A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parent on administering the medication?
Administer the granules mixed with 20 oz of water.
Administer the medication 2 hr before exercise.
Give the medication in the morning daily
Give the medication at the onset of wheezing
The Correct Answer is B
A. Administering the granules mixed with 20 oz of water is not necessary. Montelukast granules can be administered directly into the mouth or mixed with a small amount of soft food (e.g., applesauce) if necessary. The specific instructions for administration should be provided by the healthcare provider or included in the product labeling.
B. If you’re using it to prevent breathing problems related to exercise, take a single dose at least 2 hours before exercising. However, another dose cannot be taken within 24 hours.
C. Montelukast is a leukotriene receptor antagonist commonly used for the maintenance treatment of asthma in children and adults. The usual recommended dose is once daily in the evening, depending on the specific instructions from the healthcare provider.
D. Administering the medication at the onset of wheezing is not the recommended approach. Montelukast is a daily maintenance medication for asthma and should be taken regularly as prescribed, regardless of wheezing symptoms. It is not intended to be used for immediate relief of wheezing or acute asthma symptoms. Short-acting bronchodilators are typically used for quick relief of wheezing or acute asthma symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Expectorants are medications that help to loosen and thin mucus in the respiratory tract, making it easier to cough up and expel. They work by increasing the production of respiratory tract secretions, which helps to hydrate and thin the mucus, making it less sticky and easier to clear from the airways. By stimulating the production and secretion of mucus, expectorants promote coughing and facilitate the removal of excess mucus and phlegm from the respiratory system.
It's important to note that expectorants are primarily used for productive coughs (coughs that produce phlegm or mucus). If the cough is dry and non-productive, other types of cough suppressants or remedies may be more appropriate.
Regarding the other options:
Reduces inflammation: Expectorants do not have a direct effect on reducing inflammation in the respiratory tract. Anti-inflammatory medications such as glucocorticoids are typically used for reducing inflammation in conditions like asthma or chronic obstructive pulmonary disease (COPD).
Dries mucous membranes: Expectorants do not have a drying effect on mucous membranes. In fact, they work to increase the hydration and fluidity of respiratory secretions.
Suppresses the urge to cough: Expectorants do not suppress the urge to cough. They promote coughing by facilitating the clearance of mucus and phlegm from the airways. Cough suppressants, on the other hand, are medications used to relieve a dry, non-productive cough by suppressing the cough reflex.

Correct Answer is B
Explanation
Codeine is an opioid medication that can cause drowsiness and dizziness. Changing positions quickly, especially from lying down to standing up, can increase the risk of falls or accidents.
Instructing the client to change positions slowly helps prevent orthostatic hypotension (a drop in blood pressure upon standing) and reduces the risk of falls.
The other options listed are not appropriate instructions for a client taking codeine:
A. "You should expect to experience diarrhea while taking this medication." While constipation is a common side effect of opioids, diarrhea is not typically associated with codeine use. Therefore, there is no need to expect or warn about diarrhea as an anticipated effect of taking codeine.
C. "You should limit alcohol intake to 12 ounces daily." Mixing alcohol with codeine can have harmful effects, such as increased sedation and respiratory depression. However, it is generally recommended to avoid alcohol completely while taking codeine, rather than setting a specific limit of 12 ounces daily.
D. "You should take the medication on an empty stomach to prevent nausea." Taking codeine with or without food can vary depending on individual factors and the specific instructions provided by the healthcare provider. However, taking codeine on an empty stomach does not necessarily prevent nausea. In fact, taking it with food may help reduce stomach upset for some individuals. It is best to follow the specific instructions provided by the healthcare provider regarding the timing of codeine administration with or without food.

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