Nokea
A 21-year-old client complains of a mild stinging sensation on using a nasal spray decongestant. Which response by the nurse would be most appropriate?
- A. You need to stop the medication immediately.
- B. The dose is probably too strong and needs to be reduced.
- C. This sensation is common and usually disappears with continued use.
- D. We better contact your primary health care provider right away.
Correct Answer: C
Rationale: The nurse needs to assure the client that the mild stinging sensation usually disappears with continued use. The drug needs to be stopped only if the stinging sensation is severe. The dose of the medication does not need to be altered. The primary health care provider does not need to be consulted immediately in the presence of a mild stinging sensation.
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A client taking metoprolol (Lopressor) 50 mg one tablet twice daily begins taking over-the-counter pseudoephedrine. The nurse would assess for which of the following? Select all that apply.
- A. Hyperglycemic episode
- B. Hypertensive episode
- C. Rebound congestion
- D. Hypoglycemic episode
- E. Bradycardic episode
Correct Answer: B,E
Rationale: A client taking a beta-adrenergic blocker, such as metoprolol, and a decongestant, such as pseudoephedrine, may develop an initial hypertensive episode followed by a bradycardic episode.
When assessing an older client who is receiving an antihistamine, the nurse integrates knowledge of which of the following as contributing to the client's higher risk of injury? Select all that apply.
- A. Hearing loss
- B. Steady gait
- C. Visual impairment
- D. Hypertension
- E. Diabetes
Correct Answer: A,C
Rationale: Older adult clients are more likely to experience injury from dizziness because with age comes an increased risk for falls due to sensorimotor deficits (hearing loss, visual impairment) or unsteady gait.
A nurse is assigned to care for a client with bronchial irritation. The client is prescribed diphenhydramine. Before administering the drug, which of the following would the nurse do?
- A. Document color and amount of any sputum present.
- B. Record the previous prescriptions.
- C. Take vital signs every 4 hours.
- D. Assess the client's cardiovascular status.
Correct Answer: A
Rationale: Before drug administration, the nurse should document the color and amount of any sputum present. The nurse need not record the previous prescriptions; however, the nurse should determine if any drugs the client uses would potentially interact with diphenhydramine. The nurse needs to take the client's vital signs, but not every 4 hours. The nurse needs to assess the respiratory status of the client before administering mucolytics and expectorants, but not before administering diphenhydramine HCl. Assessing the client's cardiovascular status is not necessary.
A client has been prescribed a decongestant drug for congestion associated with rhinitis. When teaching the client about this drug, which of the following would the nurse include as a possible adverse reaction?
- A. Decreased pulse rate
- B. Blurred vision
- C. Drowsiness
- D. Dryness of throat
Correct Answer: B
Rationale: The nurse should inform the client that blurred vision is a possible adverse reaction of decongestant drugs. Additionally, an increased and not decreased pulse rate may also be seen. Drowsiness is not seen with decongestant usage. Dryness of the nasal mucosa and not the throat may be seen with decongestant drugs, which are used mostly as topical sprays and drops.
When describing the actions of upper respiratory system drugs, a nursing instructor explains that which of the following exerts its effect by increasing the production of secretions, thereby decreasing the viscosity? Select all that apply.
- A. Benzonatate
- B. Guaifenesin
- C. Codeine
- D. Potassium iodide
- E. Dextromethorphan
Correct Answer: A,D
Rationale: Benzonatate and potassium iodide are expectorants, which increase the production of secretions, thus making the secretions less viscous. Guaifenesin, codeine, and dextromethorphan are antitussives, which suppress cough.