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Lehne's Pharmacology Ch 70 & 71 questions with verified answers
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Lehne's Pharmacology Ch 70 & 71 questions with verified answers
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Lehne's Pharmacology Ch 70 & 711. A 5-year-old child is brought to the emergency department after ingesting
diphenhydramine [Benadryl]. The child is uncoordinated and agitated. The nurse
observes that the child's face is flushed, the temperature is 37.1 degrees C, and the
heart rate is 110 beats per minute. The nurse will
2. expect to:
3.
4. a. administer atropine to reverse the adverse effects
5. b. apply ice packs to stop the flushing
6. c. give activated charcoal to absorb the drug
7. d. prepare to provide mechanical ventilation - ANS-c.
8. Ch. 70
9.
10. In acute toxicity, patients present with agitation, a flushed face, tachycardia, and
uncoordinated movements. There is no specific antidote, so drug removal is the
focus of treatment, starting with activated charcoal to absorb the drug, followed by a
cathartic to enhance excretion. Atropine would cause an increase in the heart rate.
Application of ice packs is recommended for hyperthermia and not for flushing. The
child's temperature is normal. Mechanical ventilation is not indicated with this
presentation of symptoms, although cardiovascular collapse may eventually develop.
11. A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine [Zyrtec]
syrup once daily. The parents tell the nurse that the child does not like the syrup, and
they do not think that the drug is effective. The nurse will suggest they discuss which
drug with their child's healthcare provider?
12.
13. a. Cetirizine [Zyrtec] 5-mg chewable tablet once daily
14. b. Loratadine [Claritin] 10-mg chewable tablet once daily
15. c. Fexofenadine [Allegra] syrup 5 mL twice daily
16. d. Desloratadine [Clarinex] 5-mg rapid-disintegrating tablet once daily - ANS-a.
17. Ch. 70
18.
19. The child is receiving a low dose of cetirizine and can receive up to 5 mg per day in
either a single dose or two divided doses. Cetirizine is available in a chewable tablet,
which this child may tolerate better, so the parents should be encouraged to explore
this option with their provider. The loratadine 10-mg chewable tablet is approved for
children 6 years and older. Fexofenadine would be safe for this child, but it is unlikely
that the syrup would be any better than the cetirizine syrup. Desloratadine is not
approved for children under the age of 12 years.
20. A family is preparing for travel and the parents report that their 5-year-old child has
frequent motion sickness. The nurse will tell the parents to ask the provider about
which antihistamine to help prevent symptoms?
21.
22. a. Desloratadine [Clarinex]
, 23. b. Dimenhydrinate [Dramamine]
24. c. Hydroxyzine [Vistaril]
25. d. Promethazine [Phenergan] - ANS-b.
26. Ch. 70
27.
28. Some antihistamines, including dimenhydrinate and promethazine, are labeled for
use in motion sickness. Promethazine, however, is contraindicated in children under
age 2 years and should be used with caution in children older than 2 years because
of the risks for severe respiratory depression. Desloratadine and hydroxyzine are not
used for motion sickness.
29. A nurse is caring for a patient who has been taking low-dose aspirin for several days.
The nurse notes that the patient has copious amounts of watery nasal secretions and
an urticarial rash. The nurse will contact the provider to discuss:
30.
31. a. administering epinephrine
32. b. changing to a first-generation NSAID
33. c. reducing the dose of aspirin
34. d. giving an antihistamine - ANS-a.
35. Ch. 71
36.
37. Aspirin can cause a hypersensitivity reaction in some patients. This may start with
profuse watery rhinorrhea and progress to generalized urticaria, bronchospasm,
laryngeal edema, and shock. It is not a true anaphylactic reaction, because it is not
mediated by the immune system. Epinephrine is the treatment of choice. Patients
with sensitivity to ASA often also have sensitivity to NSAIDs; the first indication with
this patient is to treat the potential life-threatening effect, not to change the
medication. Reduction of the dose of ASA is not indicated, because this reaction is
not dose dependent. Antihistamines are not effective, because this is not an allergic
reaction.
38. A nurse is providing medication teaching for a patient who will begin taking diclofenac
[Voltaren] gel for osteoarthritis in both knees and elbows. Which statement by the
patient indicates understanding of the teaching?
39.
40. a. "Because this is a topical drug, liver toxicity will not occur"
41. b. "I should cover areas where the gel is applied to protect them from sunlight"
42. c. "I will apply equal amounts of gel to all affected areas"
43. d. "The topical formulation has the same toxicity as the oral formulation" - ANS-b.
44. Ch. 71
45.
46. Diclofenac is available in topical and oral preparations. Patients should be warned to
protect treated areas from sunlight. Side effects occur, such as liver toxicity, even
with topical dosing. Patients should apply smaller amounts to the upper extremities.
Systemic toxicity is lower with topical formulations.
47. A nurse is providing teaching for an adult patient with arthritis who has been
instructed to take ibuprofen [Motrin] for discomfort. Which statement by the patient
indicates a need for further teaching?
48.
49. a. "I may experience tinnitus with higher doses of this medication"
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