(Pharmacology) Ch.29 Drugs Used to Treat Upper Respiratory Disease

Question 1

A rebound of nasal secretions caused from overuse of topical decongestants.

Answer 1

rhinitis medicamentosa

Question 2

Drugs of choice for relieving congestion associated with rhinitis caused by the common cold.

Answer 2

Decongestants

Question 3

A compound derived from an amino acid stored in small granules in most body tissues.

Answer 3

Histamine

Question 4

An inflammation of the nasal mucosa.

Answer 4

rhinitis

Question 5

An inflammation of the nasal mucosa as a result of an allergic reaction.

Answer 5

Allergic Rhinitis

Question 6

A runny nose from nasal and lacrimal secretions.

Answer 6

rhinorrhea

Question 7

A drug class that works by competing with the allergy- liberated histamine for h1 receptor sites.

Answer 7

antihistamines

Question 8

NCLEX item type: extended multiple response
Cognitive skill: recognize cues

The nurse explains to the patient in the scenario the body’s response to allergens is to release histamine causing the mucous membranes of the nose to have which reaction? (471)

1. Arterioles dilate allowing increased blood flow resulting in redness
2. Decreased ciliary movement
3. Rhinorrhea and watery eyes
4. Increased surface area of the nasal passages
5. Capillaries become more permeable causing edema and congestion

Answer 8

1. Arterioles dilate allowing increased blood flow resulting in redness
2. Decreased ciliary movement
3. Rhinorrhea and watery eyes

Question 9

NCLEX item type: extended multiple response
Cognitive skill: recognize cues

The nurse recognized that the patient’s symptoms in scenario #1 were probably caused by exposure to which allergens? (Select all that apply.) (471)

1. Dust mites
2. Viruses
3. Pollens
4. Peanuts
5. Animal dander
6. Feathers
7. House dust
8. Smoke

Answer 9

1. Dust mites
2. Viruses
3. Pollens
4. Peanuts

Question 10

NCLEX item type: multiple response
Cognitive skill: explain

The nurse educating a patient on ways to treat rhinitis medicamentosa should provide the patient with which instructions? (Select all that apply.) (472)

1. “The best treatment for this condition is to avoid it in the first place.’
2. “One option for you would be to work to clear one nostril at a time.”
3. There are several treatment options available for you, but first it is important to understand the cause of the problem.”
4. “One option for you would be to completely stop taking the decongestant and work through the discomfort you will experience.”
5. “One option for you would be to switch to another decongestant- one that will not cause this condition.”

Answer 10

1. “The best treatment for this condition is to avoid it in the first place.’

Question 11

NCLEX item type: multiple choice
Cognitive skill: interpret

A patient in scenario #1 asks the nurse what would be recommended to treat his nasal congestion from allergy symptoms. What would be an appropriate response by the nurse? (472)

1. “To eliminate your symptoms, you simply must avoid the allergen.”
2. “It does not matter what type of decongestant you use, they are all very similar.”
3. “You should avoid topical decongestants as their use could cause a rebound problem that is difficult to treat.”
4. “Only use prescription medications, as the over-the-counter medications often do not work for people.”

Answer 11

3. “You should avoid topical decongestants as their use could cause a rebound problem that is difficult to treat.”

Question 12

Objective: Explain the major actions (effects) of sympathomimetic, antihistaminic, and corticosteroid medicines.

NCLEX item type: multiple response
Cognitive skill: application

The nurse knows to watch for potential anticholinergic adverse effects of antihistamine therapy which include what symptoms? (Select all that apply.) (475)

1. Diarrhea
2. Stuffy nose
3. Dry mouth
4. Blurred vision
5. Urinary retention

Answer 12

1. Diarrhea
2. Dry mouth
3. Blurred vision
4. Urinary retention

Question 13

NCLEX item type: multiple choice
Cognitive skill: relate

The nurse explains to the patient in scenario #l that antihistamines such as fexofenadine (Allegra) are H1 receptor antagonists and they work by what mechanism? (475)

1. Blocking the H1 receptor sites on the target cells
2. Causing sedation and dryness of mucous membranes
3. Constricting the blood vessels in the nasal passages
4. Prevent the release of histamine to reduce the symptoms of an allergic reaction

Answer 13

2. Causing sedation and dryness of mucous membranes
3. Constricting the blood vessels in the nasal passages

Question 14

NCLEX item type: cloze
Cognitive skill: generate solutions
Choose the most likely options for the information
missing from the statements below by selecting from
the list of options provided.

The nurse explains to the patient in scenario #1 with allergic rhinitis the option to use an _____1 _____ with a _____ 1 _____ when there is inadequate response to monotherapy, and if symptoms become severe then the use of an _____ 2 _____ and a _____ 2 _____ and _____ 2 _____ simultaneously may be recommended. (472)

Option 1
Systemic corticosteroids
Anti Inflammatory Decongestant Antihistamine

Option 2
Cromolyn sodium
Nasal corticosteroids
Decongestant
NSAIDs
Antihistamine

Answer 14

Option 1

• Decongestant.
• Anti Inflammatory
• Antihistamine
• Systemic corticosteroids

Option 2

• Cromolyn sodium
• Decongestant
• NSAIDs
• Antihistamine
• Nasal corticosteroids

Question 15

NCLEX item type: multiple choice
Cognitive skill: explain

Which statement does the nurse include when teaching a patient about the use of intranasal cromolyn sodium? (478-479)

1. “Cromolyn sodium should not be used with a decongestant.”
2. “A 2- to 4-week course of therapy is usually required to reach full therapeutic benefit.”
3. “Cromolyn sodium should be administered as needed when symptoms occur.”
4. “Cromolyn sodium should be discontinued when the desired therapeutic response is achieved.

Answer 15

2. “A 2- to 4-week course of therapy is usually required to reach full therapeutic benefit.”
3. “Cromolyn sodium should be administered as needed when symptoms occur.”
4. “Cromolyn sodium should be discontinued when the desired therapeutic response is achieved.

Question 16

NCLEX item type: multiple response
Cognitive skill: application

Which findings does the nurse typically assess in a patient experiencing a severe allergic reaction? (Select all that apply.) (471)

1. Dry skin
2. Urticaria
3. Hypertension
4. Bronchospasms
5. Copious secretions

Answer 16

1. Dry skin

Question 17

Objective: Explain why all decongestants products should be used cautiously by people with hypertension, hyperthyroidism, diabetes mellitus, cardiac disease, increased intraocular pressure, or prostatic disease.

NCLEX item type: multiple choice
Cognitive skill: contrast

When patients use nasal decongestants such as pseudoephedrine, nurses need to educate them to be aware of the possible resulting hypertension, because of which action of sympathomimetic decongestants? (474)

1. Vasodilation
2. Vasoconstriction
3. Bronchodilation
4. Bronchoconstriction

Answer 17

2. Vasoconstriction

Question 18

NCLEX item type: multiple choice
Cognitive skill: analysis

The patient in scenario #2 has hyperthyroidism, which prompted the nurse to caution the patient regarding the use of sympathomimetic decongestants because these agents will have what effect? (474)

1. They stimulate the alpha receptors.
2. They cause eye irritation and lacrimation.
3. They have no effect on allergic rhinitis.
4. They tend to produce stinging of the nasal membranes.

Answer 18

2. They cause eye irritation and lacrimation.

Question 19

NCLEX item type: multiple response
Cognitive skill: application

The nurse consults the prescriber before administering a sympathomimetic decongestant to patients with which conditions? (Select all that apply.) (474)

1. Glaucoma
2. Diabetes mellitus
3. Hypothyroidism
4. Allergy to shellfish
5. Prostatic hyperplasia

Answer 19

1. Glaucoma
2. Diabetes mellitus 5. Prostatic hyperplasia

Question 20

Objective: Discuss the nursing assessments needed during therapy to monitor the therapeutic response to and the common and serious adverse effects of decongestant drug therapy.

NCLEX item type: multiple response
Cognitive skill: take action

What are important premedication assessments that the nurse will include for patients who starting on decongestants? (Select all that apply.) (474)

1. Obtain baseline vital signs
2. Assess nasal and sinus congestion
3. Ask about any urinary problems, especially in male patients over 55 years
4. Review history for evidence of hypothyroidism or hypotension
5. Determine if the patient has glaucoma or cardiac dysrhythmias and consult the healthcare provider

Answer 20

1. Obtain baseline vital signs
2. Assess nasal and sinus congestion
3. Ask about any urinary problems, especially in male patients over 55 years
4. Determine if the patient has glaucoma or cardiac dysrhythmias and consult the healthcare provider

Question 21

NCLEX item type: multiple choice
Cognitive skill: compare

When teaching adult patients with blocked nasal passages about the correct order to administer their intranasal corticosteroid medications, the nurse will instruct them to do what? (477-478)

1. Explain that they need to administer their intranasal corticosteroid before any decongestant.
2. Explain that they need to administer a nasal decongestant just before the intranasal therapy.
3. Explain that they need to administer their antihistamine 30 minutes prior to the use of any decongestants.
4. Explain that they need to avoid using a nasal decongestant; use their intranasal corticosteroid instead.

Answer 21

1. Explain that they need to administer their intranasal corticosteroid before any decongestant.

Question 22

NCLEX item type: grid/ matrix
Cognitive skill: recognize cues

The nurse reviewed the adverse effects from the medications used to treat allergic rhinitis and nasal congestion.

Indicate with an X’ which adverse effect can be see with which class of drugs. (474,477,479)

Answer 22