A patient tells the nurse she takes Advil PM (ibuprofen plus diphenhydramine) every night for sleep along with the use of CPAP for sleep apnea. She states that lately she is feeling "hung over" in the morning. What is the best response by the nu
1. "Are you using the CPAP regularly the way it was ordered?"
2. "That medication is not recommended for people with sleep apnea."
3. "That's a safe over-the-counter medication. What other meds do you take?"
4. "I will let the physician know so that she can order a new sleep study for you."
Answer: 2
Explanation: Diphenhydramine is contraindicated for patients with sleep apnea because it can increase severity of apnea and decrease the likelihood that the patient will awake with the apneic event. A new sleep study might be indicated at some point, but not as a first response. Diphenhydramine is not safe for this patient, and questioning the patient's adherence to treatment should not be the first response for this scenario.
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