Nokea
The nurse is preparing to administer a drug that acts by reducing the swelling in the nasal passages by vasoconstriction. Which of the following might the nurse be administering? Select all that apply.
- A. Loratadine
- B. Guaifenesin
- C. Dextromethorphan
- D. Phenylephrine
- E. Oxymetazoline
Correct Answer: D,E
Rationale: Phenylephrine and oxymetazoline are decongestants that reduce swelling in the nasal passages by vasoconstriction. Loratadine is an antihistamine, guaifenesin is an expectorant, and dextromethorphan is a centrally acting antitussive.
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A nursing instructor is describing the advantages of using a second-generation antihistamine over a first-generation antihistamine. Which of the following would the instructor most likely include? Select all that apply.
- A. Less sedation
- B. Fewer anticholinergic effects
- C. Less nausea
- D. Can be used during pregnancy
- E. Can be used during lactation
Correct Answer: A,B
Rationale: Second-generation antihistamines cause less sedation and fewer anticholinergic effects because they selectively bind to peripheral rather than central H1 receptors. Some first-generation antihistamines can be used as antiemetics. Use of any antihistamine is contraindicated during pregnancy and lactation.
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.
A client has a nursing diagnosis of Ineffective Airway Clearance. Which of the following would the nurse include in the client's plan of care? Select all that apply.
- A. Encouraging increased fluid intake
- B. Assisting the client in taking deep, diaphragmatic breaths
- C. Discouraging client movement
- D. Instructing the client to avoid coughing
- E. Encouraging the client to change positions
Correct Answer: A,B,E
Rationale: Clients should be encouraged to change positions frequently, breathe deeply, and increase fluid intake to aid in effectively clearing the airway of sputum. Coughing helps to move mucus.
After teaching a group of nursing students about antihistamines, the instructor determines that the teaching was successful when the students identify which of the following as less sedating? Select all that apply.
- A. Loratadine (Claritin)
- B. Fexofenadine (Allegra)
- C. Cetirizine (Zyrtec)
- D. Brompheniramine (Lodrane)
- E. Clemastine (Tavist)
Correct Answer: A,B,C
Rationale: Loratadine, fexofenadine, and cetirizine are considered second-generation antihistamines that are less sedating than first-generation antihistamines (brompheniramine and clemastine).
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.