Nokea
A patient has been advised to add an adrenergic decongestant nasal spray to treat a cold. The nurse will include which instruction?
- A. You won't see effects for at least 1 week.
- B. Limit use of this spray to 3 to 5 days.
- C. Continue the spray until nasal stuffiness has resolved.
- D. Avoid use of this spray if a fever develops.
Correct Answer: B
Rationale: Frequent, long-term, or excessive use of adrenergic nasal decongestants may lead to rebound congestion if used beyond the recommended time. The other instructions are incorrect.
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When giving dextromethorphan, the nurse understands that this drug suppresses the cough reflex by which mechanism of action?
- A. Causing depression of the central nervous system
- B. Anesthetizing the stretch receptors
- C. Having direct action on the cough center
- D. Decreasing the viscosity of the bronchial secretions
Correct Answer: C
Rationale: Dextromethorphan suppresses the cough reflex through a direct action on the cough center. The other options are incorrect.
A patient tells the nurse that she wants to start taking the herbal product goldenseal to improve her health. The nurse will assess for which potential cautions or contraindications to goldenseal?
- A. Taking a proton-pump inhibitor
- B. Nasal congestion
- C. Hypothyroidism
- D. Taking an antihypertensive drug
- E. Sinus infections
- F. Pregnancy
Correct Answer: A,D,F
Rationale: Goldenseal is contraindicated in patients with acute or chronic gastrointestinal disorders and during pregnancy (because it has uterine stimulant properties). It should be used with caution by those with cardiovascular disorders. Potential drug interactions may occur with gastric acid suppressors such as antacids, histamine H2 blockers (e.g., ranitidine), and proton-pump inhibitors (e.g., omeprazole), theoretically because of their reduced effectiveness resulting from the acid-promoting effect of the herb, and with antihypertensive drugs (because of the vasoconstrictive activity of the herb). Goldenseal is potentially useful for sinus infections and chronic nasal allergies.
A gardener needs a decongestant because of sinus problems and asks the nurse whether he should take an oral form or a nasal spray. Which of these is a benefit of orally administered decongestants?
- A. Immediate onset
- B. A more potent effect
- C. Lack of rebound congestion
- D. Shorter duration
Correct Answer: C
Rationale: Drugs administered by the oral route produce prolonged decongestant effects, but the onset of action is more delayed and the effect less potent than those of decongestants applied topically. However, the clinical problem of rebound congestion associated with topically administered drugs is almost nonexistent with oral dosage forms.
A patient asks the nurse about the uses of the herbal product echinacea. Which use will the nurse include in the response?
- A. Memory enhancement
- B. Boosting the immune system
- C. Improving mood
- D. Promoting relaxation
Correct Answer: B
Rationale: Common uses of echinacea include stimulation of the immune system, antisepsis, treatment of viral infections and influenza-like respiratory tract infections, and promotion of the healing of wounds and chronic ulcerations. The other options are incorrect.
A patient will be receiving diphenhydramine via a PEG tube, 25 mg, every 8 hours for an allergic rash. The medication is available as a 12.5 mg/5 mL syrup. Identify how many milliliters will the nurse administer with each dose.
Correct Answer: 10 mL
Rationale: 12.5 mg : 5 mL :: 25 mg : x mL; (12.5 * x) = (5 * 25); 12.5x = 125; x = 125/12.5 = 10 mL.