rhinitis medicamentosa). This secondary congestion is thought to be caused by excessive vasoconstriction of blood vessels and direct irritation of the mucous membranes by the medication. As vasoconstriction wears off, the irritation triggers excessive blood flow to the passages, which in turn causes swelling and engorgement to reappear in greater intensity. Although decongestants can cause elevated blood pressure, they are not likely to cause hypertensive crisis. Allergic reaction is unlikely with decongestants. Damage to nasal tissues resulting from the use of decongestants is unlikely to be permanent.

DIF: Cognitive Level: Comprehension REF: pp. 473-475 OBJ: 4 | 6 | 7
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity

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

ANS: C
Antihistamines are used for inflammation and swelling resulting from the release of histamine during an antigen antibody reaction. A grass allergy means that the patient experiences a release of histamine (antibody reaction) when exposed to the antigen, grass. Antitussive medications are for relief of cough. Expectorants are for the loosening of mucus so the patient can expel it by coughing. Decongestants would not help these symptoms as much as antihistamines.

DIF: Cognitive Level: Comprehension REF: p. 474 OBJ: 2 | 6 | 7
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

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

ANS: C
Corticosteroids, whether applied topically or administered systemically, have been shown to be highly effective for the treatment of allergic rhinitis. Leukotrienes, made in the body, are mediators of the inflammatory response. Mineralocorticoids do not affect allergic responses. Cortisol is not the steroid of choice for the treatment of an allergic response.

DIF: Cognitive Level: Knowledge REF: p. 474 OBJ: 3 | 7
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity

 

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