Test 6 Ch 8 Flashcards
- A patient with allergies has been prescribed an antihistamine. Which response by the patient demonstrates understanding of the action of antihistamine drugs?
a. “Antihistamines act by blocking histamine receptors in tissues.”
b. “Antihistamines act by increasing dilation of blood vessels.”
c. “Antihistamines act by blocking the release of histamine.”
d. “Antihistamines act by increasing the production of acetylcholine.”
ANS: A
Antihistamines do not block the release of histamine, but rather, block histamine receptors in target tissues which in turn limit the blood vessel vasodilation, capillary leak, swelling, and bronchoconstriction.
- An older adult patient with glaucoma reports taking an antihistamine for allergy symptoms. What adverse effect of antihistamines would you alert this patient about?
a. Ototoxicity
b. Ocular “floaters”
c. Excessive tearing
d. Increased intraocular pressure
ANS: D
A rising intraocular pressure (pressure inside the eye) in patients with glaucoma can worsen the disease and could cause blindness.
- A 43-year-old male patient with hypertension has stated that he is taking an over-the-counter antihistamine every day for seasonally allergies. In reviewing all the drugs this patient is taking, what statement should be included in his teaching plan?
a. “Take your antihistamine 2 hours before your other prescription drugs.”
b. “Antihistamines can cause your blood pressure to rise.”
c. “Antihistamines can cause a slowing of the pulse rate.”
d. “Antihistamines must be taken at the same time as antihypertensives.”
ANS: B
A rise in blood pressure is an adverse action of antihistamines. Patients should be instructed to report all OTC drugs to their healthcare providers, as adverse interactions can occur.
- A patient taking a decongestant for seasonal allergies asks you to explain how a decongestant works. What is your best response?
a. “Decongestants act by decreasing inflammation within the respiratory tract.”
b. “Decongestants act in the respiratory tract to decrease mast cell activity.”
c. “Decongestants reduce allergy symptoms, but do not reduce inflammation.”
d. “Decongestants act by reducing the immune response of lymphocytes.”
ANS: C
Decongestants are a class of drugs that are used to control the symptoms associated with allergy. They have no anti-inflammatory action
- An adolescent with asthma is taking an inhaled anti-inflammatory drug and asks you what side effects can be expected with this inhaled drug. What is your best response?
a. “You may experience some mild anemia with this drug.”
b. “You may experience some bronchoconstriction after the first dose of this drug.”
c. “You may experience mild itching of the mucous membranes with this drug.”
d. “You may experience dryness of the mouth with this drug.”
ANS: D
Anti-inflammatory drugs reduce inflammation and dry all mucous membranes including those in the mouth and throat. They would reduce any cutaneous (skin) itching. They do not work on bronchial smooth muscles or the bone marrow (which produces red blood cells).
- Which patient would not be a candidate for a leukotriene inhibitor as part of the treatment plan for mild asthma?
a. An adult patient with a history of liver disease
b. An older patient with cognitive impairment
c. An adolescent with allergic rhinitis
d. A patient with depression
ANS: A
Liver dysfunction is possible with long-term use. The leukotriene inhibitors interact with drugs that stimulate liver metabolism such as phenytoin, phenobarbital, and carbamazepine, and rifampin.
- An adolescent with a history of asthma will need a drug to prevent exercise-induced asthma while playing high school sports.
Which drug would be appropriate for this use?
a. Cromolyn sodium
b. Theochron
c. Sus-Phrine
d. Proventil
ANS: A
Cromolyn sodium is used for prophylaxis in treating asthma. It works by slowing down the destruction of sensitized mast cells and inhaled specific antigens. This drug is taken daily as it does not act rapidly.
- You are teaching a patient with newly diagnosed asthma about using the prescribed drugs to manage acute asthma symptoms.
Which of the following statements made by the patient would indicate your teaching was effective?
a. “I will keep my short-acting bronchodilating inhaler with me at all times.”
b. “I will take my cromolyn sodium 5 minutes after asthma symptoms begin.”
c. “I will take montelukast (Singulair) at the first sign of an asthma attack.”
d. “I will take my decongestant and corticosteroid nasal spray each day.”
ANS: A
Teach patients with asthma to always have their short-acting beta2-adrenergic agonists (SABAs) reliever drug with them at all times because an attack can occur anywhere and only a SABA can work fast enough to prevent a severe attack and death.
- A patient has been prescribed fluticasone (Flonase) to control swelling of the nasal mucosa due to allergies. Which statement made by the patient alerts you to a possible adverse effect of this drug?
a. “My nasal passages appear to be dry.”
b. “I have a white patch in my throat that is sore.”
c. “I have been experiencing a fast heartbeat after taking this drug.”
d. “I feel sleepy most of the day.”
ANS: B
Fluticasone is a nasal corticosteroid that can reduce the local immune response of the patient, and a secondary fungal infection may occur.
- A patient with asthma who has been prescribed a long-acting beta-adrenergic agonist asks why this drug is not useful during an actual acute asthma attack. What is your best response?
a. “Long-acting beta agonists reduce inflammation rather than relax bronchial smooth.”
b. “Long-acting beta agonists can worsen an asthma attack.”
c. “Long-acting beta agonists need time to build up an effect.”
d. “Long-acting beta agonists take too long to be absorbed by the intestinal tract.”
ANS: C
Long-acting beta2-adrenergic agonists (LABAs) work in the same way as SABAs but need time to build up an effect. Therefore,
LABAs are used to prevent an asthma attack because their effects last longer but have no value during an acute attack.
- Which of the following patients is most at risk for overdose from the oral mucolytic drug guaifenesin?
a. A 38-year-old patient who had surgery 4 days ago
b. A 60-year-old with a history of COPD
c. An adolescent with a history of asthma
d. A 1-year-old child with a cold and cough
ANS: D
Because of cases of overdosage, the FDA recommends that these products not be given to children under 2 years old and some products not to children under 6 years old.
- Which statement made by the patient demonstrates understanding of the use of oral mucolytics?
a. “I will not use a humidifier while taking this drug.”
b. “This drug will stop me from coughing.”
c. “I will drink at least 2 quarts of water while taking this drug.”
d. “This drug will cause my urine to change color.”
ANS: C
Patient instructions should include the use of a humidifier and instruct the patient to drink at least 2 quarts of water daily while taking a mucolytic unless there is a medical reason for fluid restriction. These actions will help get the mucus out.
- What information should be included in the teaching plan for a patient who is prescribed an antitussive agent?
a. “This drug contains codeine but is not habit forming.”
b. “This drug can be taken for long periods of time.”
c. “This drug can cause drowsiness.”
d. “Do not give this drug to adults, as this drug is for children’s use only.”
ANS: C
Side effects of antitussives include drowsiness and dizziness. Antitussives should be used only for short periods of time because they can be addictive. They are prescribed for adults.
- A patient with a severe cough has been prescribed a codeine-based antitussive. What statement made by this patient would alert you that the patient is experiencing a side effect of the drug?
a. “My appetite has been greatly increased lately.”
b. “I have been having difficulty sleeping.”
c. “My fingertips feel a bit numb.”
d. “I have been experiencing constipation lately.”
ANS: D
Codeine-containing antitussives may cause severe constipation.
- You are teaching a patient with severe asthma prescribed both a short acting beta-adrenergic agonist (SABA) and an inhaled corticosteroid. Which statement made by the patient demonstrates understanding of how to use these drugs?
a. “Never take these two inhalers together.”
b. “Take the SABA before the inhaled corticosteroid.”
c. “Take the inhaled corticosteroid before the SABA.”
d. “Take the SABA on alternate days only.”
ANS: B
When both a SABA and an inhaled corticosteroid are ordered, instruct the patient to take the SABA first to relax the smooth muscle, opening the airway so the corticosteroid can reach the respiratory tract.
