A 31-year-old woman is planning to take a 7-day cruise to the Caribbean islands. She has never been on a ship before and fears developing motion sickness. She purchases scopolamine transdermal patch. When is the best time for her to place the patch to maximize drug efficacy?

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Prior to the onset of symptoms. Placing the scopolamine transdermal patch before the onset of motion sickness symptoms is crucial for maximizing its efficacy. Scopolamine works best when it has already been absorbed into the bloodstream and is circulating in the body before the symptoms of nausea or motion sickness begin. By applying the patch in advance, the drug can reach therapeutic levels in the body, providing the individual with adequate protection against motion sickness throughout the cruise. Option A) After nausea first begins is incorrect because waiting for symptoms to occur before applying the patch means that the drug will not have enough time to take effect and prevent motion sickness effectively. Option B) After nausea occurs for 2 hours is also incorrect as delaying the application of the patch until after symptoms have already started will not provide timely relief and may lead to prolonged discomfort. Option C) After vomiting occurs is not the best choice as vomiting is a severe manifestation of motion sickness and waiting until this symptom appears is not proactive in preventing motion sickness. Educationally, it is important to teach students and healthcare professionals about the importance of timing when using medications for prophylaxis. Understanding the pharmacokinetics of drugs like scopolamine can help individuals make informed decisions regarding the timing of administration to achieve the best therapeutic outcomes. By emphasizing pre-emptive use, patients can better manage potential side effects and enjoy their travel experiences with reduced discomfort.

Correct Answer: D

Rationale: Absence seizures, typical in childhood, feature brief (10-20 second) lapses in awareness with staring and eye blinking, followed by immediate resumption of activity, as described. Simple partial seizures preserve consciousness with focal symptoms (e.g., twitching). Complex partial seizures impair awareness longer, with automatisms. Tonic-clonic seizures involve convulsions. Myoclonic seizures cause jerks without staring. The short duration, blank look, and rapid recovery align with absence seizures' EEG pattern (3 Hz spike-and-wave), distinguishing it here.

Correct Answer: A

Rationale: Antihistamines for allergies (e.g., diphenhydramine) target H1 receptors , blocking histamine's effects like itching or sneezing. B1 and B2 receptors (choices B, C) involve adrenergic responses (e.g., heart rate, bronchodilation), unrelated to histamine. C1 isn't a recognized receptor. H1 blockade is the mechanism for allergy relief, making choice A correct, reflecting antihistamines' specific pharmacological action critical for nurses to understand.

Correct Answer: D

Rationale: In this scenario, the best response by the nurse is option D, which is "When he has a dry cough and cannot rest." This is the correct answer because cough medicines, especially those containing antitussives, are typically given to suppress a dry, non-productive cough that is interfering with the child's ability to rest and sleep. Option A, "When he is coughing up green secretions," is incorrect because the presence of green secretions does not necessarily indicate the need for cough medicine. Green sputum may suggest a bacterial infection, but the color alone is not an indication for cough medicine. Option B, "When he has a temperature over 102°F," is also incorrect as the presence of a fever alone does not warrant the use of cough medicine. Fever management and the use of antipyretics would be more appropriate in this situation. Option C, "When he has bronchitis," is incorrect because the treatment for bronchitis would depend on the underlying cause and severity of symptoms. Cough medicines may not always be indicated for bronchitis, especially if it is caused by a viral infection. In an educational context, it is essential for nurses to understand the appropriate indications for administering medications to pediatric patients. This question highlights the importance of assessing the nature of the cough and its impact on the child's rest before recommending the use of cough medicine. Nurses should always consider the holistic needs of the child and tailor their interventions accordingly.

Correct Answer: C

Rationale: Clonidine, an alpha-2 agonist, lowers BP but risks rebound hypertension if stopped abruptly. Tapering off shows understanding, preventing this danger. Stopping if normal or extra doses risk instability. Chewing isn't advised'oral absorption suffices. Tapering aligns with clonidine's withdrawal risk, critical in hypertension management, making C the statement of effective teaching.