43. A nurse is reinforcing teaching about use of a metered-dose inhaler (MDI) with a client who has a new diagnosis of asthma. Identify the sequence the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)

Shake the canister 3 to 5 seconds vigorously.

Place her lips firmly around the mouthpiece.

Inhale slowly over 3 to 5 seconds while pushing down on the canister.

Hold her breath for 10 seconds.

Exhale slowly through pursed lips.

Answer and Explanation

The Correct Answer is A, B, C, D, E

A.   Shake the canister 3 to 5 seconds vigorously.
Before each use, it's important to shake the MDI to ensure proper mixing of the medication.
B.   Place her lips firmly around the mouthpiece.
Creating a tight seal around the mouthpiece ensures that the medication is delivered directly into the airways.
C.   Inhale slowly over 3 to 5 seconds while pushing down on the canister.
While pressing down on the canister, the client should inhale slowly to allow the medication to reach the lungs.
D.   Hold her breath for 10 seconds.
After inhaling the medication, holding the breath for 10 seconds allows for better absorption of the medication into the lungs.
E.   Exhale slowly through pursed lips.
After holding the breath, exhaling slowly through pursed lips helps to fully exhale and ensures that the medication remains in the airways.

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Correct Answer is ["A","B","C","D"]

Explanation

HR: 110 bpm; regular - The heart rate has decreased from 115 bpm and is now regular, suggesting improved cardiac rhythm stability.

RR: 24 breaths/min; rapid, deep - The respiratory rate has decreased from 26 breaths/min, indicating less rapid breathing.

BP: 94/56 mm Hg - While the blood pressure remains relatively low, there is a slight improvement compared to the previous reading.

Glucose 460 mg/dl - The glucose level has decreased from 525 mg/dL and 530 mg/dL in previous readings. While still elevated, this indicates some improvement in hyperglycemia.

A. A 35-year-old patient using the incentive spirometer following abdominal surgery B. A 55-year-old patient who is eating in the chair following a rhinoplasty C. A 40-year-old patient who refuses to cough and deep breath following a splenectomy D. A24-year-old patient ambulating in the hall following an appendectomy

Correct Answer is C

Explanation

C. This patient is at high risk for hospital-acquired pneumonia. After a splenectomy (removal of the spleen), patients may experience pain and discomfort, which can make them reluctant to perform necessary activities like coughing and deep breathing. These activities are crucial for preventing lung complications such as atelectasis and pneumonia.
A. This patient is actively using an incentive spirometer, which is a device that encourages deep breathing and helps keep the lungs clear. This practice significantly reduces the risk of developing pneumonia by preventing atelectasis (collapse of part of the lung) and promoting lung expansion.

B. This patient is out of bed and eating, which indicates they are relatively mobile and maintaining normal respiratory function. Rhinoplasty, a surgical procedure on the nose, generally does not impair lung function or significantly increase the risk of pneumonia. Being active and upright further reduces the risk of HAP.
D. This patient is actively ambulating, which is highly beneficial for lung function and overall recovery. Walking and moving around helps to prevent respiratory complications, including pneumonia, by promoting lung expansion and circulation.

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43. A nurse is reinforcing teaching about use of a metered-dose inhaler (MDI) with a client who has a new diagnosis of asthma. Identify the sequence the client should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","C","D"]

Explanation

Which patient does the LPN/LVN identify at high risk for hospital-acquired pneumonia?

Correct Answer is C

Explanation

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