Nokea
A patient is learning about his new diagnosis of asthma with the asthma nurse. What medication has the ability to prevent the onset of acute asthma exacerbations?
- A. Diphenhydramine (Benadryl)
- B. Montelukast (Singulair)
- C. Albuterol sulfate (Ventolin)
- D. Epinephrine
Correct Answer: B
Rationale: Many manifestations of inflammation can be attributed in part to leukotrienes. Medications categorized as leukotriene antagonists or modifiers such as montelukast (Singulair) block the synthesis or action of leukotrienes and prevent signs and symptoms associated with asthma. Diphenhydramine prevents histamines effect on smooth muscle. Albuterol sulfate relaxes smooth muscle during an asthma attack. Epinephrine relaxes bronchial smooth muscle but is not used on a preventative basis.
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A patient has been living with seasonal allergies for many years, but does not take antihistamines, stating, When I was young I used to take antihistamines, but they always put me to sleep. How should the nurse best respond?
- A. Newer antihistamines are combined with a stimulant that offsets drowsiness.
- B. Most people find that they develop a tolerance to sedation after a few months.
- C. The newer antihistamines are different than in years past, and cause less sedation.
- D. Have you considered taking them at bedtime instead of in the morning?
Correct Answer: C
Rationale: Unlike first-generation H1 receptor antagonists, newer antihistamines bind to peripheral rather than central nervous system H1 receptors, causing less sedation, if at all. Tolerance to sedation did not usually occur with first-generation drugs and newer antihistamines are not combined with a stimulant.
The nurse is planning the care of a patient who has a diagnosis of atopic dermatitis, which commonly affects both of her hands and forearms. What risk nursing diagnosis should the nurse include in the patients care plan?
- A. Risk for Disturbed Body Image Related to Skin Lesions
- B. Risk for Disuse Syndrome Related to Dermatitis
- C. Risk for Ineffective Role Performance Related to Dermatitis
- D. Risk for Self-Care Deficit Related to Skin Lesions
Correct Answer: A
Rationale: The highly visible skin lesions associated with atopic dermatitis constitute a risk for disturbed body image. This may culminate in ineffective role performance, but this is not likely the case for the majority of patients. Dermatitis is unlikely to cause a disuse syndrome or self-care deficit.
A child is undergoing testing for food allergies after experiencing unexplained signs and symptoms of hypersensitivity. What food items would the nurse inform the parents are common allergens?
- A. Citrus fruits and rice
- B. Root vegetables and tomatoes
- C. Eggs and wheat
- D. Hard cheeses and vegetable oils
Correct Answer: C
Rationale: The most common causes of food allergies are seafood (lobster, shrimp, crab, clams, fish), legumes (peanuts, peas, beans, licorice), seeds (sesame, cottonseed, caraway, mustard, flaxseed, sunflower seeds), tree nuts, berries, egg white, buckwheat, milk, and chocolate.
A patient was prescribed an oral antibiotic for the treatment of sinusitis. The patient has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurses most appropriate response?
- A. Encourage the woman to continue with the medication while monitoring her skin condition closely.
- B. Refer the woman to her primary care provider to have the medication changed.
- C. Arrange for the woman to go to the nearest emergency department.
- D. Encourage the woman to take an OTC antihistamine with each dose of the antibiotic.
Correct Answer: B
Rationale: On discovery of a medication allergy, patients are warned that they have a hypersensitivity to a particular medication and are advised not to take it again. As a result, the patient would need to liaise with the primary care provider. There is no need for emergency care unless symptoms worsen to involve respiratory function. An antihistamine would not be an adequate or appropriate recommendation from the nurse.
A patient has sought care, stating that she developed hives overnight. The nurses inspection confirms the presence of urticaria. What type of allergic hypersensitivity reaction has the patient developed?
- A. Type I
- B. Type II
- C. Type III
- D. Type IV
Correct Answer: A
Rationale: Urticaria (hives) is a type I hypersensitive allergic reaction.