Nokea
The nurse understands that an expectorant is administered cautiously to a client with which condition?
- A. Renal impairment
- B. Persistent headache
- C. Persistent cough
- D. Seizure disorder
Correct Answer: C
Rationale: The nurse should use the expectorant drugs with caution in clients with persistent cough. The nurse should use antitussives with caution in clients with persistent headache. The nurse needs to use opioid antitussives cautiously in clients with renal impairment and seizure disorders.
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A client with vasomotor rhinitis has been prescribed an antihistamine. The client is eager to know whether the prescribed antihistamine may cause excessive sedation. Which antihistamine would the nurse identify as having very little sedative effect?
- A. Brompheniramine
- B. Clemastine
- C. Chlorpheniramine
- D. Azelastine
Correct Answer: D
Rationale: The nurse should assure the client that azelastine has very little sedative effect; it is a second-generation antihistamine with little effect on central nervous system (CNS) depression. Brompheniramine, clemastine, and chlorpheniramine are first-generation antihistamines. Sedation is seen more often with first-generation antihistamines.
Assessment of a client reveals that he is taking phenelzine (Nardil), a monoamine oxidase inhibitor, for depression. The client reports that he just started using dextromethorphan over the counter without consulting his primary health care provider. The nurse would be alert for which of the following? Select all that apply.
- A. Hypertension
- B. Fever
- C. Coma
- D. Constipation
- E. Shortness of breath
Correct Answer: B,C
Rationale: Coadministration of dextromethorphan and a monoamine oxidase inhibitor may result in hypotension, fever, nausea, leg jerking, and coma.
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 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.
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.