A client who is being discharged today is going home with an inhaler. The client is to administer 2 puffs of the inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the client to refill the medication?

6 weeks from the start of using the inhaler

As soon as the client leaves the hospital

50 days after discharge

When the inhaler is half empty

Answer and Explanation

The Correct Answer is C

A) 6 weeks from the start of using the inhaler: This option is not accurate. The timing for refilling should be based on the actual usage rather than a fixed period, and 6 weeks may not align with the client’s actual consumption.

B) As soon as the client leaves the hospital: This option is premature. The client does not need to refill the inhaler immediately upon discharge since they may not have used many puffs yet.

C) 50 days after discharge: This is the correct answer. If the client is to administer 2 puffs twice daily, that totals 4 puffs per day. With 200 puffs in the inhaler, the inhaler would last for 50 days (200 puffs ÷ 4 puffs per day = 50 days). Advising the client to refill the medication approximately 50 days after discharge ensures they have enough medication available.

D) When the inhaler is half empty: This option could lead to refilling too early or too late, depending on the individual’s usage pattern. Advising to refill based on a specific number of days or puffs used provides a more precise recommendation.

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Correct Answer is A

Explanation

A. "I should wait 20 to 30 seconds between puffs and 2 to 5 minutes between inhalations of different medications. I should administer the inhaled steroids first followed by the bronchodilator."

Explanation:

Inhaled bronchodilators (such as albuterol) should be administered before inhaled steroids (such as fluticasone). This is because bronchodilators help open up the airways, allowing better delivery of the steroid medication to the lungs.
Steroids should not be given first because they are not effective in immediately opening the airways, which can reduce the effectiveness of the steroid if given before a bronchodilator.

Here’s a breakdown of the other options, which are correct:

B: Correct. The proper technique is to remove the mouthpiece cover, shake the inhaler well (2 to 5 seconds), and then insert the inhaler into the spacer.
C: Correct. Rinsing the mouth with warm water and spitting it out after using an inhaled steroid is important to prevent oral thrush (a fungal infection).
D: Correct. The proper technique involves closing the mouth around the spacer mouthpiece, pressing the MDI to release the medication, inhaling slowly and deeply for about 5 seconds, and holding the breath for about 10 seconds to allow for better absorption.

Thus, A is the statement that requires further teaching because the client has the incorrect sequence of medication administration (steroid first, bronchodilator second).

A. apply it behind the ear. B. place it over a hairy skin area. C. rotate sites to avoid skin irritation. D. put the initials on patch when applied.

Correct Answer is C

Explanation

A) Apply it behind the ear: This option is not correct. Nitroglycerin patches are typically applied to hairless areas of the skin to ensure proper adhesion and absorption. The preferred locations are usually the chest, upper arm, or thigh.

B) Place it over a hairy skin area: This action is inappropriate as hair can interfere with the adhesion of the patch and may affect absorption. It is essential to apply the patch to a clean, dry, and hairless area for optimal effectiveness.

C) Rotate sites to avoid skin irritation: This is the correct action. Rotating the application site helps prevent skin irritation and allows for better absorption of the medication. It also reduces the risk of sensitization or reaction at any one site.

D) Put the initials on the patch when applied: While documenting the application is important, simply putting initials on the patch is not sufficient for ensuring proper administration. It is more crucial to ensure that the patch is applied correctly, and monitoring for skin integrity and effectiveness should be part of the nursing care plan.

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A client who is being discharged today is going home with an inhaler. The client is to administer 2 puffs of the inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the client to refill the medication?

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Naxlex Comprehensive Predictor Exams

The nurse is teaching the client how to use an MDI with a spacer device. Which statement, if made by the client, indicates further teaching is required?

Correct Answer is A

Explanation

A client has an order for a nitroglycerin transdermal patch. The best way to ensure proper administration of this medication is to:

Correct Answer is C

Explanation

The UAP reports the client is complaining of dizziness and nausea after the administration of eardrops. What is the most likely cause of the dizziness?

A client who is being discharged today is going home with an inhaler. The client is to administer 2 puffs of the inhaler twice daily. The inhaler contains 200 puffs. When should the nurse appropriately advise the client to refill the medication?

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