NR-293 Pharmacology for Nursing Practice - Set 3 - Part 3

Correct Answer: Explain that clearing secretions is the goal

A productive cough is doing useful work, moving infected secretions out of the lung. Suppressing it traps mucus and invites atelectasis or a worsening infection, so hydration and effective coughing come first. Option a is incorrect because dextromethorphan quiets the medullary cough center, which is wanted only for a dry hacking cough. Here it would leave purulent sputum sitting in the airways. Option b is incorrect because an opioid antitussive adds sedation, respiratory depression, and constipation on top of trapped secretions. Nothing about recovering pneumonia justifies that combination of risks in a client clearing infection. Option d is incorrect because limiting fluids thickens mucus and makes each cough less effective. Clients clearing a chest infection need generous hydration, provided no cardiac or renal restriction applies.

Correct Answer: Tachycardia, tremor, insomnia and heat intolerance

Too much replacement drives the metabolic rate upward and reproduces hyperthyroidism. A racing pulse, fine tremor, sleeplessness and intolerance of warm rooms all point to over treatment, so the provider needs these findings promptly. Option a is incorrect because a slow pulse with sluggish bowels and chilliness describes untreated hypothyroidism, the very picture the drug corrects. Findings like these suggest the dose is too small rather than excessive. Option b is incorrect because gaining weight alongside coarse dry skin and thinning hair reflects continued hormone deficiency. Over replacement moves the body in the opposite direction, burning calories and shedding pounds instead. Option c is incorrect because low mood, delayed responses and facial swelling belong to the underactive thyroid state. Excess hormone produces agitation and nervous energy, not the mental slowing described in this option.

Correct Answer: Start intravenous hydrocortisone and isotonic saline

Abrupt withdrawal leaves atrophied adrenal glands unable to make cortisol, and circulatory collapse follows. Acute adrenal insufficiency is treated with intravenous hydrocortisone and volume replacement, which reverses the hypotension and stabilises sodium, potassium and glucose. Option b is incorrect because settling the stomach ignores the reason the client is vomiting. An hour of watching while perfusion falls further moves a treatable crisis toward irreversible shock. Option c is incorrect because a tablet swallowed by a vomiting hypotensive client will not be absorbed, and waiting until bedtime wastes hours. Steroid replacement in this emergency has to travel by vein. Option d is incorrect because gastroenteritis would not explain weakness, hypotension and the timing three days after stopping a steroid. Sending stool for culture delays the one intervention that reverses this presentation.

Correct Answer: Albuterol first, so beclomethasone travels deeper afterward

The beta agonist relaxes smooth muscle within minutes, so waiting about five minutes lets the widened airways carry steroid particles into the smaller branches instead of dropping them in the large airways. Option a is incorrect because giving the steroid into a narrowed airway leaves most of the dose in the upper branches. Reversing the sequence throws away the benefit the bronchodilator was meant to create. Option c is incorrect because back to back puffs remove the pause that lets bronchodilation develop. Convenience is not the goal, and the airways need a few minutes to open before the steroid arrives. Option d is incorrect because sequence genuinely changes how much steroid reaches the lower lung. Rinsing matters for thrush prevention, yet it does nothing to improve drug delivery through constricted passages.

Correct Answer: Arrange same-day evaluation and notify the provider

Steroids blunt fever and immune defense, so a documented temperature this high with cough signals infection that may already be advanced. Rapid assessment and provider notification come before any home remedy or dose change. Option a is incorrect because comfort measures at home suit an immunocompetent adult with a mild viral illness. This client cannot mount a normal defense, so pneumonia can progress to sepsis within hours. Option b is incorrect because stress dosing is real but belongs to the prescriber, who decides the amount after examining the client. A telephone instruction to self escalate skips the assessment that determines whether infection is treatable. Option d is incorrect because sudden withdrawal after two years of daily therapy invites adrenal crisis on top of the infection. Illness raises cortisol demand, so the drug is never dropped at the moment of greatest need.

Correct Answer: Tremor, nervousness, and a fast heartbeat

Beta stimulation spills past the airway onto skeletal muscle and the heart, so tremor, jitteriness, and a rapid pulse follow a rescue dose. These effects are expected and usually fade within hours. Option a is incorrect because beta receptor stimulation speeds the heart instead of slowing it. Drowsiness fits sedating antihistamines, and albuterol tends to leave clients wide awake rather than sleepy after dosing. Option b is incorrect because blurred vision belongs to anticholinergic exposure, not to a beta agonist. Blood pressure more often rises slightly with albuterol, so a hypotensive picture would point elsewhere entirely. Option c is incorrect because that cluster describes ipratropium or diphenhydramine, drugs that block muscarinic receptors. Albuterol works on beta two sites and produces stimulation rather than the dryness and slowed gut.

Correct Answer: New nightmares with sudden aggressive outbursts

Montelukast carries a boxed warning for serious neuropsychiatric events, including agitation, aggression, vivid dreams, and suicidal thinking. A behavior change of this kind is reportable at once, not something to watch quietly. Option a is incorrect because headache is a common and mild complaint across the leukotriene class. It deserves documentation and comfort measures rather than an urgent call about the safety warning. Option c is incorrect because cold like symptoms and throat irritation show up frequently with these tablets. A single day of soreness in a school aged child rarely signals anything dangerous. Option d is incorrect because mild gastrointestinal upset ranks among the ordinary adverse effects listed for montelukast. Giving the dose with a small snack usually settles it without any change in therapy.

Correct Answer: Hold the dose and notify the provider promptly

Rigidity, severe pain, and silent bowel sounds suggest obstruction, and every laxative class is contraindicated in that setting. Stimulating peristaltic waves against a blocked lumen risks perforation, so the nurse holds the drug. Option a is incorrect because administering an irritant agent to an obstructed bowel can rupture it long before two hours pass. Reassessment after the fact does nothing to undo a perforation. Option b is incorrect because water improves tolerance of many oral drugs yet cannot make a contraindicated one safe. The problem is the absent bowel sounds and rigidity, not how the tablet goes down. Option d is incorrect because bisacodyl tablets are enteric coated, and crushing releases the irritant in the stomach and causes cramping. Faster onset is the last thing this abdomen needs.

Correct Answer: Aluminum and magnesium antacid suspension

Antacids chemically neutralize acid that is already sitting in the stomach, so relief begins in roughly fifteen minutes. That speed is the reason they remain the choice for breakthrough heartburn between scheduled doses. Option b is incorrect because omeprazole must inactivate proton pumps before it can lower acid output, and several doses over days are needed for full effect. Nothing about it relieves pain within minutes. Option c is incorrect because famotidine competitively blocks histamine at the parietal cell, cutting secretion gradually rather than removing acid already present. A bedtime dose targets overnight secretion, not a burning episode happening right now. Option d is incorrect because sucralfate coats an ulcer crater with a sticky barrier and leaves acid production untouched. Its value shows over weeks of healing, and it does nothing for symptoms in the moment.

Correct Answer: "Daily stimulant use can make the colon less responsive over time."

Stimulant laxatives are the class most often abused, and chronic use blunts the colon's response to normal signals and damages the myenteric plexus. Fiber, fluids, and activity are the way back. Option a is incorrect because layering another agent deepens the dependence that already exists. The colon needs to recover its own reflex, and more drug pushes recovery further out of reach. Option b is incorrect because restricting fluid worsens constipation by leaving stool hard and dry. Every teaching plan for sluggish bowels raises fluid intake rather than trimming it back. Option c is incorrect because long term misuse is well documented as a cause of bowel injury and electrolyte loss. Dismissing the risk would leave this client comfortable continuing a harmful habit.