A client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive.
What does the nurse expect the provider will prescribe?

Benzonatate.

Dextromethorphan.

Guaifenesin.

Answer and Explanation

The Correct Answer is D

Guaifenesin is an expectorant that helps thin and loosen mucus in the lungs, making it easier to cough up the sputum. Some possible explanations for the other choices are:

Choice A. Benzonatate is wrong because benzonatate is an antitussive that suppresses the cough reflex by numbing the throat and lungs.

It does not help with sputum production or clearance.

Choice B. Dextromethorphan is wrong because dextromethorphan is also an antitussive that acts on the brain to reduce the urge to cough.

It does not affect the mucus or bronchial secretions.

Choice C. Hydrocodone is wrong because hydrocodone is a narcotic antitussive that works by binding to opioid receptors in the brain and spinal cord, blocking pain signals and decreasing cough.

It can cause sedation, respiratory depression, and dependence, and is not indicated for bronchitis.

Normal ranges for sputum production vary depending on the individual and the cause of the cough, but generally range from 10 to 100 mL per day.

Excessive or abnormal sputum may indicate an infection, inflammation, or obstruction of the airways.

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Correct Answer is A

Explanation

Prednisone is a glucocorticoid that suppresses the production of natural cortisol by the adrenal glands. Taking prednisone on alternate days allows the adrenal glands to recover and produce some cortisol on the days without prednisone.

Corticosteroids and Adrenal Glands

Choice B is wrong because prednisone does not eliminate adverse side effects, but may cause some such as weight gain, fluid retention, increased blood pressure, increased blood glucose, and increased risk of infection.

Choice C is wrong because there is no evidence of steroid tolerance, which means that higher doses are needed to achieve the same effect.

Choice D is wrong because prednisone does not prolong therapeutic effects, but may decrease them over time due to feedback inhibition of cortisol secretion.

Normal ranges for cortisol are 6 to 23 mcg/dL in the morning and 2 to 11 mcg/dL in the afternoon.

A. Decrease theophylline dosage immediately. B. Decrease theophylline dose when normal thyroid function returns. C. Discontinue the client’s theophylline. D. Increase theophylline dosage immediately.

Correct Answer is B

Explanation

This is because hypothyroidism can reduce the metabolism and clearance of theophylline, leading to higher serum levels and increased risk of toxicity. Therefore, when the thyroid function is restored by levothyroxine or liothyronine, the dose of theophylline may need to be lowered to avoid excessive effects.

Choice A is wrong because decreasing theophylline dosage immediately may result in suboptimal control of asthma symptoms.

The dose adjustment should be based on serum theophylline levels and clinical response.

Choice C is wrong because discontinuing the client’s theophylline may cause worsening of asthma and potentially life-threatening complications.

Theophylline is an important bronchodilator that should not be stopped abruptly without medical supervision.

Choice D is wrong because increasing theophylline dosage immediately may cause overdose and adverse effects such as nausea, vomiting, headache, tachycardia, arrhythmias, seizures and even death.

The dose of theophylline should be carefully titrated according to serum levels and clinical response.

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A client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive. What does the nurse expect the provider will prescribe?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge teaching for a client prescribed prednisone to be taken on alternate days. The client asks why he cannot just take half a pill every day. What rationale should the nurse describe?

Correct Answer is A

Explanation

The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms. What change may need to be made to the client’s theophylline dose?

Correct Answer is B

Explanation

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A client presents at the clinic with a dry nonproductive cough. The client is diagnosed with bronchitis, and it has been determined that assistance is needed in thinning the sputum so the cough can become productive.
What does the nurse expect the provider will prescribe?