A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication?
Administer the granules mixed with 20 oz of water.
Administer the medication 2 hr before exercise.
Give the medication in the morning daily
Give the medication at the onset of wheezing
The Correct Answer is B
A. Administering the granules mixed with 20 oz of water is not necessary. Montelukast granules can be administered directly into the mouth or mixed with a small amount of soft food (e.g., applesauce) if necessary. The specific instructions for administration should be provided by the healthcare provider or included in the product labeling.
B. If you’re using it to prevent breathing problems related to exercise, take a single dose at least 2 hours before exercising. However, another dose cannot be taken within 24 hours.
C. Montelukast is a leukotriene receptor antagonist commonly used for the maintenance treatment of asthma in children and adults. The usual recommended dose is once daily in the evening, depending on the specific instructions from the healthcare provider.
D. Administering the medication at the onset of wheezing is not the recommended approach. Montelukast is a daily maintenance medication for asthma and should be taken regularly as prescribed, regardless of wheezing symptoms. It is not intended to be used for immediate relief of wheezing or acute asthma symptoms. Short-acting bronchodilators are typically used for quick relief of wheezing or acute asthma symptoms.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Codeine is an opioid medication that can cause drowsiness and dizziness. Changing positions quickly, especially from lying down to standing up, can increase the risk of falls or accidents.
Instructing the client to change positions slowly helps prevent orthostatic hypotension (a drop in blood pressure upon standing) and reduces the risk of falls.
The other options listed are not appropriate instructions for a client taking codeine:
A. "You should expect to experience diarrhea while taking this medication." While constipation is a common side effect of opioids, diarrhea is not typically associated with codeine use. Therefore, there is no need to expect or warn about diarrhea as an anticipated effect of taking codeine.
C. "You should limit alcohol intake to 12 ounces daily." Mixing alcohol with codeine can have harmful effects, such as increased sedation and respiratory depression. However, it is generally recommended to avoid alcohol completely while taking codeine, rather than setting a specific limit of 12 ounces daily.
D. "You should take the medication on an empty stomach to prevent nausea." Taking codeine with or without food can vary depending on individual factors and the specific instructions provided by the healthcare provider. However, taking codeine on an empty stomach does not necessarily prevent nausea. In fact, taking it with food may help reduce stomach upset for some individuals. It is best to follow the specific instructions provided by the healthcare provider regarding the timing of codeine administration with or without food.

Correct Answer is C
Explanation
Montelukast is a medicine used to treat and prevent asthma and allergic rhinitis. It can cause some side effects, such as stomach pain, headache, cough, or fever. However, some side effects are more serious and need to be reported to the provider.
According to the sources I found, the most serious side effect of montelukast that should be reported to the provider is depression. Depression is a mental health condition that can affect your mood, thoughts, and behavior. It can cause symptoms such as feeling sad, hopeless, or worthless; losing interest in activities you used to enjoy; having trouble sleeping or concentrating; or having thoughts of harming yourself or others.
Montelukast has been linked to neuropsychiatric events, such as agitation, aggression, sleep disturbances, suicidal thoughts and behavior (including suicide). The mechanisms underlying these events are not well understood, but they can occur at any time during treatment. Therefore, patients and caregivers should be alert for changes in behavior or new neuropsychiatric symptoms when taking montelukast. If these occur, they should discontinue montelukast and contact a healthcare provider immediately.
The other options are not listed as serious side effects of montelukast that need to be reported to the provider. Constipation, blurred vision, and palpitations are possible side effects of other medicines used to treat asthma or allergic rhinitis, such as corticosteroids, antihistamines, or beta-agonists. However, they are not specific to montelukast and may not be related to its use.

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