Chapter 40: Drugs for Upper Respiratory Disorders

Chapter 40: Drugs for Upper Respiratory Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who has narrow-angle glaucoma asks the nurse to recommend a medication to alleviate cold symptoms such as nasal congestion and runny nose. The nurse will suggest the patient talk to the provider about which medication?

a.	Azelastine (Astelin)
b.	Cetirizine (Zyrtec)
c.	Chlorpheniramine maleate (Chlor-Trimeton)
d.	Diphenhydramine (Benadryl)

 

 

ANS:  A

Antihistamines have anticholinergic effects, which are contraindicated in patients with narrow-angle glaucoma. Cetirizine and azelastin are second-generation antihistamines, with fewer anticholinergic side effects, but azelastine is a nasal spray and is less likely to have systemic side effects.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 574

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. The nurse is caring for a patient who is receiving diphenhydramine. The nurse notes that the patient has not voided for 12 hours. What action will the nurse take?

a.	Encourage the patient to drink more fluids.
b.	Evaluate the bladder to check for distension.
c.	Request an order for an intravenous fluid bolus.
d.	Request an order for urinary catheterization.

 

 

ANS:  B

Diphenhydramine has anticholinergic effects, including urinary retention. The nurse should assess for bladder distension to determine if this is the case. Encouraging the patient to drink more fluids or giving intravenous fluids may be necessary if the patient has oliguria secondary to dehydration. Urinary catheterization is not indicated until urinary retention has been identified.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 575

TOP:   NURSING PROCESS: Evaluation/Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient arrives in the emergency department after developing a rash, runny nose, and sneezing after eating strawberries. What action will the nurse expect to take first?

a.	Administer diphenhydramine.
b.	Administer epinephrine.
c.	Assess for urinary retention.
d.	Assess heart rate, respiratory rate, and lung sounds.

 

 

ANS:  D

The patient probably has a food allergy, since eating strawberries is the precipitating event. The nurse should assess cardiac and respiratory status to determine whether the patient is developing an anaphylactic reaction. Diphenhydramine will be given for mild allergic symptoms of rash, runny nose, and sneezing, but epinephrine must be given for anaphylaxis. Urinary retention is a side effect of diphenhydramine and will be assessed if diphenhydramine is given.

 

DIF:    COGNITIVE LEVEL: Applying (Application)                  REF:   Page 575

TOP:   NURSING PROCESS: Nursing Intervention

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient who has seasonal allergies with a runny nose during the daytime reports increasing nighttime symptoms of coughing and sneezing that are interfering with sleep. The provider recommends diphenhydramine (Benadryl) at bedtime. What information will the nurse include when teaching the patient about this medication?

a.	“Avoid fluids at bedtime to prevent urinary retention.”
b.	“This will help clear your daytime symptoms, too.”
c.	“You should be able to sleep better when you take this medication.”
d.	“You should take this medication on an empty stomach.”

 

 

ANS:  C

A side effect of diphenhydramine is drowsiness. Patients whose nighttime symptoms clear should be able to sleep better, especially with drowsiness side effects. Avoiding fluids does not prevent urinary retention. The half-life of diphenhydramine is short, so drug effects will not last through the next day. There is no need to take the medication on an empty stomach.

 

DIF:    COGNITIVE LEVEL: Understanding (Comprehension)    REF:   Page 575

TOP:   NURSING PROCESS: Nursing Intervention: Patient Teaching

MSC:   NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies