A client who is taking sildenafil 50 mg PO PRN reports experiencing visual changes to the practical nurse (PN). Which instruction should the PN give to the client?

Choice A reason: Montelukast is a leukotriene receptor antagonist that inhibits leukotrienes, mediators of inflammation in allergic responses. By blocking these, it reduces airway inflammation, bronchoconstriction, and mucus production, preventing asthma or allergic rhinitis symptoms. This prophylactic action targets the immune response to allergens, stabilizing respiratory function before symptoms escalate.

Choice B reason: Montelukast does not increase mucus production. Instead, it reduces mucus by inhibiting leukotriene-driven inflammation in the airways. Increased mucus is a symptom of uncontrolled asthma or allergies, which montelukast aims to prevent. This choice is incorrect as it contradicts the drug’s mechanism of reducing inflammatory responses in the lungs.

Choice C reason: Montelukast does not contract respiratory smooth muscles. It prevents bronchoconstriction by blocking leukotrienes, which cause smooth muscle contraction in asthma. By inhibiting this pathway, it promotes airway relaxation, not contraction. This choice is incorrect, as it misrepresents the drug’s role in maintaining open airways.

Choice D reason: Montelukast does not repair damaged lung tissue. Its primary role is to prevent inflammation and bronchoconstriction caused by allergens. Lung tissue repair involves other physiological processes, not influenced by montelukast. This choice is incorrect, as it falsely attributes tissue regeneration to a drug focused on immune modulation.

Choice A reason: Donepezil, a cholinesterase inhibitor, increases acetylcholine in the brain, enhancing cognitive function in early Alzheimer’s. It improves memory and daily functioning by supporting neuronal communication, particularly in mild-to-moderate stages, slowing symptom progression temporarily, making this the accurate description of its action.

Choice B reason: Donepezil does not target psychotic features, like hallucinations, which are managed with antipsychotics. It enhances cognitive function by boosting acetylcholine, not addressing behavioral symptoms. Psychotic features require different therapies, making this choice incorrect for donepezil’s primary role.

Choice C reason: Donepezil does not alter Alzheimer’s progressive course, as it cannot stop neuronal degeneration. It provides symptomatic relief by enhancing acetylcholine levels, temporarily improving cognition, but the disease’s underlying pathology continues, making this choice inaccurate for describing the drug’s effect.

Choice D reason: Donepezil does not cause sedation or reduce hostility. It enhances cognitive function, potentially increasing alertness. Sedation is a side effect of other drugs, like antipsychotics, not cholinesterase inhibitors, making this choice incorrect for donepezil’s therapeutic action.