Chapter 29: Drugs Used to Treat Upper Respiratory Disease

Chapter 29: Drugs Used to Treat Upper Respiratory Disease

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which is a serious adverse effect of decongestants?

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:   Page 452        OBJ:   3 | 5

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Safety; Perfusion

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?

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:   Page 452        OBJ:   3

TOP:   Nursing Process Step: Planning

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  CONCEPT(S): Clinical Judgment; Patient Education; Health Promotion

3. What can result if a patient overuses topical decongestants?

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:   Page 449 | Page 451

OBJ:   3 | 5                TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment; Safety

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?

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:   Page 449 | Page 452

OBJ:   3                    TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

NOT:  CONCEPT(S): Clinical Judgment