The practical nurse (PN) applies a preparation with keratolytic properties to both legs of a client with psoriasis. Which finding indicates that the desired effect has been achieved?

Choice A reason: Explaining the medication’s purpose is important but does not address the inappropriate bedtime dosing. Diuretics increase urination, causing nocturia and sleep disruption. Administering as scheduled without review risks client discomfort, making this choice less appropriate than verifying timing.

Choice B reason: Reviewing the prescription with the charge nurse is critical, as bedtime diuretic administration causes nocturia, disrupting sleep. Diuretics, like hydrochlorothiazide, increase urine production, and morning dosing aligns with daily activity, minimizing nighttime disturbance, ensuring safe and effective administration timing.

Choice C reason: Withholding the medication until the next day delays treatment, risking conditions like edema or hypertension. Consulting the charge nurse allows timely clarification of dosing time, ensuring therapeutic benefits without sleep disruption, making this choice overly cautious and unnecessary.

Choice D reason: Administering the diuretic early without confirmation violates protocol, as the prescription specifies bedtime. Unilateral changes risk errors, and morning dosing requires provider approval. Reviewing with the charge nurse is safer, ensuring alignment with clinical intent while addressing sleep concerns.

Choice A reason: Montelukast is a leukotriene receptor antagonist that inhibits leukotrienes, mediators of inflammation in allergic responses. By blocking these, it reduces airway inflammation, bronchoconstriction, and mucus production, preventing asthma or allergic rhinitis symptoms. This prophylactic action targets the immune response to allergens, stabilizing respiratory function before symptoms escalate.

Choice B reason: Montelukast does not increase mucus production. Instead, it reduces mucus by inhibiting leukotriene-driven inflammation in the airways. Increased mucus is a symptom of uncontrolled asthma or allergies, which montelukast aims to prevent. This choice is incorrect as it contradicts the drug’s mechanism of reducing inflammatory responses in the lungs.

Choice C reason: Montelukast does not contract respiratory smooth muscles. It prevents bronchoconstriction by blocking leukotrienes, which cause smooth muscle contraction in asthma. By inhibiting this pathway, it promotes airway relaxation, not contraction. This choice is incorrect, as it misrepresents the drug’s role in maintaining open airways.

Choice D reason: Montelukast does not repair damaged lung tissue. Its primary role is to prevent inflammation and bronchoconstriction caused by allergens. Lung tissue repair involves other physiological processes, not influenced by montelukast. This choice is incorrect, as it falsely attributes tissue regeneration to a drug focused on immune modulation.