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 B
Explanation
Choice A reason: Glucuronidation does not primarily involve fecal excretion; it conjugates drugs for urinary excretion. Hydrolysis is unrelated, and fecal routes are secondary, so this is incorrect for glucuronidation’s role.
Choice B reason: Glucuronidation conjugates drugs, making them water-soluble for transport across renal tubules and excretion in urine. This is the primary mechanism, making it the correct choice for drug elimination.
Choice C reason: Enterohepatic recirculation involves some drugs, but glucuronidation aims for excretion, not recycling. Prolonging drug presence is not the goal, so this is incorrect for the process.
Choice D reason: Glucuronidation facilitates excretion, not reabsorption. Reabsorbing drugs would counteract its purpose of eliminating metabolites, making this incorrect compared to urinary excretion.
Correct Answer is C
Explanation
Choice A reason: Bananas do not interact with acetaminophen. They are a potassium-rich food without impact on acetaminophen metabolism or hepatotoxicity. Acetaminophen’s primary risk is liver damage, especially with alcohol or overdose, making bananas irrelevant to its safe use, so this choice is incorrect.
Choice B reason: Leafy green foods, rich in vitamin K, may affect anticoagulants like warfarin but have no significant interaction with acetaminophen. They don’t influence acetaminophen’s metabolism or liver toxicity risk, making this choice irrelevant for patient instructions regarding safe acetaminophen use post-surgery.
Choice C reason: Alcohol increases acetaminophen’s hepatotoxicity by inducing CYP2E1 enzymes, which metabolize acetaminophen into toxic NAPQI, depleting liver glutathione and causing damage. Avoiding alcohol prevents severe liver injury, especially post-surgery when liver function is critical, making this the correct choice for patient safety.
Choice D reason: Dairy products do not interact with acetaminophen’s metabolism or toxicity. They may slow gastric emptying, slightly delaying absorption, but this isn’t a significant concern. Acetaminophen’s primary risk is hepatotoxicity, unaffected by dairy, making this choice incorrect for discharge instructions.
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