The following are H1 receptor antagonist, except :

Correct Answer: D

Rationale: Terfenadine is a second-generation antihistamine, but it is not an H1 receptor antagonist like the other options listed. Terfenadine was once used for the treatment of allergic conditions, but it is known for its potential to cause cardiac side effects due to its interaction with other medications and prolongation of the QT interval. Consequently, terfenadine has been largely replaced by newer, safer antihistamines. The rest of the options listed (chlorpheniramine, promethazine, cimetidine, and diphenhydramine) are all H1 receptor antagonists commonly used to block the action of histamine and relieve symptoms of allergies.

Correct Answer: D

Rationale: Bisoprolol is the drug of choice for older adults. It is not associated with as many adverse effects in the elderly and regular dosing profiles can be used. This drug does not have an established pediatric dosage. Although the 37-year-old patient is an adult, there are additional choices for this patient, with a more favorable adverse effect profile. The nurse should consider age-related factors when selecting antihypertensive medications.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Vitamin A. The patient's symptoms of hair loss and peeling skin are indicative of hypervitaminosis A, which can occur due to excessive intake of Vitamin A supplements. Vitamin A is a fat-soluble vitamin that is stored in the body, and excessive levels can lead to toxicity symptoms like skin changes and hair loss. Option B) Zinc is incorrect because zinc deficiency, not excess, is associated with hair loss and skin issues. Option C) Vitamin C is incorrect as excess Vitamin C is usually excreted in urine and is not typically associated with hair loss or skin peeling. Option D) Vitamin D is incorrect as excess Vitamin D can lead to toxicity symptoms, but these usually manifest as hypercalcemia-related issues rather than hair loss and skin peeling. Educationally, this question highlights the importance of understanding the effects of vitamins and minerals on the body. Nurses need to be aware of potential toxicities associated with excessive intake of certain nutrients and be able to identify symptoms related to these toxicities to provide appropriate care and education to patients.

Correct Answer: C

Rationale: In Chinese culture, the use of heat, such as through warm foods or heating pads, is often believed to restore balance and promote healing. This cultural practice may influence the patient's preferences and expectations during hospitalization. Radiographs, hospital diets, and the perception of hospitalization are less likely to be significant cultural factors in this context. Therefore, the nurse should consider the patient's cultural beliefs about heat and incorporate them into the care plan as appropriate.

Correct Answer: C

Rationale: Central venous access devices (CVADs) are advantageous for chemotherapy administration because they allow caustic or vesicant drugs to be delivered directly into larger veins, reducing the risk of vein irritation, thrombosis, or extravasation. While CVADs may have other benefits, such as long-term use and reduced need for repeated IV insertions, their primary advantage in chemotherapy is the safe administration of potentially damaging agents. Home administration and cost are secondary considerations.