A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

Take the bronchodilator inhaler first.

Take the corticosteroid inhaler first.

Take these two drugs at least 2 hours apart.

It does not matter which inhaler you use first.

Answer and Explanation

The Correct Answer is A

Choice A reason: Taking the bronchodilator inhaler first will help to open up the airways and make it easier for the corticosteroid inhaler to reach the lungs and reduce inflammation. This will improve the effectiveness and safety of the inhalers.

Choice B reason: Taking the corticosteroid inhaler first may not be as effective as taking the bronchodilator inhaler first, because the airways may be constricted and prevent the corticosteroid from reaching the lungs. This may reduce the anti-inflammatory effect of the corticosteroid and increase the risk of side effects.

Choice C reason: Taking these two drugs at least 2 hours apart is not necessary and may not be practical for the patient. The bronchodilator and the corticosteroid can be taken together, as long as the bronchodilator is taken first.

Choice D reason: It does matter which inhaler the patient uses first, because the order of the inhalers can affect their efficacy and safety. The patient should always use the bronchodilator inhaler first, followed by the corticosteroid inhaler.

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Correct Answer is A

Explanation

The correct answer is a. Alcohol.

Choice A: Alcohol

Reason: Alcohol can significantly affect blood glucose levels in patients taking glimepiride. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur depending on the amount and frequency of alcohol consumption. Alcohol can enhance the blood sugar-lowering effect of glimepiride, leading to a dangerous drop in blood sugar levels, known as hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, weakness, and in severe cases, loss of consciousness. Therefore, it is advised to avoid alcohol while taking glimepiride.

Choice B: Milk

Reason: There are no known interactions between glimepiride and milk. Milk does not affect the absorption or efficacy of glimepiride. Therefore, it is generally safe to consume milk while taking this medication.

Choice C: Grapefruit juice

Reason: Grapefruit juice might theoretically increase the levels of drugs metabolized by CYP2C9, including glimepiride, due to its potential to inhibit CYP2C9 enzymes. However, this interaction has not been reported in humans and is considered unlikely to have a significant clinical impact. Therefore, grapefruit juice is not a major concern for patients taking glimepiride.

Choice D: Coffee

Reason: Coffee and other caffeinated beverages may increase blood sugar levels, which can counteract the effects of glimepiride. However, this interaction is not as significant as the interaction with alcohol. It is generally advised to monitor blood sugar levels and consume coffee in moderation while taking glimepiride.

A. Immediate onset B. Absence of rebound congestion C. Shorter duration D. More potent effect

Correct Answer is B

Explanation

Choice A reason: This is incorrect because orally administered decongestants do not have an immediate onset. They take longer to act than nasal sprays because they have to be absorbed through the gastrointestinal tract. Nasal sprays act directly on the nasal mucosa and have a faster onset.

Choice B reason: This is correct because orally administered decongestants do not cause rebound congestion. Rebound congestion is a condition in which the nasal passages become more swollen and congested after the effect of the nasal spray wears off. This can lead to overuse and dependence on the nasal spray. Orally administered decongestants do not have this effect because they act systemically and not locally.

Choice C reason: This is incorrect because orally administered decongestants do not have a shorter duration. They have a longer duration than nasal sprays because they are metabolized more slowly by the liver. Nasal sprays have a shorter duration because they are eliminated more quickly by the nasal mucosa.

Choice D reason: This is incorrect because orally administered decongestants are not more potent than nasal sprays. They have a similar potency, but they have a different mechanism of action. Orally administered decongestants act on the alpha-adrenergic receptors in the blood vessels, causing vasoconstriction and reducing congestion. Nasal sprays act on the beta-adrenergic receptors in the bronchial smooth muscle, causing bronchodilation and improving airflow.

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A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers will the nurse give to the patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is B

Explanation

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