The prescriber has changed the patient’s medication regimen to include montelukast to treat asthma. The nurse will emphasize which point about this medication?
When the asthma symptoms improve, the dosage schedule can be tapered and eventually discontinued.
The proper technique for inhalation must be followed.
The patient needs to always keep it close by to treat acute asthma attacks.
It needs to be taken every day on a continuous schedule, even if symptoms improve.
The Correct Answer is D
Choice A reason: Montelukast, a leukotriene receptor antagonist, is not typically tapered or discontinued when symptoms improve. It is used for chronic asthma management to prevent exacerbations by blocking leukotriene-mediated inflammation. Discontinuing it prematurely may lead to symptom recurrence, as it does not provide acute relief.
Choice B reason: Montelukast is an oral medication, not an inhaler, so inhalation technique is irrelevant. It blocks leukotriene D4 receptors to reduce airway inflammation and bronchoconstriction. Proper administration involves daily oral dosing, and no inhalation device is required, making this instruction incorrect for montelukast.
Choice C reason: Montelukast is not used for acute asthma attacks, as its onset is too slow (hours to days). It is a maintenance therapy that prevents inflammation, not a rescue medication like albuterol. Patients should carry short-acting beta-agonists, not montelukast, for acute symptom relief.
Choice D reason: Montelukast must be taken daily on a continuous schedule to maintain its anti-inflammatory effects by blocking leukotriene receptors, even if asthma symptoms improve. Consistent use prevents exacerbations and maintains airway stability, as its mechanism relies on sustained leukotriene inhibition to control chronic asthma symptoms effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Warfarin overdose causes excessive anticoagulation, increasing bleeding risk by inhibiting vitamin K-dependent clotting factors (II, VII, IX, X). Vitamin K reverses this by restoring clotting factor synthesis, correcting INR and stopping gastrointestinal bleeding, making it the standard treatment for warfarin toxicity.
Choice B reason: Vitamin E has no role in reversing warfarin toxicity. It is an antioxidant with no effect on clotting factor synthesis or warfarin’s mechanism. Its use may be associated with bleeding risk in high doses, making it inappropriate for managing warfarin-induced gastrointestinal bleeding.
Choice C reason: Protamine sulfate reverses heparin, not warfarin. Heparin enhances antithrombin activity, and protamine neutralizes it. Warfarin’s effect on vitamin K-dependent factors is unrelated, and protamine has no impact on warfarin toxicity or gastrointestinal bleeding, making it an incorrect choice.
Choice D reason: Potassium chloride treats hypokalemia, not warfarin toxicity. Warfarin’s bleeding complications result from inhibited clotting factor synthesis, not electrolyte imbalances. Potassium chloride is irrelevant to reversing anticoagulation or managing gastrointestinal bleeding caused by excessive warfarin, making this an inappropriate treatment.
Correct Answer is C
Explanation
Choice A reason: Griseofulvin is an antifungal used for dermatophyte infections like ringworm. It disrupts fungal mitosis by binding to keratin. It is not used for systemic infections and has minimal nephrotoxicity, as it is primarily metabolized by the liver, with side effects like rash or hepatotoxicity.
Choice B reason: Fluconazole treats systemic fungal infections like candidiasis by inhibiting ergosterol synthesis. It is generally well-tolerated and not significantly nephrotoxic, as it is excreted primarily via the kidneys unchanged. Its main side effects include hepatotoxicity and gastrointestinal upset, not kidney damage.
Choice C reason: Amphotericin B is used for severe systemic fungal infections, binding to ergosterol in fungal membranes, causing cell lysis. It is highly nephrotoxic, damaging renal tubular cells and reducing glomerular filtration rate, often requiring careful monitoring of kidney function and hydration to mitigate toxicity during treatment.
Choice D reason: Terbinafine treats dermatophyte infections like onychomycosis by inhibiting squalene epoxidase. It is not typically used for systemic infections and has low nephrotoxicity risk. Its primary side effects include hepatotoxicity and gastrointestinal issues, with minimal impact on renal function compared to amphotericin B.
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