Chapter 77: Drugs for Allergic Rhinitis, Cough, and Colds

Chapter 77: Drugs for Allergic Rhinitis, Cough, and Colds

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse provides teaching to a patient with allergic rhinitis who will begin using an intranasal glucocorticoid. Which statement by the patient indicates understanding of the teaching?

a.	“If the glucocorticoid causes burning or itching, I should use it every other day.”
b.	“I should use a decongestant if necessary before using the glucocorticoid.”
c.	“I should use the glucocorticoid whenever I have symptoms.”
d.	“I will probably develop systemic effects from the topical glucocorticoid.”

 

 

ANS:  B

Patients using intranasal glucocorticoids should be taught to use a decongestant to unblock nasal passages if needed before using the medication. Intranasal glucocorticoids should be used regularly on a daily basis to achieve optimal effects and not every other day or as needed. Systemic effects from intranasal glucocorticoids can occur but are not likely.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 939

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A child with seasonal rhinitis has used budesonide [Rhinocort Aqua] for several years. The parents are concerned that the child’s rate of growth has slowed. What will the nurse do?

a.	Reassure the parents that this is an expected side effect.
b.	Suggest that the parents discuss using fluticasone [Flonase] with the provider.
c.	Tell the parents to administer the drug only when symptoms are severe.
d.	Tell the parents that antihistamines work as well as intranasal glucocorticoids.

 

 

ANS:  B

A worrisome systemic effect of intranasal glucocorticoids is suppression of linear growth in children. Although rare, it can occur; however, it is less likely with fluticasone and mometasone, so these two preparations are better options for children. Reassuring parents that this is an expected side effect is incorrect. Intranasal glucocorticoids should be given daily and not as needed. Antihistamines are not as effective as glucocorticoids, because antihistamines work only against one mediator of allergic inflammation.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 939-940

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A patient who has seasonal allergies in the spring and fall asks the nurse about oral antihistamines. Which response by the nurse is correct?

a.	“Anticholinergic effects are more common with second-generation antihistamines.”
b.	“First-generation antihistamines, such as diphenhydramine [Benadryl], are more effective.”
c.	“Make sure you take antihistamines only when you have symptoms to minimize side effects.”
d.	“You should take oral antihistamines daily during each allergy season to get maximum effects.”

 

 

ANS:  D

Antihistamines are most effective when they are taken prophylactically, and they should be administered on a regular basis throughout the allergy season, even when symptoms are not present. They are less helpful when taken after symptoms appear. Second-generation antihistamines have fewer anticholinergic effects than first-generation antihistamines. First-generation antihistamines are not more effective than second-generation antihistamines. Oral antihistamines are not as effective when given on a PRN basis.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 940

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

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

a.	Pseudoephedrine [Sudafed]
b.	Fluticasone propionate [Fluticasone]
c.	Loratadine [Claritin]
d.	Intranasal cromolyn sodium [Atrovent]

 

 

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.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 939

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies