A patient who has seasonal allergies in the spring and fall asks the nurse about oral antihistamines. Which response by the nurse is correct?

Make sure you take antihistamines only when you have symptoms to minimize side effects

First-generation antihistamines, such as diphenhydramine [Benadryl], are more effective

Anticholinergic effects are more common with second-generation antihistamines

You should take oral antihistamines daily during each allergy season to get maximum effects

Answer and Explanation

The Correct Answer is D

Choice A reason: Taking antihistamines only with symptoms may reduce side effects but provides inconsistent relief, as histamine levels fluctuate. Daily use during allergy seasons prevents symptom onset, offering better control, especially for second-generation antihistamines with longer action, making this choice less effective.

Choice B reason: First-generation antihistamines (e.g., diphenhydramine) are sedating and have more side effects than second-generation (e.g., loratadine), which are equally effective for allergies but less sedating. Claiming first-generation are more effective is incorrect, as second-generation are preferred, making this choice inaccurate.

Choice C reason: Anticholinergic effects (e.g., dry mouth) are more common with first-generation antihistamines (e.g., diphenhydramine) due to non-selective receptor binding. Second-generation antihistamines (e.g., cetirizine) are more selective for H1 receptors, reducing these effects, making this choice incorrect and opposite to pharmacological profiles.

Choice D reason: Daily oral antihistamines, especially second-generation (e.g., loratadine), during allergy seasons maintain steady histamine receptor blockade, preventing symptoms like sneezing and itching. This maximizes efficacy and improves quality of life, aligning with guidelines for seasonal allergies, making this the correct nurse response.

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Correct Answer is C

Explanation

Choice A reason: A 25-year-old man typically has mature liver and kidney function, efficiently metabolizing and excreting CNS depressants like benzodiazepines. Toxicity risk is lower compared to neonates, whose immature systems impair drug clearance, making this choice less critical for close toxicity monitoring.

Choice B reason: A 15-year-old boy has relatively mature metabolic pathways, though not fully adult-like. CNS depressants are cleared more effectively than in neonates, reducing toxicity risk. Adolescents are less vulnerable than infants to accumulation, making this choice less concerning for drug toxicity observation.

Choice C reason: A 3-week-old neonate has immature liver enzymes (e.g., CYP450) and reduced renal clearance, increasing the risk of CNS depressant toxicity (e.g., respiratory depression, sedation). Their low body mass and underdeveloped metabolism necessitate close monitoring, making this the correct choice for heightened toxicity vigilance.

Choice D reason: A 25-year-old woman, like men of the same age, typically has efficient drug metabolism and excretion. CNS depressants pose lower toxicity risk compared to neonates, whose immature systems lead to drug accumulation, making this choice less critical for close toxicity monitoring.

A. NPH insulin should only be mixed with insulin glargine B. These two forms of insulin are not compatible and cannot be mixed C. Mixing these two forms of insulin may increase the overall potency of the products D. This is an acceptable practice

Correct Answer is D

Explanation

Choice A reason: NPH insulin is not mixed with insulin glargine, as glargine’s pH and formulation cause precipitation or altered pharmacokinetics when combined. NPH can be mixed with regular insulin, as they are compatible, making this choice incorrect for the patient’s reported practice.

Choice B reason: NPH and regular insulin are compatible and routinely mixed in one syringe to provide both intermediate and short-acting coverage. They don’t react chemically or lose efficacy when combined properly, making this choice incorrect, as mixing is a standard practice in diabetes management.

Choice C reason: Mixing NPH and regular insulin does not increase potency; it combines their pharmacokinetics for basal and prandial glucose control. The mixture delivers the additive effects of each insulin’s profile without enhancing overall potency, making this choice inaccurate for their combined action.

Choice D reason: Mixing NPH (intermediate-acting) and regular insulin (short-acting) is an accepted practice to manage type 1 diabetes with one injection, covering basal and prandial needs. Proper technique (drawing regular insulin first) ensures stability, making this the correct choice for the patient’s reported insulin administration.

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A patient who has seasonal allergies in the spring and fall asks the nurse about oral antihistamines. Which response by the nurse is correct?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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