Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
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Chapter 70: Antihistamines
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Antihistamines should be avoided unless absolutely necessary. |
| b. | Second-generation antihistamines are safer than first-generation antihistamines. |
| c. | Antihistamines should not be taken during pregnancy but may be taken when breast-feeding. |
| d. | The margin of safety for antihistamines is clearly understood for pregnant patients. |
ANS: A
Antihistamines are pregnancy Category C, with debate currently occurring regarding degree of effects on the fetus. They should be avoided unless absolutely necessary. All antihistamines have adverse effects on the fetus. Antihistamines can be excreted in breast milk. The margin of safety of antihistamines in pregnancy is not clear, so these agents should be avoided unless a clear benefit of treatment outweighs any risks.
PTS: 1 DIF: Cognitive Level: Application REF: p. 843
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Physiologic Adaptation
| a. | Desloratadine [Clarinex] |
| b. | Dimenhydrinate [Dramamine] |
| c. | Hydroxyzine [Vistaril] |
| d. | Promethazine [Phenergan] |
ANS: B
Some antihistamines, including dimenhydrinate and promethazine, are labeled for use in motion sickness. Promethazine, however, is contraindicated in children under age 2 years and should be used with caution in children older than 2 years because of the risks for severe respiratory depression. Desloratadine and hydroxyzine are not used for motion sickness.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 842-844
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | “Antihistamines block H1 receptors to prevent actions of histamine at these sites.” |
| b. | “Antihistamines block release of histamine from mast cells and basophils.” |
| c. | “H1 antagonists can bind to H1 receptors, H2 receptors, and muscarinic receptors.” |
| d. | “First-generation antihistamines are more selective than second-generation antihistamines.” |
ANS: A
Antihistamines block H1 receptors to prevent the actions of histamine. They do not block the release of histamine. H1 antagonists do not bind to H2 receptors; they do bind to muscarinic receptors. Second-generation antihistamines are more selective than first-generation antihistamines.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 842-844
TOP: Nursing Process: Assessment
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | “Allergy symptoms that are severe are caused by mediators other than histamine.” |
| b. | “H1 blockers do not prevent the release of histamine from mast cells and basophils.” |
| c. | “Second-generation H1 blockers contain less active drug and do not work in severe reactions.” |
| d. | “Severe allergic reactions occur through actions on muscarinic receptors.” |
ANS: A
Severe allergic reactions with symptoms of anaphylaxis are caused by mediators other than histamine, so the benefits of antihistamines are limited. H1 blockers do not block the release of histamine, but this is not why they are not effective in anaphylaxis. Second-generation agents are as effective as first-generation agents in allergic reactions mediated by histamine; neither is effective for treating anaphylaxis.
PTS: 1 DIF: Cognitive Level: Application REF: p. 843
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
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