A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication?
Diphenhydramine [Benadryl]
Loratadine [Claritin]
Ibuprofen [Motrin]
Multivitamin
The Correct Answer is C
Choice A reason: Diphenhydramine, an antihistamine, does not significantly interact with aspirin’s antiplatelet effects. It primarily blocks histamine receptors, affecting allergies, not platelet aggregation. While it may cause drowsiness, it doesn’t increase bleeding risk or counteract aspirin’s cardiovascular benefits, making it safe to use concurrently with low-dose aspirin.
Choice B reason: Loratadine, a second-generation antihistamine, targets histamine receptors to relieve allergy symptoms. It has no known interaction with aspirin’s antiplatelet mechanism or bleeding risk. Its minimal side effect profile makes it compatible with low-dose aspirin for cardiovascular protection, so avoiding it is unnecessary in this context.
Choice C reason: Ibuprofen, an NSAID, competes with aspirin for COX-1 binding sites, reducing aspirin’s antiplatelet effect critical for preventing myocardial infarction and stroke. It also increases gastrointestinal bleeding risk when combined with aspirin, making it contraindicated for patients on low-dose aspirin therapy, thus the correct choice to avoid.
Choice D reason: Multivitamins do not interfere with aspirin’s antiplatelet action or increase bleeding risk. They provide supplemental nutrients without affecting COX-1 inhibition or platelet aggregation. There’s no pharmacological basis for avoiding multivitamins with low-dose aspirin, making this choice irrelevant for the patient’s cardiovascular regimen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Inhaled glucocorticoids, like budesonide, reduce airway inflammation over time but don’t act quickly enough to abort acute asthma attacks. Short-acting beta-agonists (e.g., albuterol) are used for acute relief, as glucocorticoids lack immediate bronchodilatory effects, making this choice incorrect for chronic asthma management.
Choice B reason: Using inhaled glucocorticoids only in emergencies is ineffective for chronic asthma. These drugs prevent inflammation and exacerbations through consistent use, not acute intervention. Emergency use is reserved for rescue inhalers like albuterol, making this choice inappropriate for long-term asthma control.
Choice C reason: Inhaled glucocorticoids require daily use to maintain anti-inflammatory effects, reducing airway hyperresponsiveness and preventing asthma exacerbations. Consistent dosing ensures steady suppression of chronic inflammation, improving lung function and reducing symptoms, making this the correct choice for managing chronic asthma effectively.
Choice D reason: A 2-week on/off schedule disrupts the consistent anti-inflammatory action of inhaled glucocorticoids needed for chronic asthma control. Intermittent use reduces efficacy, allowing inflammation to rebound, increasing exacerbation risk. Daily use is standard to maintain therapeutic benefits, making this choice incorrect.
Correct Answer is C
Explanation
Choice A reason: Theophylline is rarely used due to toxicity risks and less efficacy compared to beta-agonists. Increasing fluticasone dose doesn’t address acute exacerbations, as inhaled corticosteroids act slowly. Oxygen is appropriate, but this regimen lacks rapid-acting bronchodilators, making it inadequate for acute asthma management.
Choice B reason: Four puffs of albuterol via inhaler may be insufficient for severe asthma (90% saturation, wheezes). Theophylline is outdated, and nebulized treatments are more effective in emergencies. Oxygen is needed, but this combination lacks systemic steroids for inflammation, making it less optimal.
Choice C reason: Intravenous glucocorticoids reduce airway inflammation rapidly, nebulized albuterol and ipratropium provide synergistic bronchodilation, and oxygen corrects hypoxia (90% saturation). This aligns with guidelines for acute asthma exacerbations, addressing inflammation, bronchoconstriction, and oxygenation, making it the correct and comprehensive treatment choice.
Choice D reason: Intramuscular glucocorticoids are slower than intravenous for acute asthma. Salmeterol, a long-acting beta-agonist, is inappropriate for acute exacerbations, as it lacks rapid onset. Oxygen is needed, but this regimen doesn’t address immediate bronchoconstriction effectively, making it incorrect for emergency management.
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