NR 293 EXAM 2 EXAM WITH CORRECT QUESTIONS AND ANSWERS 2025

NR 293 EXAM 2 EXAM WITH CORRECT
QUESTIONS AND ANSWERS 2025

 Common cold - CORRECT-ANSWERSMost caused by viral infection:
rhinovirus or influenza
 -Virus invades tissues causing upper respiratory infection
 Treatment for common cold - CORRECT-ANSWERSSymptomatic only,
not curative
 "Empiric therapy"
 Empiric therapy - CORRECT-ANSWERSTreatment based on experience
usually w/o adequate data to support its use
 Antihistamines - CORRECT-ANSWERSCompete with histamine for
specific receptor sites
 Two histamine receptors: H1 and H2
 H1 (histamine 1) - CORRECT-ANSWERSCommonly referred to as
antihistamines
 Ex: fexofenadine (allegra), Ioratadine (claritin), diphenhydramine
(benedryl)
 H2 (histamine 2) - CORRECT-ANSWERSUsed to reduce gastric acid in
peptic ulcer disease
 Properties of antihistamines - CORRECT-ANSWERSAntihistaminic
 Anticholinergic
 Sedative
 Antihistamine MOA - CORRECT-ANSWERSBlock action of histamine at
H1 receptor sites, preventing adverse consequences of histamine
stimulation
 -Cannot push histamine off receptor if already bound
 -More effective in preventing actions of histamine rather than reversing
them (should be given early)

, Adverse consequences of histamine stimulation - CORRECT-
ANSWERSVasodilation
 Increased GI and respiratory secretions
 Increased capillary permeability
 Antihistamine uses - CORRECT-ANSWERSManagement of:
 -Nasal allergies
 -Seasonal or perennial allergic rhinitis (hay fever)
 -Allergic reactions
 -Motion sickness
 -Parkinson's disease
 -Sleep disorders
 Relieve symptoms of common cold, sneezing, runny nose
 Adverse effects of antihistamines - CORRECT-ANSWERSAnticholinergic
(drying) effects are most common
 -Dry mouth
 -Difficulty urinating
 -Constipation
 -Changes in vision
 Also drowsiness: mild to deep sleep
 Contraindications of antihistamines - CORRECT-ANSWERSAcute asthma
attacks
 Lower respiratory diseases (pneumonia)
 Traditional antihistamines - CORRECT-ANSWERSPeripherally and
centrally acting
 More effective than non-sedating drugs
 Ex: Diphenhydramine, bronpheniramine, chlropheniramine,
dimenhydrinate, meclizine, proethazine
 Non-sedating antihistamines - CORRECT-ANSWERSPeripherally acting
 -Eliminate unwanted ASE (sedation)
 -Work peripherally to block histamine causing fewer CNS adverse
effects

, -Longer duration of action (increases compliance)
 Ex: Fexofenadine (allegra), Ioratadine (claritin), cetirizine (zyrtec)
 Antihistamine nursing implications - CORRECT-ANSWERSAssess
condition and drug allergies
 Report excessive sedation, confusion, hypotension
 Avoid driving, alcohol, CNS depressants
 Best tolerated with meals
 Frequent mouth care, chew gum, suck on hard candy for dry mouth
 Monitor for intended therapeutic effects
 Use antihistamine with caution if: - CORRECT-ANSWERSIncreased
intraocular pressure
 Cardiac or renal disease
 Hypertension
 Asthma
 COPD
 Peptic ulcer disease
 BPH
 Pregnancy
 Adrenergics: Sympathomimetics - CORRECT-ANSWERSUsed for nasal
congestion
 -Constrict small blood vessels, nasal secretions in swollen mucous
membranes are better able to drain
 Sympathomimetics adverse effects - CORRECT-ANSWERSSNS
stimulation
 Palpitations
 Insomnia
 Nervousness
 Tremors
 Corticosteroids: Topical, intranasal steroids - CORRECT-ANSWERSUsed
for nasal decongestion
 -Anti-inflammatory effect, decreasing congestion

,  Ex: fluticasone (flonase), budesonide (rhinocort)
 Corticosteroids: Topical, intranasal steroids adverse effects - CORRECT-
ANSWERSLocal mucosal dryness and irritation
 Oral adrenergic decongestants - CORRECT-ANSWERS-Delayed onset
 -Prolonged decongestant
 -Less potent effect than topical
 -No rebound congestion
 Ex: pseudoephedrine (sudafed)
 Topical adrenergic decongestants - CORRECT-ANSWERS-Prompt onset
 -Potent
 -Sustained use may cause rebound congestion
 Nursing implications of nasal decongestants - CORRECT-ANSWERSMay
cause hypertension, palpitations, CNS stimulation
 Assess for drug allergies
 Avoid caffeine
 Report fever, cough or other symptoms lasting longer than a week
 Monitor for intended therapeutic effects
 Cough reflex - CORRECT-ANSWERSInduces coughing and expectoration
 Initiated by irritation of sensory receptors in the respiratory tract
 Antitussives - CORRECT-ANSWERSDrugs to stop or reduce coughing
 Used only for non-productive coughs
 May be used in cases where coughing is harmful (post op hernia
repair)
 Opioid antitussives MOA - CORRECT-ANSWERSSuppress cough reflex
by direct action on the cough center in the medulla
 Ex: Codeine (robitussin A-C, Dimetane-DC), hydrocodone
 Non-opioid antitussives MOA - CORRECT-ANSWERSSuppress cough
reflex by numbing the stretch receptors in the respiratory tract
preventing cough reflex from being stimulated
 Ex: Benzonatate (tessalon perles) dextromethorphan (vicks formula 44,
robitussin DM)