A 52-year-old man who works as an air traffic controller has seasonal allergies. Currently, he is very symptomatic but cannot miss work because of staffing issues. Which of the following agents would be best suited for this patient?

Correct Answer: D

Rationale: In this scenario, the most appropriate agent for the air traffic controller with seasonal allergies who cannot miss work due to staffing issues is option D, Fexofenadine. Fexofenadine is a second-generation non-sedating antihistamine that provides effective relief from allergy symptoms without causing drowsiness or impairing cognitive function. This is crucial for the patient's job as an air traffic controller, where alertness and focus are paramount. Option A, Chlorpheniramine, and Option C, Doxylamine, are first-generation antihistamines that are known to cause sedation and drowsiness. Using these medications could potentially impact the patient's ability to perform his job safely and effectively, especially in a high-stress environment like air traffic control. Option B, Diphenhydramine, though effective in relieving allergy symptoms, is also a first-generation antihistamine known for its sedating effects. Similar to Chlorpheniramine and Doxylamine, Diphenhydramine can impair cognitive function and alertness, making it unsuitable for a patient in a critical role like air traffic control. Educationally, this scenario highlights the importance of selecting appropriate medications based not only on their efficacy but also on their side effect profiles and how they may impact an individual's ability to perform specific tasks. Understanding the differences between first and second-generation antihistamines and their effects on sedation can help healthcare professionals make informed decisions when managing patients with allergies who have occupational considerations.

Correct Answer: C

Rationale: Teriflunomide, used in multiple sclerosis, inhibits dihydroorotate dehydrogenase, blocking pyrimidine synthesis critical for lymphocyte proliferation, reducing CNS inflammation by limiting activated immune cells. Riluzole modulates glutamate for ALS, not immunity. Rotigotine, a dopamine agonist, treats Parkinson's. Dexamethasone, a corticosteroid, suppresses inflammation broadly via glucocorticoid pathways, not pyrimidine-specific mechanisms. Teriflunomide's targeted action on lymphocyte replication distinguishes it in MS, decreasing relapses by curbing immune-mediated damage, a precise fit for this description.

Correct Answer: A

Rationale: Oxytocin induces labor by stimulating uterine contractions, but excessive use can cause hyperstimulation, leading to continuous, sustained contractions . This risks uterine rupture or fetal distress, necessitating immediate cessation of the infusion to protect mother and baby. Transition is a labor stage, not a reason to stop unless complications arise. Strong contractions are expected, and regular contractions every 2-3 minutes are normal for labor induction. The nurse stops the infusion for sustained contractions due to their potential for catastrophic outcomes, making choice A the most likely trigger based on oxytocin's safety profile.

Correct Answer: D

Rationale: Respiratory alkalosis occurs when there is a decrease in carbon dioxide levels in the blood, leading to an increase in pH. The correct answer is D) hyperventilation because when a person breathes rapidly and shallowly, excess carbon dioxide is expelled from the body, causing respiratory alkalosis. Option A) hypotension refers to low blood pressure and is not a direct cause of respiratory alkalosis. Option B) hypertension, or high blood pressure, is also not a direct cause of respiratory alkalosis. Option C) hypoventilation, which is insufficient breathing, would actually lead to an accumulation of carbon dioxide in the blood, causing respiratory acidosis, the opposite of respiratory alkalosis. Educationally, understanding the causes of respiratory alkalosis is crucial for nursing students and healthcare professionals to assess and manage patients experiencing acid-base imbalances. Recognizing the relationship between respiratory rate and pH levels is essential for providing appropriate care and interventions for patients with respiratory conditions.

Correct Answer: B

Rationale: Lorazepam, a benzodiazepine, reduces anxiety via GABA enhancement but potentiates CNS depression with alcohol, risking sedation or respiratory failure. Avoiding alcohol shows understanding of this danger, key for safety. Driving is unsafe due to drowsiness. It doesn't cure anxiety 'it's symptomatic relief. Extra doses risk dependence. Avoiding alcohol aligns with lorazepam's pharmacology, critical in anxiety management where misuse is common, making B the statement reflecting proper education.