NURS-167 Exam 4 study
guide with answers
2025
A gardener needs a decongestant because of seasonal allergy problems and asks the
nurse whether he should take an oral form or a nasal spray. The nurse's answer
considers that one benefit of orally administered decongestants is
immediate onset.
a more potent effect.
lack of rebound congestion.
shorter duration. - Ans ✅✅-lack of rebound congestion.
Drugs administered by the oral route produce prolonged decongestant effects, but the
onset of action is more delayed and the effect less potent than those of decongestants
applied topically. However, the clinical problem of rebound congestion associated with
topically administered drugs is almost nonexistent with oral dosage forms.
When teaching a patient who will be receiving antihistamines, the nurse will include
which instructions? (Select all that apply.)
"Antihistamines are generally safe to take with over-the-counter medications."
"Take the medication on an empty stomach to maximize absorption of the drug."
"Take the medication with food to minimize gastrointestinal distress."
"Drink extra fluids if possible."
"Antihistamines may cause restlessness and disturbed sleep."
"Avoid activities that require alertness until you know how adverse effects are tolerated."
- Ans ✅✅-"Take the medication with food to minimize gastrointestinal distress."
"Drink extra fluids if possible."
"Avoid activities that require alertness until you know how adverse effects are tolerated."
Antihistamines should be taken with food, even though this slightly reduces the
absorption of the drug, so as to minimize the gastrointestinal upset that can occur.
Over-the-counter medications must not be taken with an antihistamine unless approved
by the physician because of the serious drug interactions that may occur. Drinking extra
fluids will help to ease the removal of secretions, and activities that require alertness,
such as driving, must not be engaged in until the patient knows how he or she responds
to the sedating effects of antihistamines.
A patient with a tracheostomy has difficulty removing excessive, thick mucus from the
respiratory tract. The nurse expects that which drug will be ordered to aid in the removal
of mucus?
guaifenesin (Humibid)
benzonatate (Tessalon Perles)
,diphenhydramine (Benadryl)
dextromethorphan (Robitussin DM) - Ans ✅✅-guaifenesin (Humibid)
Expectorants such as guaifenesin work to loosen and thin sputum and the bronchial
secretions, thereby indirectly diminishing the tendency to cough. The other drugs listed
do not have this effect.
A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection.
Which instruction will the nurse include during patient teaching?
Force fluids to help loosen and liquefy secretions.
Report clear-colored sputum to the prescriber.
Avoid driving a car or operating heavy machinery because of the sedating effects.
Report symptoms that last longer than 2 days. - Ans ✅✅-Force fluids to help loosen
and liquefy secretions.
Forcing fluids helps to loosen and liquefy secretions. The patient must be fully aware
that any fever, chest tightness, change in sputum from clear to colored, difficult or noisy
breathing, activity intolerance, or weakness needs to be reported. The patient also must
report to the prescriber a fever of higher than 100.4° F (38° C) or symptoms that last
longer than 3 to 4 days. Decongestants do not cause sedation, and therefore the patient
does not need to avoid driving a car or operating heavy machinery.
When giving dextromethorphan, the nurse understands that this drug suppresses the
cough reflex by which mechanism of action?
Causing depression of the central nervous system
Anesthetizing the stretch receptors
Having direct action on the cough center
Decreasing the viscosity of the bronchial secretions - Ans ✅✅-Having direct action on
the cough center
Dextromethorphan suppresses the cough reflex through a direct action on the cough
center. The other options are incorrect.
The nurse is providing instructions to a patient who has a new prescription for a
corticosteroid metered-dose inhaler. Which statement by the patient indicates that
further instruction is needed? (Select all that apply.)
"I will rinse my mouth with water after using the inhaler and then spit out the water."
"I will gargle after using the inhaler and then swallow."
"I will clean the plastic inhaler casing weekly by removing the canister and then washing
the casing in warm soapy water. I will then let it dry before reassembling."
"I will use this inhaler for asthma attacks."
"I will continue to use this inhaler, even if I am feeling better."
, "I will use a peak flow meter to measure my response to therapy." - Ans ✅✅-"I will
gargle after using the inhaler and then swallow."
"I will use this inhaler for asthma attacks."
The inhaled corticosteroid is a maintenance drug used to prevent asthma attacks; it is
not indicated for acute asthma attacks. Rinsing the mouth with water is appropriate and
necessary to prevent oral fungal infections; the water is not to be swallowed after
rinsing. The patient needs to be given instructions about keeping the inhaler clean,
including removing the canister from the plastic casing weekly and washing the casing
in warm soapy water. Once the casing is dry, the canister and mouthpiece may be put
back together and the cap applied. The glucocorticoid may predispose the patient to
oral fungal overgrowth, thus the need for implicit instructions about cleaning inhaling
devices. Use of a peak flow meter assists in monitoring the patient's response to
therapy. The medication needs to be taken as ordered every day, regardless of whether
the patient is feeling better.
A patient is in an urgent-care center with an acute asthma attack. The nurse expects
that which medication will be used for initial treatment?
An anticholinergic such as ipratropium (Atrovent)
A short-acting beta2 agonist such as albuterol (Proventil)
A long-acting beta2 agonist such as salmeterol (Serevent)
A corticosteroid such as fluticasone (Flovent) - Ans ✅✅-A short-acting beta2 agonist
such as albuterol (Proventil)
The short-acting beta2 agonists are commonly used during the acute phase of an
asthmatic attack to reduce airway constriction quickly and to restore airflow to normal
levels. The other drugs listed are not appropriate for acute asthma attacks.
Anticholinergic drugs and long-acting beta2 agonists are used to prevent attacks;
corticosteroids are used to reduce airway inflammation.
A patient is taking a xanthine derivative as part of treatment for chronic obstructive
pulmonary disease. The nurse will monitor for adverse effects associated with the use
of xanthine derivatives, such as
diarrhea.
palpitations.
bradycardia.
drowsiness. - Ans ✅✅-palpitations
The common adverse effects of the xanthine derivatives include nausea, vomiting, and
anorexia. In addition, gastroesophageal reflux has been observed to occur during sleep
in patients taking these drugs. Cardiac adverse effects include sinus tachycardia,
extrasystole, palpitations, and ventricular dysrhythmias. Transient increased urination
and hyperglycemia are other possible adverse effects.
guide with answers
2025
A gardener needs a decongestant because of seasonal allergy problems and asks the
nurse whether he should take an oral form or a nasal spray. The nurse's answer
considers that one benefit of orally administered decongestants is
immediate onset.
a more potent effect.
lack of rebound congestion.
shorter duration. - Ans ✅✅-lack of rebound congestion.
Drugs administered by the oral route produce prolonged decongestant effects, but the
onset of action is more delayed and the effect less potent than those of decongestants
applied topically. However, the clinical problem of rebound congestion associated with
topically administered drugs is almost nonexistent with oral dosage forms.
When teaching a patient who will be receiving antihistamines, the nurse will include
which instructions? (Select all that apply.)
"Antihistamines are generally safe to take with over-the-counter medications."
"Take the medication on an empty stomach to maximize absorption of the drug."
"Take the medication with food to minimize gastrointestinal distress."
"Drink extra fluids if possible."
"Antihistamines may cause restlessness and disturbed sleep."
"Avoid activities that require alertness until you know how adverse effects are tolerated."
- Ans ✅✅-"Take the medication with food to minimize gastrointestinal distress."
"Drink extra fluids if possible."
"Avoid activities that require alertness until you know how adverse effects are tolerated."
Antihistamines should be taken with food, even though this slightly reduces the
absorption of the drug, so as to minimize the gastrointestinal upset that can occur.
Over-the-counter medications must not be taken with an antihistamine unless approved
by the physician because of the serious drug interactions that may occur. Drinking extra
fluids will help to ease the removal of secretions, and activities that require alertness,
such as driving, must not be engaged in until the patient knows how he or she responds
to the sedating effects of antihistamines.
A patient with a tracheostomy has difficulty removing excessive, thick mucus from the
respiratory tract. The nurse expects that which drug will be ordered to aid in the removal
of mucus?
guaifenesin (Humibid)
benzonatate (Tessalon Perles)
,diphenhydramine (Benadryl)
dextromethorphan (Robitussin DM) - Ans ✅✅-guaifenesin (Humibid)
Expectorants such as guaifenesin work to loosen and thin sputum and the bronchial
secretions, thereby indirectly diminishing the tendency to cough. The other drugs listed
do not have this effect.
A patient is taking guaifenesin (Humibid) as part of treatment for a sinus infection.
Which instruction will the nurse include during patient teaching?
Force fluids to help loosen and liquefy secretions.
Report clear-colored sputum to the prescriber.
Avoid driving a car or operating heavy machinery because of the sedating effects.
Report symptoms that last longer than 2 days. - Ans ✅✅-Force fluids to help loosen
and liquefy secretions.
Forcing fluids helps to loosen and liquefy secretions. The patient must be fully aware
that any fever, chest tightness, change in sputum from clear to colored, difficult or noisy
breathing, activity intolerance, or weakness needs to be reported. The patient also must
report to the prescriber a fever of higher than 100.4° F (38° C) or symptoms that last
longer than 3 to 4 days. Decongestants do not cause sedation, and therefore the patient
does not need to avoid driving a car or operating heavy machinery.
When giving dextromethorphan, the nurse understands that this drug suppresses the
cough reflex by which mechanism of action?
Causing depression of the central nervous system
Anesthetizing the stretch receptors
Having direct action on the cough center
Decreasing the viscosity of the bronchial secretions - Ans ✅✅-Having direct action on
the cough center
Dextromethorphan suppresses the cough reflex through a direct action on the cough
center. The other options are incorrect.
The nurse is providing instructions to a patient who has a new prescription for a
corticosteroid metered-dose inhaler. Which statement by the patient indicates that
further instruction is needed? (Select all that apply.)
"I will rinse my mouth with water after using the inhaler and then spit out the water."
"I will gargle after using the inhaler and then swallow."
"I will clean the plastic inhaler casing weekly by removing the canister and then washing
the casing in warm soapy water. I will then let it dry before reassembling."
"I will use this inhaler for asthma attacks."
"I will continue to use this inhaler, even if I am feeling better."
, "I will use a peak flow meter to measure my response to therapy." - Ans ✅✅-"I will
gargle after using the inhaler and then swallow."
"I will use this inhaler for asthma attacks."
The inhaled corticosteroid is a maintenance drug used to prevent asthma attacks; it is
not indicated for acute asthma attacks. Rinsing the mouth with water is appropriate and
necessary to prevent oral fungal infections; the water is not to be swallowed after
rinsing. The patient needs to be given instructions about keeping the inhaler clean,
including removing the canister from the plastic casing weekly and washing the casing
in warm soapy water. Once the casing is dry, the canister and mouthpiece may be put
back together and the cap applied. The glucocorticoid may predispose the patient to
oral fungal overgrowth, thus the need for implicit instructions about cleaning inhaling
devices. Use of a peak flow meter assists in monitoring the patient's response to
therapy. The medication needs to be taken as ordered every day, regardless of whether
the patient is feeling better.
A patient is in an urgent-care center with an acute asthma attack. The nurse expects
that which medication will be used for initial treatment?
An anticholinergic such as ipratropium (Atrovent)
A short-acting beta2 agonist such as albuterol (Proventil)
A long-acting beta2 agonist such as salmeterol (Serevent)
A corticosteroid such as fluticasone (Flovent) - Ans ✅✅-A short-acting beta2 agonist
such as albuterol (Proventil)
The short-acting beta2 agonists are commonly used during the acute phase of an
asthmatic attack to reduce airway constriction quickly and to restore airflow to normal
levels. The other drugs listed are not appropriate for acute asthma attacks.
Anticholinergic drugs and long-acting beta2 agonists are used to prevent attacks;
corticosteroids are used to reduce airway inflammation.
A patient is taking a xanthine derivative as part of treatment for chronic obstructive
pulmonary disease. The nurse will monitor for adverse effects associated with the use
of xanthine derivatives, such as
diarrhea.
palpitations.
bradycardia.
drowsiness. - Ans ✅✅-palpitations
The common adverse effects of the xanthine derivatives include nausea, vomiting, and
anorexia. In addition, gastroesophageal reflux has been observed to occur during sleep
in patients taking these drugs. Cardiac adverse effects include sinus tachycardia,
extrasystole, palpitations, and ventricular dysrhythmias. Transient increased urination
and hyperglycemia are other possible adverse effects.
