A nurse caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide to the client's parents on administering the medication?

Give the medication in the morning daily.

Administer the medication 2 hours before exercise

Administer the granules mixed with 20 ounces of water

Give the medication at the onset of wheezing

Answer and Explanation

The Correct Answer is A

A. Give the medication in the morning daily. Montelukast (a leukotriene receptor antagonist) is given once daily in the evening for long-term asthma control. If prescribed for allergic rhinitis, it can be given in the morning.

B. Administer the medication 2 hours before exercise. Montelukast is not a rescue medication but a maintenance drug. However, it can be prescribed for exercise-induced bronchospasm and is taken at least 2 hours before exercise when used for that purpose.

C. Administer the granules mixed with 20 ounces of water. Montelukast granules should be mixed with a small amount of soft food (e.g., applesauce, mashed carrots) or breast milk/formula but not a large volume of liquid.

D. Give the medication at the onset of wheezing. Montelukast is not a quick-relief medication and does not work immediately. Short-acting bronchodilators (e.g., albuterol) should be used for acute wheezing.

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Correct Answer is C

Explanation

A. Calcium channel blocker: Calcium channel blockers (e.g., amlodipine, diltiazem) do not commonly cause a dry cough. They primarily work by relaxing blood vessels and reducing heart workload.

B. Angiotensin II receptor blocker: ARBs (e.g., losartan, valsartan) do not typically cause a persistent cough. They are often prescribed instead of ACE inhibitors for patients who experience this side effect.

C. Angiotensin-converting enzyme (ACE) inhibitors: ACE inhibitors (e.g., lisinopril, enalapril) can cause a persistent dry cough due to the accumulation of bradykinin, a substance that can irritate the airways.

D. Beta-blockers: Beta-blockers (e.g., metoprolol, propranolol) are not commonly associated with a dry cough. They mainly affect heart rate and blood pressure but can cause bronchospasms in some patients.

A. AV Node B. SA Node C. Purkinje Fibers D. Bundle of HIS

Correct Answer is B

Explanation

A. AV Node: The AV node is responsible for delaying electrical impulses before they pass to the ventricles, but it does not generate the P wave. It affects the PR interval rather than the P wave itself.

B. SA Node: The SA (sinoatrial) node initiates electrical impulses and is responsible for atrial depolarization, which produces the P wave on an ECG. This makes it the correct answer.

C. Purkinje Fibers: The Purkinje fibers play a role in ventricular contraction (QRS complex), not in the formation of the P wave.

D. Bundle of HIS: The Bundle of HIS transmits impulses to the ventricles and is involved in ventricular depolarization, not atrial activity. It is not responsible for the P wave.

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A nurse caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide to the client's parents on administering the medication?

Nursing Test Bank

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