A client newly diagnosed with asthma is being given discharge instructions. The nurse works collaboratively with the client, instructing the client to use a metered dose inhaler (MDI). What is the first priority and last priority step in the procedure?

Hold breath for 5 seconds and exhale / shake inhaler.

Place mouthpiece in mouth / exhale slowly and completely.

Press and hold the canister down while inhaling deeply and slowly / exhale slowly and completely.

Remove cap from inhaler and shake inhaler / rinse your mouth, gargle, spit out.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Holding your breath for 5 seconds and exhaling is not the first step in using an MDI. Shaking the inhaler is necessary to ensure the medication is properly mixed, but it should be done after removing the cap.

Choice B reason:

Placing the mouthpiece in the mouth and exhaling slowly and completely is an important step, but it is not the first priority. Exhaling fully before inhaling the medication helps ensure that the medication reaches deep into the lungs.

Choice C reason:

Pressing and holding the canister down while inhaling deeply and slowly is a crucial step in using an MDI, but it is not the first step. This action releases the medication into the lungs.

Choice D reason:

Removing the cap from the inhaler and shaking it is the first priority step. This ensures the medication is ready for use. Rinsing your mouth, gargling, and spitting out after using the inhaler is the last priority step to prevent oral thrush and other side effects.

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

Explanation

Choice A reason:

Avoiding playing with the grandchildren is not necessary for clients with emphysema. While it is important to avoid strenuous activities that can exacerbate symptoms, engaging in light activities and spending time with family can improve mental health and overall well-being.

Choice B reason:

Small frequent meals are recommended for clients with emphysema. Eating smaller meals more frequently can help prevent bloating and discomfort, which can make breathing more difficult. This approach also ensures that the client maintains adequate nutrition without overexerting themselves during meals.

Choice C reason:

Proper use of home oxygen as prescribed is crucial for clients with emphysema. Oxygen therapy can help maintain adequate oxygen levels in the blood, reduce shortness of breath, and improve overall quality of life. Clients should be educated on how to use their oxygen equipment correctly and consistently.

Choice D reason:

Smoking cessation is the most important step for clients with emphysema. Smoking is the primary cause of emphysema, and quitting smoking can slow the progression of the disease, improve lung function, and enhance overall health. Support and resources for smoking cessation should be provided.

Choice E reason:

The importance of a regular exercise program cannot be overstated for clients with emphysema. Regular exercise, particularly pulmonary rehabilitation programs, can improve lung function, increase endurance, and enhance the ability to perform daily activities. Exercise programs should be tailored to the client’s abilities and limitations.

A. Bronchitis B. A pneumothorax C. Asthma D. Emphysema

Correct Answer is A

Explanation

Choice A reason: Fine crackles are often associated with bronchitis, particularly chronic bronchitis. These sounds are caused by the presence of mucus in the airways, which creates a crackling noise when air passes through. Chronic bronchitis involves inflammation and increased mucus production in the bronchi, leading to these characteristic lung sounds.

Choice B reason: A pneumothorax, or collapsed lung, typically presents with absent or diminished breath sounds on the affected side rather than fine crackles. The absence of breath sounds is due to the lack of air movement in the collapsed portion of the lung. Fine crackles are not a common finding in pneumothorax.

Choice C reason: Asthma is characterized by wheezing, which is a high-pitched whistling sound caused by narrowed airways. While crackles can occasionally be heard in asthma, they are not the primary lung sound associated with this condition. Wheezing is more indicative of asthma due to bronchoconstriction and inflammation.

Choice D reason: Emphysema, a form of chronic obstructive pulmonary disease (COPD), typically presents with decreased breath sounds and prolonged expiration rather than fine crackles. The destruction of alveolar walls in emphysema leads to reduced lung sounds overall. Fine crackles are not a hallmark of emphysema.

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A client newly diagnosed with asthma is being given discharge instructions. The nurse works collaboratively with the client, instructing the client to use a metered dose inhaler (MDI). What is the first priority and last priority step in the procedure?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client recently diagnosed with emphysema. What information, regarding health maintenance, would the nurse include in teaching sessions? (SELECT ALL THAT APPLY)

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

Explanation

The nurse is assessing the client and notes fine crackles throughout the lungs bilaterally. This assessment finding is often associated with:

Correct Answer is A

Explanation

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The experienced nurse understands that the student nurse may require additional instruction regarding proper respiratory assessment techniques when the nurse observes the student: (SELECT ALL THAT APPLY)

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