A client with depression who is taking a tricyclic antidepressant (TCA) reports frequent early morning awakening and difficulty going back to sleep. Which information from the client is important for the practical nurse (PN) to obtain to improve the client’s sleep pattern?

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: Observing the client’s ability to open the pill box ensures accessibility but does not address nitroglycerin’s stability. Nitroglycerin degrades when exposed to air, light, or plastic, reducing potency. The original container is critical for maintaining efficacy, making this choice secondary.

Choice B reason: Nitroglycerin must be stored in its original amber glass container to protect it from light, air, and moisture, which degrade its potency. Plastic pill boxes allow exposure, reducing effectiveness for angina relief. Explaining this ensures the client maintains the drug’s therapeutic integrity.

Choice C reason: Reminding the client to refresh nitroglycerin every 30 days is relevant due to its short shelf life, but the priority is proper storage. Without the original container, even fresh pills lose potency, making this choice less critical than ensuring correct storage conditions.

Choice D reason: Labeling the pill box improves usability but does not address nitroglycerin’s stability. Plastic containers expose the drug to air and light, reducing efficacy. Proper storage in the original container is more critical to ensure the drug remains effective for emergency use.