To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

Choice A reason: Benzonatate suppresses cough by anesthetizing stretch receptors in the respiratory tract, reducing the cough reflex. It acts locally on nerve endings in the lungs and pleura, effectively decreasing cough frequency without systemic opioid effects, making it an appropriate choice for cough suppression.

Choice B reason: Guaifenesin is an expectorant, promoting mucus clearance by thinning secretions, not suppressing the cough reflex. It facilitates productive coughing rather than inhibiting it, making it ineffective for cough suppression and an incorrect choice for this indication in managing cough symptoms.

Choice C reason: Dextromethorphan suppresses cough by acting on the medulla’s cough center, reducing the urge to cough. As a non-opioid antitussive, it effectively controls non-productive cough without significant respiratory depression, making it a suitable and correct choice for cough suppression in various conditions.

Choice D reason: Codeine, an opioid, suppresses cough by acting on the central nervous system’s cough center, reducing reflex activity. It’s effective for non-productive cough but carries risks of sedation and dependency, making it a correct but cautiously used choice for cough suppression.

Choice A reason: Adrenergic neuron blockers, like guanethidine, reduce blood pressure by inhibiting norepinephrine release. They are not first-line for stage 1 hypertension (140-159/90-99 mm Hg). Their side effects, like orthostatic hypotension, make them less suitable. Lifestyle changes are preferred initially for this patient’s mild elevation and normal diagnostic tests, making this choice inappropriate.

Choice B reason: Beta blockers, like atenolol, reduce heart rate and cardiac output, lowering blood pressure. They are not first-line for stage 1 hypertension without compelling indications (e.g., heart failure). Guidelines recommend lifestyle modifications first for this patient’s blood pressure range, as they effectively reduce risk without medication side effects, making this choice less suitable.

Choice C reason: For stage 1 hypertension (140-159/90-99 mm Hg) with normal diagnostic tests, guidelines recommend lifestyle changes, such as diet, exercise, and weight loss, as first-line treatment. These reduce blood pressure by improving vascular health and reducing cardiac strain, offering a low-risk approach to manage mild hypertension effectively, making this the correct choice.

Choice D reason: ACE inhibitors, like lisinopril, block angiotensin II formation, reducing blood pressure. They are effective but not first-line for stage 1 hypertension without comorbidities. Lifestyle changes are prioritized to avoid medication side effects like cough or hyperkalemia, making this choice less appropriate for initial management in this patient.