Chapter 76: Drugs for Allergic Rhinitis, Cough, and Colds

Chapter 76: Drugs for Allergic Rhinitis, Cough, and Colds

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1. Which statement made by a patient indicates the need for further teaching about the use of diphenhydramine (Benadryl) for the treatment of allergic rhinitis?

ANS:   B

For treatment of allergic rhinitis, antihistamines, such as diphenhydramine, are most effective when taken prophylactically and are less helpful when the symptoms appear. This statement indicates that further teaching is required.

Diphenhydramine is effective against sneezing, rhinorrhea, and nasal itching. It does not reduce nasal congestion. No further teaching is required.

The most common complaint with antihistamines is sedation, which often occurs with first-generation antihistamines, such as diphenhydramine. No further teaching is required.

Anticholinergic side effects, such as constipation, urinary retention, and dry mouth, commonly occur with first-generation antihistamines. No further teaching is required.

DIF:    Cognitive Level: Application             REF:    p. 907

TOP:    Nursing Process: Evaluation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A patient asks the nurse if any of the antihistamines are available as a nasal spray. Which of the following medications should the nurse instruct the patient to discuss with the prescriber?

ANS:   A

Azelastine is the only intranasal antihistamine available.

Mometasone is an intranasal glucocorticoid spray.

Sertraline is an oral selective serotonin reuptake inhibitor used for depression.

Ipratropium bromide is an anticholinergic medication, not an antihistamine.

DIF:    Cognitive Level: Comprehension      REF:    p. 907

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A patient is starting azelastine (Astelin) spray for allergic rhinitis. The nurse should discuss which common side effect during patient education?

ANS:   B

A bitter taste in the mouth occurs in about 20% of patients using azelastine nasal spray. Patients should be informed of this side effect.

Hemoptysis, cough, and increased nasal stuffiness are not common side effects.

DIF:    Cognitive Level: Application             REF:    p. 907

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A clinic patient asks the nurse what type of medications would be most effective for treating seasonal and perennial rhinitis? Which of the following would be an accurate response by the nurse?

ANS:   B

Intranasal glucocorticoids, such as fluticasone propionate, are the most effective drugs for prevention and treatment, because they prevent or suppress all the major symptoms of allergic rhinitis (congestion, rhinorrhea, sneezing, nasal itching, and erythema).

Pseudoephedrine is an oral sympathomimetic used to reduce nasal congestion associated with allergic rhinitis. It has no effect on other symptoms.

Loratadine, an oral antihistamine, reduces sneezing, rhinorrhea, and nasal itching only and is less effective than intranasal glucocorticoids.

Intranasal cromolyn sodium is moderately effective in the treatment of allergic rhinitis, but the benefits are much less than those of intranasal glucocorticoids.

DIF:    Cognitive Level: Application             REF:    p. 908

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies