Counselling, OTC and triage
Practice questions with explanations

D. Use plain language, limit to a few key points, use teach-back to confirm understanding, and provide simple written or pictorial support

Teach-back, asking the person to explain in their own words what they will do, reliably reveals misunderstandings that a yes-or-no question misses, and it frames any gap as the explainer's failure rather than the patient's. Limiting to two or three points per encounter respects how much anyone retains from a single conversation.

A. Assess for red flags and consider referral, since chronic cough in a smoker warrants investigation and is an opportunity to discuss cessation

Normalising a smoker's cough delays diagnosis of lung cancer and COPD, both of which present this way. A cough lasting more than three weeks, haemoptysis, weight loss or breathlessness warrants assessment. The conversation is also one of the most effective moments to raise cessation, since a symptom makes the issue concrete.

A. Rebound congestion, rhinitis medicamentosa, develops with continued use

Continued alpha-adrenergic stimulation leads to receptor downregulation and reactive vasodilation, so congestion returns worse each time the drug wears off and the patient uses more. Breaking the cycle requires stopping the spray, which is uncomfortable, sometimes with a saline or intranasal corticosteroid bridge. The usual limit given at the counter is three to five days.