Question 1

An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine [Phenergan]. What will the nurse do?

Accepted Answer

A)  Give the medication as ordered. 
B)  Monitor the child for bronchoconstriction. 
C)  Question the order. 
D)  Request an order to give the drug orally. 
A)  Give the medication as ordered. 
B)  Monitor the child for bronchoconstriction. 
C)  Question the order. 
D)  Request an order to give the drug orally. C

Question 2

A patient has seasonal allergies and needs an antihistamine to control symptoms. The patient likes to have wine with dinner occasionally and wants to know which antihistamine will be the safest to take. The nurse will tell the patient to discuss which medication with the provider?

Accepted Answer

A)  Cetirizine [Zyrtec] 
B)  Fexofenadine [Allegra] 
C)  Levocetirizine [Xyzal] 
D)  Loratadine [Claritin] 
A)  Cetirizine [Zyrtec] 
B)  Fexofenadine [Allegra] 
C)  Levocetirizine [Xyzal] 
D)  Loratadine [Claritin] B

Question 3

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°C,and the heart rate is 110 beats per minute. The nurse will expect to:

Accepted Answer

A)  administer atropine to reverse the adverse effects. 
B)  apply ice packs to stop the flushing. 
C)  give activated charcoal to absorb the drug. 
D)  prepare to provide mechanical ventilation. 
A)  administer atropine to reverse the adverse effects. 
B)  apply ice packs to stop the flushing. 
C)  give activated charcoal to absorb the drug. 
D)  prepare to provide mechanical ventilation. C

Question 4

A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the patient?

Accepted Answer

A)  Antihistamines should be avoided unless absolutely necessary. 
B)  Second-generation antihistamines are safer than first-generation antihistamines. 
C)  Antihistamines should not be taken during pregnancy but may be taken when breast-feeding. 
D)  The margin of safety for antihistamines is clearly understood for pregnant patients. 
A)  Antihistamines should be avoided unless absolutely necessary. 
B)  Second-generation antihistamines are safer than first-generation antihistamines. 
C)  Antihistamines should not be taken during pregnancy but may be taken when breast-feeding. 
D)  The margin of safety for antihistamines is clearly understood for pregnant patients.

Question 5

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?

Accepted Answer

A)  Desloratadine [Clarinex] 
B)  Dimenhydrinate [Dramamine] 
C)  Hydroxyzine [Vistaril] 
D)  Promethazine [Phenergan] 
A)  Desloratadine [Clarinex] 
B)  Dimenhydrinate [Dramamine] 
C)  Hydroxyzine [Vistaril] 
D)  Promethazine [Phenergan]

Question 6

A patient is brought to the emergency department after ingesting a handful of diphenhydramine [Benadryl] tablets. The patient has dilated pupils,a flushed face,and tremors. The patient is agitated and has a heart rate of 110 beats per minute. The nurse may anticipate administering which agents? (Select all that apply.)

Accepted Answer

A)  Activated charcoal 
B)  Atropine 
C)  Cathartics 
D)  Lorazepam 
E)  Second-generation H1 antagonists 
A)  Activated charcoal 
B)  Atropine 
C)  Cathartics 
D)  Lorazepam 
E)  Second-generation H1 antagonists

Question 7

A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines?

Accepted Answer

A)  "Antihistamines block H2 receptors to prevent actions of histamine at these sites." 
B)  "Antihistamines block release of histamine from mast cells and basophils." 
C)  "H2 antagonists can bind to H2receptors, H2 receptors, and muscarinic receptors." 
D)  "First-generation antihistamines are more selective than second-generation antihistamines." 
A)  "Antihistamines block H2 receptors to prevent actions of histamine at these sites." 
B)  "Antihistamines block release of histamine from mast cells and basophils." 
C)  "H2 antagonists can bind to H2receptors, H2 receptors, and muscarinic receptors." 
D)  "First-generation antihistamines are more selective than second-generation antihistamines."

Question 8

Which parenteral antihistamines have sedative effects that are classified as low to none? (Select all that apply.)

Accepted Answer

A)  Cetirizine [Zyrtec] 
B)  Clemastine [Tavist Allergy] 
C)  Desloratadine [Clarinex] 
D)  Fexofenadine [Allegra] 
E)  Loratadine [Claritin] 
A)  Cetirizine [Zyrtec] 
B)  Clemastine [Tavist Allergy] 
C)  Desloratadine [Clarinex] 
D)  Fexofenadine [Allegra] 
E)  Loratadine [Claritin]

Question 9

A provider has ordered intravenous promethazine [Phenergan] for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do?

Accepted Answer

A)  Administer the drug at a rate of 25 mg/min or more to achieve maximum effects. 
B)  Contact the provider to suggest using dimenhydrinate [Dramamine] instead. 
C)  Ensure that the IV is infusing freely through a large-bore needle. 
D)  Monitor the patient closely for cardiac dysrhythmias. 
A)  Administer the drug at a rate of 25 mg/min or more to achieve maximum effects. 
B)  Contact the provider to suggest using dimenhydrinate [Dramamine] instead. 
C)  Ensure that the IV is infusing freely through a large-bore needle. 
D)  Monitor the patient closely for cardiac dysrhythmias.

Question 10

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?

Accepted Answer

A)  Cetirizine [Zyrtec] 5-mg chewable tablet once daily 
B)  Loratadine [Claritin] 10-mg chewable tablet once daily 
C)  Fexofenadine [Allegra] syrup 5 mL twice daily 
D)  Desloratadine [Clarinex] 5-mg rapid-disintegrating tablet once daily 
A)  Cetirizine [Zyrtec] 5-mg chewable tablet once daily 
B)  Loratadine [Claritin] 10-mg chewable tablet once daily 
C)  Fexofenadine [Allegra] syrup 5 mL twice daily 
D)  Desloratadine [Clarinex] 5-mg rapid-disintegrating tablet once daily

Question 11

A patient who has chronic allergies takes loratadine [Claritin] and develops a severe reaction to bee stings. The patient asks the nurse why the antihistamine did not prevent the reaction. What will the nurse say?

Accepted Answer

A)  "Allergy symptoms that are severe are caused by mediators other than histamine." 
B)  "H1 blockers do not prevent the release of histamine from mast cells and basophils." 
C)  "Second-generation H1 blockers contain less active drug and do not work in severe reactions." 
D)  "Severe allergic reactions occur through actions on muscarinic receptors." 
A)  "Allergy symptoms that are severe are caused by mediators other than histamine." 
B)  "H1 blockers do not prevent the release of histamine from mast cells and basophils." 
C)  "Second-generation H1 blockers contain less active drug and do not work in severe reactions." 
D)  "Severe allergic reactions occur through actions on muscarinic receptors."

Question 12

A patient will begin taking fexofenadine [Allegra] for hay fever. The nurse teaching this patient will tell the patient that:

Accepted Answer

A)  fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms. 
B)  the medication may be taken once or twice daily. 
C)  tolerance to sedation will occur in a few weeks. 
D)  with renal impairment, this drug should be taken every other day. 
A)  fexofenadine should be taken with food to prevent gastrointestinal (GI) symptoms. 
B)  the medication may be taken once or twice daily. 
C)  tolerance to sedation will occur in a few weeks. 
D)  with renal impairment, this drug should be taken every other day.

Question 13

A prescriber orders hydroxyzine [Vistaril] for a patient with acute urticaria. The nurse will include which information when teaching the patient about this drug?

Accepted Answer

A)  The drug will reduce redness and itching but not edema. 
B)  This antihistamine is not likely to cause sedation. 
C)  The patient should avoid drinking alcohol while taking the drug. 
D)  The patient should report shortness of breath while taking the drug. 
A)  The drug will reduce redness and itching but not edema. 
B)  This antihistamine is not likely to cause sedation. 
C)  The patient should avoid drinking alcohol while taking the drug. 
D)  The patient should report shortness of breath while taking the drug.

Question 14

A patient tells a nurse that antihistamines help relieve cold symptoms and wants to know why they are not recommended or prescribed for this purpose. The nurse tells the patient that antihistamines provide only mild relief from some cold symptoms by:

Accepted Answer

A)  anticholinergic properties that decrease rhinorrhea. 
B)  blocking H1 receptors in nasal passages. 
C)  reducing secretions at H2 receptor sites. 
D)  having sedative effects, which help patients rest and sleep. 
A)  anticholinergic properties that decrease rhinorrhea. 
B)  blocking H1 receptors in nasal passages. 
C)  reducing secretions at H2 receptor sites. 
D)  having sedative effects, which help patients rest and sleep.

Exam 70: Antihistamines

An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine [Phenergan]. What will the nurse do?

A patient has seasonal allergies and needs an antihistamine to control symptoms. The patient likes to have wine with dinner occasionally and wants to know which antihistamine will be the safest to take. The nurse will tell the patient to discuss which medication with the provider?

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°C,and the heart rate is 110 beats per minute. The nurse will expect to:

A pregnant patient asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the patient?

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?

A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines?

Which parenteral antihistamines have sedative effects that are classified as low to none? (Select all that apply.)

A provider has ordered intravenous promethazine [Phenergan] for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do?

A patient who has chronic allergies takes loratadine [Claritin] and develops a severe reaction to bee stings. The patient asks the nurse why the antihistamine did not prevent the reaction. What will the nurse say?

A patient will begin taking fexofenadine [Allegra] for hay fever. The nurse teaching this patient will tell the patient that:

A prescriber orders hydroxyzine [Vistaril] for a patient with acute urticaria. The nurse will include which information when teaching the patient about this drug?

A patient tells a nurse that antihistamines help relieve cold symptoms and wants to know why they are not recommended or prescribed for this purpose. The nurse tells the patient that antihistamines provide only mild relief from some cold symptoms by:

Orientation to Pharmacology

Application of Pharmacology in Nursing Practice

Drug Regulation, Development, Names, and Information

Pharmacokinetics

Pharmacodynamics

Drug Interactions

Adverse Drug Reactions and Medication Errors

Individual Variation in Drug Responses

Drug Therapy During Pregnancy and Breast-Feeding

Drug Therapy in Pediatric Patients

Drug Therapy in Geriatric Patients

Basic Principles of Neuropharmacology

Physiology of the Peripheral Nervous System

Muscarinic Agonists and Antagonists

Cholinesterase Inhibitors and Their Use in Myasthenia Gravis

Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking Agents

Adrenergic Agonists

Adrenergic Antagonists

Indirect-Acting Antiadrenergic Agents

Introduction to Central Nervous System Pharmacology

Drugs for Parkinson’s Disease

Drugs for Alzheimer’s Disease

Drugs for Multiple Sclerosis

Drugs for Epilepsy

Drugs for Muscle Spasm and Spasticity

Local Anesthetics

General Anesthetics

Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics

Pain Management in Patients with Cancer

Drugs for Headache

Antipsychotic Agents and Their Use in Schizophrenia

Antidepressants

Drugs for Bipolar Disorder

Sedative-Hypnotic Drugs

Management of Anxiety Disorders

Central Nervous System Stimulants and Attention-Deficit/Hyperactivity Disorder

Drug Abuse I: Basic Considerations

Drug Abuse II: Alcohol

Drug Abuse III: Nicotine and Smoking

Drug Abuse IV: Major Drugs of Abuse Other Than Alcohol and Nicotine

Diuretics

Agents Affecting the Volume and Ion Content of Body Fluids

Review of Hemodynamics

Drugs Acting on the Renin-Angiotensin-Aldosterone System

Calcium Channel Blockers

Vasodilators

Drugs for Hypertension

Drugs for Heart Failure

Antidysrhythmic Drugs

Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

Drugs for Angina Pectoris

Anticoagulant, Antiplatelet, and Thrombolytic Drugs

Management of ST-Elevation Myocardial Infarction

Drugs for Hemophilia

Drugs for Deficiency Anemias

Hematopoietic Agents

Drugs for Diabetes Mellitus

Drugs for Thyroid Disorders

Drugs Related to Hypothalamic and Pituitary Function

Drugs for Disorders of the Adrenal Cortex

Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications

Birth Control

Drug Therapy of Infertility

Drugs That Affect Uterine Function

Androgens

Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia

Review of the Immune System