NURS 6521 Week 4 Quiz 3

NURS 6521 Week 4 Quiz 3 • Question 1

• out of 1 points

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his “puffers”. In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

Response

Feedback:

Patients who self-administer albuterol may use their MDIs more frequently than recommended.This practice can result in rebound bronchoconstriction, which may motivate the patient to increase MDI use, stimulating the cycle of rebound congestion. Overuse of albuterol is not linked to pneumonia or hepatotoxicity. Albuterol is not an anticholinergic drug.

• Question 2

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A 68-year-old man complains of a chronic, nonproductive cough. He states that he has to have relief, that he has been coughing every 2 to 3 minutes, and he is worn out. Dextromethorphan is prescribed for him. Before he leaves the clinic he asks how long it will take for the medicine to work. The nurse will advise him that he should experience therapeutic effects in

Response

Feedback:

The nurse should explain to the patient that he should get some relief in 15 to 30 minutes.Dextromethorphan is absorbed rapidly from the GI tract, which allows for therapeutic effects to be experienced within a half hour.

• Question 3

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A female patient, age 36, is prescribed inhaled corticosteroid (ICS) for daily use. Which of the following adverse effects should the nurse closely monitor for in this patient?

Response

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Dysphonia and oropharyngeal Candida albicans infections are common adverse effects associated with daily use of ICS. Long-term use of ICS may delay growth in children, not adults. Suppression of the hypothalamic-pituitary-adrenal axis is a rare adverse effect, and hypotension is not an identified adverse effect of the drug.

• Question 4

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A 47-year-old woman has been diagnosed with open-angle glaucoma. Pilocarpine drops are prescribed. The nurse's assessment reveals that the patient has worn soft contact lenses for 15 years. The nurse will instruct the patient to

Response

Feedback:

The nurse should instruct the patient to remove the contact lenses before applying the drops to the eyes. If pilocarpine drops are applied to the eyes when soft contact lenses are in place, the lenses can deteriorate or absorb the drug. There is no need to stop wearing contact lenses during this therapy, but application of the lenses should take place after the drops have been applied.

• Question 5

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The lower respiratory system utilizes a number of different mechanisms that confer protection and maintain homeostasis. Which of the following physiological processes protects the lower respiratory system?

Response

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During the passage through the bronchi, microorganisms and other foreign bodies are removed from the air by tiny hair-like structures called cilia, which project from the cells that line the bronchial wall. With a wave-like motion, these cilia sweep the foreign material and mucus upward toward the trachea and larynx. Goblet cells do not produce phagocytes and the airway does not close off at the carina when offended. Alveoli are not capable of independently producing positive pressure.

• Question 6

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A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family doctor. What effect will the patient's smoking status have on the therapeutic use of theophylline?

Response

Feedback:

Smoking cigarettes may decrease serum theophylline levels. In fact, some patients who smoke require an increase in theophylline dosage of up to 50%. Theophylline is not associated with a risk of anaphylactoid reaction. Theophylline doses do not need to be concurrent with the use of bronchodilators.

• Question 7

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A nurse is providing patient education to a 42-year-old man who has been prescribed dextromethorphan (Robitussin). The patient is a crane operator for a local construction company. The nurse's assessment reveals that the patient is a smoker and has diabetes. The most important safety consideration while the nurse is designing a plan of care for this patient would be the fact that he is

Response

Feedback:

Dextromethorphan may cause sedation, drowsiness, and impaired orientation, so it may be dangerous for the patient to operate a crane during drug therapy. The patient's age, smoking habits, and diabetes would not present a significant or immediate safety risk to the patient or others.

• Question 8

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A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may

Response

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It is essential to caution the patient against taking aspirin or drugs that contain aspirin while on doxorubicin drug therapy because aspirin may promote bleeding during periods of suppressed bone marrow function. Aspirin will not cause extravasation injury, radiation recall reaction, or acute nausea and vomiting; these are adverse effects of doxorubicin.

• Question 9

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A female patient calls the clinic and reports that since she has been taking dextromethorphan (Robitussin), she has been extremely drowsy and dizzy. The nurse will question the patient about which of the following?

Response

Feedback:

The nurse should assess the amount of grapefruit or orange juice ingestion, because these juices can substantially increase the concentration of dextromethorphan and cause an increase in the frequency and severity of the adverse effects of the drug. Tea, soft drinks, coffee, or water would not increase the drowsiness or dizziness that is often associated with the use of this drug.

• Question 10

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A patient is being treated for respiratory infection. He is a recovering alcoholic and has impaired liver function. The nurse will instruct the patient to be especially cautious when taking

Response

Feedback:

An elixir is a clear hydro-alcoholic mixture that is usually sweetened. Most elixirs contain ethanol and water. Ethanol is a form of alcohol, and the content may exceed 25%. Patients with a history of alcohol abuse should be informed that elixirs contain alcohol, so they are not inadvertently exposed to alcohol. The other medication forms have no special considerations relevant to this patient.

• Question 11

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A patient with bronchial asthma is prescribed a sustained-release preparation of theophylline. To help minimize the adverse effects of the drug, which of the following should the nurse suggest?

Response

Feedback:

Sustained-release preparations of theophylline should be taken on an empty stomach, 1 hour before or 2 hours after meals. Immediate-release preparations should be administered with meals to alleviate gastrointestinal distress. Foods containing xanthines, in particular caffeine, increase the effects of theophylline, but they do not help minimize the adverse effects of theophylline. Patients who smoke may require an increase in theophylline dosage of up to 50%, but increasing the dosage is not a nursing responsibility.

• Question 12

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A male patient is to begin treatment for pneumonia with an albuterol (Ventolin) inhaler. The nurse will advise the patient that he will most likely experience which of the following common adverse effects of the drug?

Response

Feedback:

The most common adverse effects of inhaled albuterol include throat irritation, palpitations, sinus tachycardia, anxiety tremor, and increased blood pressure. Serious adverse effects such as bronchospasm, urticaria, and angioedema rarely occur. Headache, dyspepsia, and muscle cramps are frequent adverse effects of oral albuterol only.

• Question 13

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A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for which of the following?

Response

Feedback:

The nurse should observe the patient closely for hypotension and anaphylactic reactions. The drug should not cause hypertension, hypoglycemia, or tachycardia.

• Question 14

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A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma. Which of the following findings would alert the nurse to the need for close monitoring?

Response

Feedback:

Older men taking theophylline should be carefully assessed for an enlarged prostate gland because this drug may lead to urinary retention in persons with prostate enlargement. These patients should be monitored closely for any prostate changes. Assessing the need for additional bronchodilation, signs of an active lung infection, and hypersensitivity to povidone would not concern the nurse related to the use of this drug.

• Question 15

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A 70-year-old woman has a complex medical and a current drug regimen that includes calcium and vitamin D supplements for osteoporosis, metformin (Glucophage) for type 2 diabetes, phenelzine (Nardil) for depression, and metoprolol (Lopressor) and furosemide (Lasix) for hypertension. The woman is requesting

dextromethorphan for the treatment of a recurrent cough. What component of her drug regimen contraindicates the use of dextromethorphan?Response

Feedback:

Dextromethorphan can block neuronal uptake of serotonin and may produce serotonin syndrome. The concurrent use of dextromethorphan and metformin, calcium supplements, and metoprolol is not problematic.

• Question 16

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A college student has presented the campus medical clinic complaining of cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student?

Response

Feedback:

Frequent, long-term, or excessive use of decongestants induces rebound congestion. Rebound congestion occurs when the nasal passages become congested as the drug effect wears off and the body compensates by vasodilating the same nasal arterioles that the drug constricted. This does not occur because of the ineffectiveness of decongestants, however. Dosing should be based on the instructions provided.

• Question 17

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The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a “rescue drug” for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?

Response

Feedback:

Albuterol is a rescue drug that should be used first for all acute symptoms of shortness of breath or wheezing. Theophylline does not produce rapid symptom relief and beclomethasone is a maintenance drug. Acetylcysteine is not used in the treatment of asthma because it is used to manage secretions, which are not associated with asthma.

• Question 18

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Which of the following will a nurse inform the patient is one of the most common adverse effects of guaifenesin (Robitussin)?

Response

Feedback:

The most common adverse effects of guaifenesin use are GI symptoms, including nausea, vomiting, and anorexia. Increased blood pressure, increased blood glucose, and urinary retention are not commonly identified adverse effects of this drug.

• Question 19

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A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose?

Response

Feedback:

The amount of alcohol consumption would be the priority assessment, since both guaifenesin and alcohol can cause drowsiness. The amount of salt the patient consumes as well as the amount of fatty foods and number of cigarettes would be important to know when planning care for this patient, but none of these would pose the safety risk of drowsiness, especially considering the patient's occupation.

• Question 20

• out of 1 points