A patient says to the nurse what type of medications would be most effective for treating seasonal and perennial rhinitis. Which response by the nurse is correct?
Pseudoephedrine [Sudafed]
Intranasal cromolyn sodium [Atrovent]
Propranolol [Inderal]
Fluticasone propionate [Flonase]
The Correct Answer is D
Choice A reason: Pseudoephedrine, a decongestant, relieves nasal congestion by vasoconstriction but doesn’t address inflammation or histamine-mediated symptoms like sneezing or itching in rhinitis. It’s less effective than intranasal corticosteroids, which target the underlying allergic response, making this choice less optimal for comprehensive rhinitis treatment.
Choice B reason: Intranasal cromolyn sodium stabilizes mast cells, reducing histamine release, but it’s less effective than corticosteroids for rhinitis. Atrovent (ipratropium) is incorrectly referenced here, as it treats rhinorrhea, not inflammation. Corticosteroids like fluticasone are preferred, making this choice incorrect for optimal treatment.
Choice C reason: Propranolol, a beta-blocker, treats hypertension and cardiac conditions, not rhinitis. It has no effect on allergic inflammation, histamine, or nasal congestion. Its use in rhinitis could worsen symptoms by causing bronchoconstriction in asthmatics, making this choice inappropriate and incorrect.
Choice D reason: Fluticasone propionate, an intranasal corticosteroid, reduces inflammation, edema, and histamine effects in seasonal and perennial rhinitis. It targets the allergic cascade, decreasing nasal congestion, sneezing, and itching, making it the most effective and guideline-recommended treatment, thus the correct choice for rhinitis management.
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: A sodium level of 140 mEq/L is within the normal range (135-145 mEq/L). While furosemide can cause hyponatremia, this value is not concerning. Hypokalemia is a greater risk with furosemide and digoxin, as it potentiates digoxin toxicity, making this choice less critical than potassium.
Choice B reason: Oxygen saturation of 95% is normal (95-100%). Crackles suggest pulmonary edema, but this saturation doesn’t indicate severe hypoxia requiring immediate action. Hypokalemia poses a greater risk with digoxin and furosemide, as it increases toxicity potential, making this choice less concerning.
Choice C reason: A potassium level of 3.0 mEq/L (normal: 3.5-5.0 mEq/L) indicates hypokalemia, exacerbated by furosemide’s diuretic effect. In digoxin use, low potassium increases cardiac toxicity risk, causing arrhythmias, especially with an irregular heart rate noted, making this the most concerning value requiring immediate attention.
Choice D reason: A blood glucose level of 100 mg/dL is normal (70-110 mg/dL fasting). It’s unrelated to digoxin or furosemide’s primary risks (e.g., electrolyte imbalances, arrhythmias). Hypokalemia is a more immediate concern due to its synergistic toxicity with digoxin, making this choice less critical.
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