A nurse is caring for a patient who has been using the nasal decongestant phenylephrine for the past 10 days for sinusitis.
The nurse should assess the patient for which adverse effect of the medication?
Constipation.
Productive cough.
Sedation.
Nasal congestion.
The Correct Answer is D
This question tests for knowledge of the adverse effects of prolonged topical decongestant use. It requires recognizing the pathophysiology of rebound congestion, which occurs when the nasal mucosa becomes dependent on exogenous adrenergic stimulation to maintain vasoconstriction, leading to severe chronic swelling upon cessation.
Choice A rationale
Nasal decongestants like phenylephrine are sympathomimetic agents that act locally on alpha-adrenergic receptors. They are not associated with systemic cholinergic inhibition that would cause constipation, which is a typical side effect of agents like anticholinergics or opioid medications.
Choice B rationale
Phenylephrine does not stimulate the production of respiratory secretions. It works through vasoconstriction of the nasal blood vessels to reduce mucosal edema, and it does not have a mechanism that would induce the production of sputum or productive cough.
Choice C rationale
Phenylephrine is a systemic or topical sympathomimetic stimulant. It does not possess sedative properties; in fact, patients may experience nervousness, insomnia, or increased heart rate due to its stimulatory effects on the sympathetic nervous system and its receptors.
Choice D rationale
Long-term use of nasal decongestants leads to rhinitis medicamentosa, or rebound congestion. The nasal blood vessels lose their ability to constrict normally after prolonged stimulation, resulting in increased swelling and severe congestion when the medication is discontinued by the patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This question requires knowledge of the adverse effect profile of statin therapy. It focuses on identifying muscle-related toxicities, which are the most clinically significant complications of this drug class, necessitating vigilance for signs of muscle pain or breakdown to prevent severe renal damage.
Choice A rationale
Niacin is a vitamin used to improve lipid profiles, mainly by lowering triglycerides. While it causes side effects like flushing and pruritus, it is not primarily associated with the development of myopathy or muscle breakdown as its hallmark adverse effect.
Choice B rationale
HMG-CoA reductase inhibitors are known to cause myopathy, ranging from mild muscle pain to severe rhabdomyolysis. Monitoring for muscle aches and elevations in serum creatine kinase levels is essential to prevent potential renal failure caused by the release of intracellular muscle proteins.
Choice C rationale
Fibric acid derivatives can increase the risk of muscle injury, especially when used in combination with statins. However, HMG-CoA reductase inhibitors are more universally associated with the primary risk of myopathy, making them the most critical class to monitor for this specific complication.
Choice D rationale
Bile acid sequestrants work by preventing the reabsorption of bile acids in the intestine, which forces the liver to use cholesterol for synthesis. They are not systemically absorbed and therefore do not carry a risk of myopathy or muscle-related toxicities.
Correct Answer is ["Bolus 4.36 mL"," infusion rate 0.87 mL\/hr"]
Explanation
Step 1 is convert 160 pounds to kilograms: 160 lb ÷ 2.2 = 72.73 kg.
Step 2 is calculate the bolus dose: 72.73 kg × 60 units/kg = 4,363.8 units.
Step 3 is calculate bolus volume: 4,363.8 units ÷ 1,000 units/mL = 4.36 mL.
Step 4 is calculate infusion dose: 72.73 kg × 12 units/kg/hr = 872.76 units/hr.
Step 5 is calculate infusion rate: 872.76 units/hr ÷ 1,000 units/mL = 0.87 mL/hr. Final calculated answer: Bolus 4.36 mL, infusion rate 0.87 mL/hr.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.