Test Bank For Pharmacotherapeutics for Advanced
Nursing Practice, 1ST EDITION By Tammie Lee Demler
9781284154290 Chapter 1-14 Complete Guide .
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Chapter 1 Antihistamines
1. A patient has all of the following health problems and seasonal allergies. Which one must the
nurse warn the patient can be made worse by over-the-counter antihistamines?
a. Asthma
b. Breast cancer
c. Rheumatoid arthritis
d. High blood pressure
ANS: D
When antihistamines bind to histamine receptors on blood vessels, they cause blood vessels to
constrict. Blood vessel constriction raises blood pressure. When the patient already has high
blood pressure, these drugs can make the problem worse.
2. A 78-year-old man has been taking diphenhydramine (Benadryl) for seasonal allergies. Which
new symptom would the nurse report to the prescriber?
a. Decreased urination
b. Drowsiness
c. Dry mouth
d. Cough
ANS: A
Diphenhydramine is an antihistamine with anticholinergic actions that include dry mouth,
drowsiness, and urinary retention. An enlarged prostate is common among older men and causes
difficulty urinating. This problem can be made much worse when taking a drug that can cause
urinary retention.
3. A patient is prescribed triamcinolone (Kenalog) ointment for an allergic skin rash. Which
precaution is most important for the nurse to teach?
a. Always wear gloves when applying this ointment.
b. Do not use the ointment on an infected skin area.
c. Keep the drug refrigerated between applications.
d. Do not wash the ointment off until the area is healed.
ANS: B
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,Topical corticosteroids lower immunity in the area where it is applied. This means that if there is
a skin infection and topical corticosteroids are applied in that area, the infection can spread to
surrounding areas more easily. For this reason, do not apply a topical corticosteroid if there is
any question that the skin is infected instead of just being irritated or having a rash.
4. The nurse is teaching a patient about the administration of antihistamines. The nurse will
instruct the patient to take the medication at what time of day?
a. PRN throughout the day
b. After contact with an allergen
c. 45 minutes before exposure to an allergen
d. Once nasal congestion begins
ANS: C
Allergies may be seasonal or perennial. People are commonly allergic to more than one antigen
simultaneously, so seasons may overlap or occur more than once per year. Antihistamines do not
prevent histamine release, but reduce the symptoms of an allergic reaction by competing with the
histamines for receptor sites. Antihistamines are most effective when taken 45 to 60 minutes
before anticipated exposure to the allergen or when symptoms first appear. PRN use of
antihistamines, waiting until after contact with an allergen, or waiting until nasal congestion
begins is not the most effective administration of antihistamines.
5. A patient at sports camp is complaining of itchy and watery eyes, coughing, and sneezing
when outdoors. The patients chart states that he has an allergy to grasses. Which medication will
the nurse administer?
a. Antitussive
b. Expectorant
c. Antihistamine
d. Decongestant
ANS: C
Antihistamines are used for inflammation and swelling resulting from the release of histamine
during an antigen antibody reaction. A grass allergy means that the patient experiences a release
of histamine (antibody reaction) when exposed to the antigen, grass. Antitussive medications are
for relief of cough. Expectorants are for the loosening of mucus so the patient can expel it by
coughing. Decongestants would not help these symptoms as much as antihistamines.
DIF: Cognitive Level: Comprehension REF: dm. 474 OBJ: 2 | 6 | 7
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
6. Which medication may be given to patients with allergic seasonal rhinitis who do not respond
to antihistamines and sympathomimetics?
a. Leukotrienes
b. Mineralocorticoids
c. Corticosteroids
d. Cortisol
ANS: C
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, Corticosteroids, whether applied topically or administered systemically, have been shown to be
highly effective for the treatment of allergic rhinitis. Leukotrienes, made in the body, are
mediators of the inflammatory response. Mineralocorticoids do not affect allergic responses.
Cortisol is not the steroid of choice for the treatment of an allergic response.
7. The nurse is caring for a 27-year-old patient taking a cannabinoid during chemotherapy.
Which consideration will the nurse take into account?
a. Antihistamines may potentiate the effects.
b. Monitor the patient for fluid volume excess.
c. Previous use of marijuana requires increased dosage.
d. Inform the patient to avoid the intake of potassium.
ANS: A
Antihistamines, alcohol, analgesics, benzodiazepines, barbiturates, antidepressants, muscle
relaxants, and sedative hypnotics increase toxic effects. Fluid volume excess is not an adverse
effect of cannabinoids. Previous use does not necessarily require increased dosage. There are no
dietary restrictions with the use of cannabinoids.
Chapter 2 Anti-Infective Agents
1.
A patient asks the nurse how an anti-infective produces a therapeutic effect. What key point will
the nurse explain to this patient?
A)
Drugs used to treat infections date back to the 17th century.
B)
All anti-infectives work in the same way to destroy organisms.
C)
Selective toxicity determines the appropriate drug dosage needed.
D)
The goal of anti-infectives is to interfere with normal functioning of the organism.
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