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Clayton’s Basic Pharmacology for Nurses, 18th Edition

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A patient has questions regarding a recently prescribed antitussive agent. Which response by the nurse is the best? a. “It will eliminate your cough at night.” b. “It will reduce the frequency of your cough.” c. “It should be used in the morning.” d. “It should be taken before sleep.” ANS: B Antitussive agents act by suppressing the cough center in the brain. The expected therapeutic outcome is reduced frequency of nonproductive cough to promote rest. Antitussive agents should be taken as prescribed by the healthcare provider. Antitussives are not likely to eliminate cough. Antitussives should be taken throughout the day. DIF: Cognitive Level: Comprehension REF: p. 468 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Implementation CON: Clinical Judgment | Patient Education 2. Which is a common expectorant in over-the-counter medications? a. Dextromethorphan b. Diphenhydramine c. Guaifenesin d. Codeine ANS: C Guaifenesin is used for symptomatic relief of conditions characterized by a dry, nonproductive cough such as the common cold, bronchitis, laryngitis, pharyngitis, and sinusitis. Guaifenesin is also used to remove mucous plugs from the respiratory tract. Dextromethorphan is an antitussive. Diphenhydramine is an anticholinergic agent with antihistaminic and antitussive properties. Codeine is an antitussive. DIF: Cognitive Level: Knowledge REF: p. 472 OBJ: 3 NAT: NCLEX Client Needs Category: Physiological Integrity TOP: Nursing Process Step: Implementation CON: Clinical Judgment 3. What is the reason for administering sodium chloride to a patient with emphysema? a. To increase blood sodium levels b. To decrease mucus viscosity c. To reduce metabolic needs of the body d. To decrease bronchial irritation ANS: B Sodium chloride acts by hydrating mucus. This will decrease the viscosity of mucous plugs, which makes it easier for patients to cough up the dry hardened plugs blocking the bronchial tubes. Sodium chloride is not given to increase serum sodium iodide levels. Sodium does not reduce metabolic needs of the body or bronchial irritation.

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Clayton's Basic Pharmacology for Nurses 18th Edition Willihnganz Test Bank


Chapter 30: Drugs Used to Treat Lower Respiratory Disease
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 18th Edition


MULTIPLE CHOICE

1. A patient has questions regarding a recently prescribed antitussive agent. Which response by
the nurse is the best?
a. “It will eliminate your cough at night.”
b. “It will reduce the frequency of your cough.”
c. “It should be used in the morning.”
d. “It should be taken before sleep.”
ANS: B
Antitussive agents act by suppressing the cough center in the brain. The expected therapeutic
outcome is reduced frequency of nonproductive cough to promote rest. Antitussive agents
should be taken as prescribed by the healthcare provider. Antitussives are not likely to
eliminate a cough. Antitussives should be taken throughout the day.

DIF: Cognitive Level: Comprehension REF: p. 468 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Patient Education

2. Which is a common expectorant in over-the-counter medications?
a. Dextromethorphan
b. Diphenhydramine
c. Guaifenesin NURSINGTB.COM
d. Codeine
ANS: C
Guaifenesin is used for symptomatic relief of conditions characterized by a dry,
nonproductive cough such as the common cold, bronchitis, laryngitis, pharyngitis, and
sinusitis. Guaifenesin is also used to remove mucous plugs from the respiratory tract.
Dextromethorphan is an antitussive. Diphenhydramine is an anticholinergic agent with
antihistaminic and antitussive properties. Codeine is an antitussive.

DIF: Cognitive Level: Knowledge REF: p. 472 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Implementation CON: Clinical Judgment

3. What is the reason for administering sodium chloride to a patient with emphysema?
a. To increase blood sodium levels
b. To decrease mucus viscosity
c. To reduce metabolic needs of the body
d. To decrease bronchial irritation
ANS: B
Sodium chloride acts by hydrating mucus. This will decrease the viscosity of mucous plugs,
which makes it easier for patients to cough up the dry hardened plugs blocking the bronchial
tubes. Sodium chloride is not given to increase serum sodium iodide levels. Sodium does not
reduce metabolic needs of the body or bronchial irritation.




NURSINGTB.COM

, Clayton's Basic Pharmacology for Nurses 18th Edition Willihnganz Test Bank


DIF: Cognitive Level: Application REF: p. 473 OBJ: 3
NAT: NCLEX Client Needs Category: Physiological Integrity
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Gas Exchange

4. Within minutes of the initiation of a nebulizer treatment with a sympathomimetic
bronchodilator, the patient turns on his call light and states that he feels “panicky” and his
heart is racing. Which action will the nurse take?
a. Reassure the patient this is expected.
b. Add more diluents to the nebulizer.
c. Administer a sedative.
d. Stop treatment and notify the healthcare provider.
ANS: D
Sympathomimetic drugs increase sympathetic nervous stimulation. Symptoms such as
nervousness, palpitations, tremors, tachycardia, and anxiety typically are dose related. These
symptoms should be reported to the healthcare provider immediately because the patient may
require a decreased dosage. These symptoms could lead to further complications if allowed to
persist and are not common adverse effects. Although this may be a common result, it is not
an expected outcome. Diluting the medication would not decrease the dose. Although a
sedative might be appropriate for the patient, this is not the intervention of choice.

DIF: Cognitive Level: Analysis REF: p. 476 OBJ: 5
NAT: NCLEX Client Needs Category: Safe, Effective Care Environment
TOP: Nursing Process Step: Planning CON: Clinical Judgment | Gas Exchange | Safety

N R the
5. Premedication assessments before I use
G ofB.C
U S N T M
anticholinergic
O bronchodilating agents should
verify that the patient has no history of which condition?
a. Diabetes
b. Hypertension
c. Liver disease
d. Glaucoma
ANS: D
Anticholinergic bronchodilating agents cause mydriasis (dilation of the pupils) and
cycloplegia (loss of power in the ciliary muscle); therefore, they should not be used in patients
with a history of closed-angle glaucoma. Diabetes, hypertension, and liver disease are not
affected by the use of anticholinergic bronchodilating agents.

DIF: Cognitive Level: Comprehension REF: p. 478 OBJ: 5
NAT: NCLEX Client Needs Category: Safe, Effective Care Environment
TOP: Nursing Process Step: Assessment CON: Clinical Judgment | Safety

6. A patient is seen in the emergency department. The patient had been maintained on
theophylline (Theo Dur), and a blood sample reveals the serum theophylline level is
subtherapeutic. Which may cause a subtherapeutic serum level?
a. Cimetidine use
b. Drug tolerance
c. Smoking
d. Overuse of the inhaler




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