A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device.
Which statement indicates that the client understands the instructions for using this medication?
"If I have sudden shortness of breath, I will use this inhaler."
"When I cough up sputum, the secretions should be less thick."
"I will use my other inhaler in between uses."
"I should use this medication in its handihaler every day."
The Correct Answer is D
Choice A rationale:
Tiotropium is a long-acting bronchodilator, not a rescue inhaler for sudden shortness of breath.
It takes several hours to reach its full effect and is not designed to provide immediate relief during acute symptoms.
Using tiotropium for sudden shortness of breath could delay the use of a more appropriate rescue medication, potentially worsening the situation.
Choice B rationale:
While tiotropium can help reduce mucus production and make secretions easier to clear, this is not its primary mechanism of action.
The client's statement focuses on a potential side effect rather than demonstrating a clear understanding of the medication's intended purpose.
Choice C rationale:
The frequency of inhaler use depends on the specific medications prescribed. Some inhalers are used daily, while others are used only as needed for symptoms.
It's essential to follow the healthcare provider's instructions for each inhaler to ensure proper use and avoid potential drug interactions.
Choice D rationale:
This statement correctly reflects the appropriate use of tiotropium.
It's typically taken once daily via a handihaler device to maintain open airways and prevent COPD symptoms. Regular daily use is crucial for optimal effectiveness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Hypothermia is a condition in which the body's core temperature falls below 95°F (35°C). It is not directly indicated by the client's vital signs as presented in the question.
Other factors that would more strongly suggest hypothermia include exposure to cold environments, immersion in cold water, or impaired thermoregulation due to conditions like hypothyroidism or alcohol intoxication.
Choice C rationale:
Hypotension is a condition in which blood pressure is abnormally low. It is also not directly indicated by the client's vital signs as presented in the question.
Hypertension, on the other hand, is a condition in which blood pressure is abnormally high.
The client's history of hypertension, and the fact that he takes enalapril (an antihypertensive medication), suggests that he may be more likely to experience hypertension than hypotension.
Choice D rationale:
Hypertension, as mentioned above, is a condition in which blood pressure is abnormally high.
While it's possible that the client is experiencing hypertension, the question specifically asks about the condition indicated by the client's vital signs.
Tachypnea, or rapid breathing, is a more direct indication of the client's respiratory distress, which is a common symptom of pneumonia.
Choice B rationale:
Tachypnea is the most likely condition indicated by the client's vital signs.
Tachypnea is often a sign of respiratory distress, which can be caused by a variety of conditions, including pneumonia. When a person has pneumonia, their lungs become inflamed and filled with fluid, making it difficult to breathe.
This can lead to rapid, shallow breathing, which is called tachypnea.
Other signs of respiratory distress that may be present in a client with pneumonia include: Coughing
Wheezing Chest pain
Feeling short of breath
Use of accessory muscles to breathe (e.g., muscles in the neck and chest) Nasal flaring
Cyanosis (a bluish tint to the skin)
Correct Answer is B
Explanation
Choice A rationale:
Hemoccult test on sputum collected from hemoptysis is not a diagnostic test for TB. It is a test for blood in the stool, which can be a symptom of TB but is not specific to TB.
Hemoptysis, or coughing up blood, can occur in various conditions, including bronchitis, pneumonia, lung cancer, and TB. The Hemoccult test cannot differentiate between these causes, making it an unreliable test for diagnosing TB.
Choice B rationale:
Sputum culture positive for Mycobacterium tuberculosis is the definitive diagnostic test for TB.
It involves collecting a sample of sputum, which is the mucus coughed up from the lungs, and culturing it in a laboratory to see if Mycobacterium tuberculosis, the bacteria that causes TB, grows.
This test is highly specific for TB, meaning that a positive result is almost always indicative of TB infection. It is also sensitive, meaning that it can detect TB infection even when there are few bacteria present.
Choice C rationale:
Positive purified protein derivative (PPD) skin test indicates exposure to TB but does not confirm active infection.
The PPD skin test involves injecting a small amount of tuberculin, a protein derived from Mycobacterium tuberculosis, into the skin.
If a person has been exposed to TB, their immune system will react to the tuberculin, causing a raised red bump to appear at the injection site.
However, a positive PPD skin test does not necessarily mean that a person has active TB infection.
It could also mean that they have been exposed to TB in the past but have successfully fought off the infection. Further testing, such as a sputum culture, is needed to confirm the diagnosis of TB.
Choice D rationale:
Chest X-ray or computed tomography (CT) can show abnormalities in the lungs that are suggestive of TB, but they cannot definitively diagnose TB.
These imaging tests can reveal changes in the lungs, such as nodules, inflammation, or fluid buildup, which can be caused by TB or other conditions.
Therefore, a chest X-ray or CT scan alone is not sufficient to diagnose TB. A sputum culture is still needed to confirm the diagnosis.
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