Which set of instructions will the nurse include in the teaching plan of a patient who is prescribed fluphenazine (Prolixin) and has developed a thickly white-coated tongue?

Correct Answer: A

Rationale: The correct answer is A because it provides comprehensive and appropriate instructions for managing the thickly white-coated tongue associated with fluphenazine. First, advising to avoid foods high in sugar helps prevent further irritation. Second, emphasizing good oral hygiene by brushing teeth and tongue, flossing, and gargling with mouthwash helps to reduce the coating. Third, encouraging daily tongue checks and prompt physician notification ensures monitoring and timely intervention if needed. Choice B is incorrect because it lacks the comprehensive approach of Choice A, omitting the importance of flossing and daily tongue checks. Choice C is incorrect as it dismisses the issue without providing any guidance on how to manage the side effect. Choice D is incorrect as it introduces irrelevant information about nasal inhalants that can confuse the patient and is not directly related to managing the white-coated tongue.

Correct Answer: B

Rationale: The correct answer is B: Self-injury or suicidal tendencies. This is because during the early stages of SSRI antidepressant therapy, there is an increased risk of suicidal ideation and behavior before the full therapeutic effects are achieved. This is known as the "suicidal ideation paradox." The other options are incorrect because hypertensive crisis is not a common side effect of SSRI therapy, extrapyramidal symptoms are typically associated with antipsychotic medications, and loss of appetite is a common side effect but not specific to the early stages of SSRI therapy.

Correct Answer: C

Rationale: The correct answer is C: Administer the furosemide in a separate intravenous line. This is the correct approach to prevent potential drug interactions between milrinone and furosemide. Mixing the two drugs in the same IV line can lead to incompatibility issues or chemical reactions that may reduce the effectiveness of both medications. Administering furosemide in a separate IV line ensures that each medication is delivered as intended without compromising their therapeutic effects. Additionally, this method reduces the risk of line contamination and minimizes the potential for errors in drug administration. Therefore, it is crucial for the nurse to follow this protocol to ensure the safety and efficacy of the patient's treatment.

Correct Answer: C

Rationale: The correct answer is C: lack of rebound congestion. Orally administered decongestants are less likely to cause rebound congestion compared to nasal sprays. This is because oral decongestants work systemically, targeting the whole body, whereas nasal sprays work locally, leading to potential rebound congestion when discontinued. Immediate onset (A) and potent effect (B) are not specific benefits of oral decongestants. Shorter duration (D) is also not a distinctive benefit of oral decongestants.

Correct Answer: B

Rationale: The correct answer is B: Oral. When a drug is administered orally, it passes through the gastrointestinal tract and then the liver before reaching systemic circulation, leading to the first-pass effect. This effect occurs because the liver metabolizes a portion of the drug before it reaches the bloodstream. Sublingual administration (choice A) bypasses the liver initially, reducing the first-pass effect. Intravenous (choice C) and intramuscular (choice D) routes also bypass the liver initially, thus reducing the first-pass effect compared to oral administration.