JL is a 22-year-old female who is complaining of the following SEVERE allergic rhinitis nasal symptoms: nasal congestion, and a runny/itchy nose. She has experienced these symptoms in the past. She states she typically feels this way every Fall for the last 3 years. Which of the following medication recommendations is MOST appropriate for JL?
Fluticasone propionate nasal spray daily
Diphenhydramine oral capsules every 4 hours
Loratadine oral tablets daily
Phenylephrine oral tablets every 4 hours
The Correct Answer is A
A. Fluticasone propionate nasal spray daily: Intranasal corticosteroids like fluticasone are first-line therapy for moderate to severe allergic rhinitis. They target the underlying inflammatory response by reducing histamine release, cytokine production, and nasal mucosal edema, effectively controlling nasal congestion, rhinorrhea, and itching.
B. Diphenhydramine oral capsules every 4 hours: Diphenhydramine is a first-generation antihistamine that can relieve sneezing, itching, and rhinorrhea. However, it causes significant sedation and anticholinergic side effects. For chronic, recurrent seasonal allergic rhinitis, it is less practical for daily long-term use compared with intranasal corticosteroids.
C. Loratadine oral tablets daily: Loratadine is a second-generation antihistamine that reduces sneezing, itching, and rhinorrhea without significant sedation. While effective for mild to moderate symptoms, it is often less effective than intranasal corticosteroids for controlling severe congestion and comprehensive nasal inflammation.
D. Phenylephrine oral tablets every 4 hours: Phenylephrine is a systemic decongestant that temporarily reduces nasal swelling by vasoconstriction. It does not treat the underlying allergic inflammation, and prolonged or frequent use can cause rebound congestion, making it inappropriate as first-line therapy for chronic seasonal allergic rhinitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
When using medicated nasal sprays, patients should be instructed to blow their nose gently before administering the spray to clear the nasal passages. However, they should not blow their nose immediately after the dose, as this can remove the medication from the nasal mucosa and reduce its effectiveness. Proper technique involves tilting the head slightly forward, aiming the spray toward the lateral wall of the nostril (not the septum), and sniffing gently after administration to help distribute the medication. Counseling on correct use ensures optimal absorption and minimizes local irritation or bleeding.
Correct Answer is B
Explanation
A. Magnesium Citrate: Magnesium citrate is an osmotic laxative. It works by drawing water into the intestinal lumen via osmotic pressure, softening stool and stimulating bowel movements. It does not coat or lubricate the stool.
B. Mineral Oil: Mineral oil is a lubricant laxative. It coats the stool and intestinal mucosa, reducing water absorption from the stool and allowing it to pass more easily. This mechanism eases defecation without significantly stimulating peristalsis, making it distinct from osmotic or bulk-forming agents.
C. Polyethylene Glycol 3350: Polyethylene glycol is an osmotic laxative that retains water in the stool through osmosis, increasing stool volume and promoting bowel movements. It does not provide lubrication or coat the stool.
D. Psyllium: Psyllium is a bulk-forming laxative. It absorbs water and expands in the intestine, increasing stool bulk and stimulating peristalsis. It does not function by lubricating the stool.
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