NURS 6521 Week 4 Quiz – Question and Answers
Question 1
1 out of 1 points
A nurse is providing discharge planning for a 45-year-old woman who
... [Show More] has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?
Response Feedback: The nurse should assess the patient's intake of caffeine, including coffee, tea, soda, cocoa, candy, and chocolate. Caffeine has sympathomimetic effects that may increase the risk for adverse effects. Alcohol, salt, and vitamin C intake is important to assess, but does not potentiate the effects of albuterol.
Question 2
1 out of 1 points
Children age 6 to 11 are recommended to start with what dosage of Allegra?
Question 3
1 out of 1 points
A nurse is assigned to a patient who is receiving IV aminophylline. The nurse is aware that the IV infusion rate should be
Response Feedback: Aminophylline is more soluble than theophylline and is therefore preferred when IV administration is recommended. It is important to administer IV aminophylline no faster than 25 mg/minute.
Question 4
1 out of 1 points
A patient is in the clinic for seasonal allergic rhinitis. Loratadine (Claritin) is prescribed. Which of the following statements will the nurse include when providing patient education concerning this drug?
Response Feedback: Loratadine (Claritin) is a second-generation antihistamine and does not usually cause drowsiness like the first-generation medications; however, the patient should take it for at least a day to determine the drug's effect before driving. Loratadine should be taken on an empty stomach to increase absorption. The drug is taken only once a day. Brompheniramine, a nonselective H1 blocker (first-generation antihistamine) is taken every 4 to 6 hours. Fexofenadine can be taken twice daily.
Question 5
1 out of 1 points
A female patient has been taking zafirlukast for a week and is experiencing diarrhea. The nurse should instruct her to do which of the following?
Response Feedback: The patient should be urged to drink plenty of fluids if she experiences diarrhea while taking zafirlukast, and she should report these symptoms to the health care provider. The patient should take nonnarcotic analgesics only for headaches. The patient should take the drug on an empty stomach to increase its bioavailability. It is not necessary to schedule a blood test.
Question 6
1 out of 1 points
A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking
Response Feedback: An elixir is a clear hydro-alcoholic mixture that is usually sweetened. Most elixirs contain ethanol and water. Ethanol is a form of alcohol, and the content may exceed 25%. Patients with a history of alcohol abuse should be informed that elixirs contain alcohol, so they are not inadvertently exposed to alcohol. The other medication forms have no special considerations relevant to this patient.
Question 7
1 out of 1 points
A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following?
Response Feedback: The nurse should assess the amount of grapefruit or orange juice ingestion, because these juices can substantially increase the concentration of dextromethorphan and cause an increase in the frequency and severity of the adverse effects of the drug. Tea, soft drinks, coffee, or water would not increase the drowsiness or dizziness that is often associated with the use of this drug.
Question 8
1 out of 1 points
A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of
Response Feedback: The walls of the nasal cavity are sensitive to irritation. When receptors in these walls are stimulated, a central nervous system (CNS) reflex is initiated, and a sneeze results. CO2 levels, goblet cells, and the cilia are do not participate directly in the sneeze reflex.
Question 9
1 out of 1 points
A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?
Response Feedback: Sustained-release preparations of theophylline should be taken on an empty stomach, 1 hour before or 2 hours after meals. Immediate-release preparations should be administered with meals to alleviate gastrointestinal distress. Foods containing xanthines, in particular caffeine, increase the effects of theophylline, but they do not help minimize the adverse effects of theophylline. Patients who smoke may require an increase in theophylline dosage of up to 50%, but increasing the dosage is not a nursing responsibility.
Question 10
1 out of 1 points
A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in
Response Feedback: The nurse should explain to the patient that he should get some relief in 15 to 30 minutes. Dextromethorphan is absorbed rapidly from the GI tract, which allows for therapeutic effects to be experienced within a half hour.
Question 11
1 out of 1 points
A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to
Response Feedback: Patients who self-administer albuterol may use their MDIs more frequently than recommended. This practice can result in rebound bronchoconstriction, which may motivate the patient to increase MDI use, stimulating the cycle of rebound congestion. Overuse of albuterol is not linked to pneumonia or hepatotoxicity. Albuterol is not an anticholinergic drug.
Question 12
1 out of 1 points
A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug?
Response Feedback: The most common adverse effects of inhaled albuterol include throat irritation, palpitations, sinus tachycardia, anxiety tremor, and increased blood pressure. Serious adverse effects such as bronchospasm, urticaria, and angioedema rarely occur. Headache, dyspepsia, and muscle cramps are frequent adverse effects of oral albuterol only.
Question 13
1 out of 1 points
Which of the following will a nurse inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)?
Response Feedback: The most common adverse effects of guaifenesin use are GI symptoms, including nausea, vomiting, and anorexia. Increased blood pressure, increased blood glucose, and urinary retention are not commonly identified adverse effects of this drug.
Question 14
1 out of 1 points
A college student has presented the campus medical clinic complaining of cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?
Response Feedback: Frequent, long-term, or excessive use of decongestants induces rebound congestion. Rebound congestion occurs when the nasal passages become congested as the drug effect wears off and the body compensates by vasodilating the same nasal arterioles that the drug constricted. This does not occur because of the ineffectiveness of decongestants, however. Dosing should be based on the instructions provided.
Question 15
1 out of 1 points
A 70-year-old woman has a complex medical and a current drug regimen that includes calcium and vitamin D supplements for osteoporosis, metformin (Glucophage) for type 2 diabetes, phenelzine (Nardil) for depression, and metoprolol (Lopressor) and furosemide (Lasix) for hypertension. The woman is requesting dextromethorphan for the treatment of a recurrent cough. What component of her drug regimen contraindicates the use of dextromethorphan?
Response Feedback: Dextromethorphan can block neuronal uptake of serotonin and may produce serotonin syndrome. The concurrent use of dextromethorphan and metformin, calcium supplements, and metoprolol is not problematic.
Question 16
1 out of 1 points
A patient with a diagnosis of nonsmall cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the patient has announced to the nurse his intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this patient's statement?
Response Feedback: Herbal remedies are not necessarily contraindicated during chemotherapy, but their safety must be carefully assessed to prevent adverse interactions.
Question 17
1 out of 1 points
A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid
Response Feedback: The patient may develop adrenal insufficiency (addisonian crisis), which is characterized by glucocorticoid insufficiency without mineralocorticoid insufficiency. Hypokalemia occurs as a result of hyperaldosteronism. Gastrointestinal distress and menstrual irregularities are common adverse effects of the drug, but these effects are not as serious as preventing adrenal insufficiency.
Question 18
1 out of 1 points
A 25-year-old woman comes to the clinic because of a chronic, nonproductive cough. Assessment reveals that she has a history of asthma and dextromethorphan, (Robitussin) is prescribed for her. The nurse will question this order because
Response Feedback: Dextromethorphan is contraindicated in patients with asthma. If coughing were to be suppressed, these patients may retain secretions, and this would exacerbate the disease. Dextromethorphan does not result in persistent coughing or thickening of respiratory secretions. The drug may lead to serotonin syndrome if used with MAOIs.
Question 19
1 out of 1 points
A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient
Response Feedback: Caffeine has sympathomimetic effects that may increase the risk for adverse effects with albuterol. The nurse should assess the patient's intake of caffeine through coffee, tea, soda, cocoa, candy, and chocolate. The patient's age, history of pneumonia, and preference for high-calorie food would not have important implications for his albuterol drug therapy.
Question 20
0 out of 1 points
A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?
Response Feedback: Dysphonia and oropharyngeal Candida albicans infections are common adverse effects associated with daily use of ICS. Long-term use of ICS may delay growth in children, not adults. Suppression of the hypothalamic-pituitary-adrenal axis is a rare adverse effect, and hypotension is not an identified adverse effect of the drug.
Question 21
1 out of 1 points
A 53-year-old man has been treated for severe asthma for several years with prednisone. Recently, his physician initiated alternate-day therapy for him. The patient tells the nurse that he would rather take the medication every day to prevent confusion. Which of the following would be the best response by the nurse?
Response Feedback: Alternate-day administration (medication given every other day instead of daily) of long-term, systemic glucocorticoids has been used to lessen the suppression of the hypothalamus, the anterior pituitary, and the rate of bone loss. The nurse will want to stress that the change from daily to alternate-day administration does not occur abruptly, because an abrupt change may cause signs and symptoms of adrenal insufficiency such as fatigue, nausea, vomiting, and hypotension on the days between doses. The alternate-day scheduling should decrease the cost of the medication and could help decrease the retention of fluid, which could result in a slight decrease in weight. The patient is afraid that this scheduling could cause him to be confused on which day he should take his medication, so it probably is not going to be more convenient for him.
Question 22
1 out of 1 points
A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may
Response Feedback: It is essential to caution the patient against taking aspirin or drugs that contain aspirin while on doxorubicin drug therapy because aspirin may promote bleeding during periods of suppressed bone marrow function. Aspirin will not cause extravasation injury, radiation recall reaction, or acute nausea and vomiting; these are adverse effects of doxorubicin.
Question 23
1 out of 1 points
The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?
Response Feedback: During the passage through the bronchi, microorganisms and other foreign bodies are removed from the air by tiny hair-like structures called cilia, which project from the cells that line the bronchial wall. With a wave-like motion, these cilia sweep the foreign material and mucus upward toward the trachea and larynx. Goblet cells do not produce phagocytes and the airway does not close off at the carina when offended. Alveoli are not capable of independently producing positive pressure.
Question 24
1 out of 1 points
A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose?
Response Feedback: The amount of alcohol consumption would be the priority assessment, since both guaifenesin and alcohol can cause drowsiness. The amount of salt the patient consumes as well as the amount of fatty foods and number of cigarettes would be important to know when planning care for this patient, but none of these would pose the safety risk of drowsiness, especially considering the patient's occupation.
Question 25
1 out of 1 points
A 20-year-old woman calls the clinic at 5 PM and reports to the nurse that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The nurse will instruct her to
Response Feedback: Since it is only 3 hours until her evening dose, the nurse will instruct her to forget about the morning dose and take the evening dose as scheduled. It is not advisable to take two doses at the same time, and there is no need to skip the evening dose as well.
Question 26
1 out of 1 points
The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a “rescue drug” for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?
Response Feedback: Albuterol is a rescue drug that should be used first for all acute symptoms of shortness of breath or wheezing. Theophylline does not produce rapid symptom relief and beclomethasone is a maintenance drug. Acetylcysteine is not used in the treatment of asthma because it is used to manage secretions, which are not associated with asthma.
Question 27
1 out of 1 points
A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to
Response Feedback: The nurse should instruct the patient to remove the contact lenses before applying the drops to the eyes. If pilocarpine drops are applied to the eyes when soft contact lenses are in place, the lenses can deteriorate or absorb the drug. There is no need to stop wearing contact lenses during this therapy, but application of the lenses should take place after the drops have been applied.
Question 28
1 out of 1 points
A 72-year-old female patient is prescribed ipratropium aerosol for pulmonary emphysema. The nurse will instruct her to “test spray” the new metered-dose inhaler (MDI) three times before using it to prevent which of the following?
Response Feedback: Ipratropium aerosols may produce paradoxic acute bronchospasm, which may be fatal. Although this is rare, the adverse effect is typically evident with the patient's first inhalation from a newly opened MDI. The patient should be advised to “test spray” the new MDI three times before using it. The anaphylactoid reaction occurs when a patient has an unknown allergy to soybeans, legumes, or soy lecithin. Severe adverse effects of asymptomatic elevated hepatic enzyme levels and symptomatic hepatitis with hyperbilirubinemia are normally associated with zafirlukast.
Question 29
1 out of 1 points
After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient?
Response Feedback: Ipratropium should be taken daily, despite the absence of symptoms. Breathing exercises are not necessarily required and the drug controls symptoms but does not cure lung diseases.
Question 30
1 out of 1 points
A nurse is caring for a female patient who has developed atelectasis because of thick mucus secretions. The nurse is monitoring IV administration of acetylcysteine (Mucomyst) and notices that the patient's face is flushed. The appropriate nursing action would be to
Response Feedback: A frequent adverse reaction to IV acetylcysteine is facial flushing. If this occurs, the nurse should slow the IV infusion and administer diphenhydramine, which is an antihistamine ordered by the physician whenever acetylcysteine is ordered. A patient receiving IV acetylcysteine should also be monitored for anaphylactic reaction, which is indicated by tightness in the chest, rash, hypotension, and tachycardia. If any of these signs occurs, the nurse should immediately stop the infusion. Removing residual drug from the face would not be an option, since the medication is delivered via the IV route and is not a drug that can be applied topically. Diluting acetylcysteine would not serve to minimize this adverse effect. [Show Less]