A client with a history of chronic obstructive pulmonary disease receives a new prescription for a bronchodilator inhaler. Which statement by the client indicates correct understanding of the inhaler’s use?

If I have sudden shortness of breath, I will use this inhaler

When I cough up sputum, the secretions should be less thick

I should use this inhaler every day

I will use my other inhaler in between uses

Answer and Explanation

The Correct Answer is C

Choice A reason: Using a bronchodilator for sudden shortness of breath applies to rescue inhalers like albuterol, not maintenance bronchodilators (e.g., tiotropium) for COPD, which are used daily. This statement indicates misunderstanding, as maintenance inhalers prevent symptoms, not treat acute dyspnea.

Choice B reason: Thinner sputum is not a primary effect of bronchodilators, which relax airway smooth muscles to improve airflow in COPD. Mucolytics, not bronchodilators, reduce sputum viscosity. This statement reflects incorrect understanding, as bronchodilators target bronchoconstriction, not secretion consistency.

Choice C reason: Daily use of a maintenance bronchodilator, like tiotropium, is correct for COPD to prevent bronchospasm and maintain airway patency. This statement shows proper understanding, as consistent use reduces exacerbations and improves lung function, aligning with standard COPD management protocols.

Choice D reason: Using another inhaler between doses suggests confusion about maintenance versus rescue inhalers. Maintenance bronchodilators are used daily, not interspersed with others. This indicates misunderstanding, as proper scheduling is essential for effective COPD control with prescribed bronchodilators.

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Correct Answer is A

Explanation

Choice A reason: Frequent small meals reduce gastroesophageal reflux by minimizing gastric distension, which decreases pressure on the lower esophageal sphincter. This prevents acid reflux into the esophagus, alleviating heartburn and irritation, making it an effective dietary strategy for managing GERD symptoms.

Choice B reason: Switching to decaffeinated coffee and tea may reduce reflux triggers, as caffeine relaxes the lower esophageal sphincter. However, small meals are more effective, as they directly reduce gastric volume and sphincter pressure, providing broader symptom relief than caffeine avoidance alone.

Choice C reason: Avoiding milk and cream is relevant for some GERD patients, as high-fat foods delay gastric emptying, increasing reflux. However, frequent small meals address the root cause of reflux by reducing gastric pressure, making this a more universally effective strategy than specific food avoidance.

Choice D reason: Listing high-dairy snack foods reinforces avoidance but is less direct than recommending small meals. Dairy may trigger reflux in some, but frequent small meals broadly reduce gastric distension and sphincter pressure, offering a more immediate and effective GERD management strategy.

A. Platelet count B. International normalized ratio (INR) C. Hemoglobin level D. Serum potassium

Correct Answer is B

Explanation

Choice A reason: Platelet count assesses bleeding risk but does not measure warfarin’s anticoagulant effect. Warfarin inhibits clotting factors, monitored by INR. Platelet counts are relevant for antiplatelet drugs, not anticoagulants, making INR the priority for evaluating warfarin efficacy in atrial fibrillation.

Choice B reason: INR measures warfarin’s anticoagulant effect by assessing prothrombin time, reflecting vitamin K-dependent clotting factor inhibition. In atrial fibrillation, therapeutic INR (2.0–3.0) prevents thromboembolism. Monitoring INR ensures effective anticoagulation, making it the critical lab value for warfarin therapy management.

Choice C reason: Hemoglobin level detects bleeding, a warfarin side effect, but does not assess its therapeutic effect. INR directly evaluates anticoagulation, ensuring stroke prevention in atrial fibrillation. Hemoglobin is secondary, monitored for complications, not efficacy, making INR the priority lab value.

Choice D reason: Serum potassium is unrelated to warfarin’s anticoagulant action. Electrolyte imbalances may affect cardiac rhythm in atrial fibrillation, but INR measures warfarin’s effect on clotting factors, ensuring therapeutic anticoagulation, making it the essential value to monitor for medication efficacy.

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A client with a history of chronic obstructive pulmonary disease receives a new prescription for a bronchodilator inhaler. Which statement by the client indicates correct understanding of the inhaler’s use?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a client with gastroesophageal reflux disease about dietary modifications. Which instruction should the nurse include?

Correct Answer is A

Explanation

A client with a history of atrial fibrillation is prescribed warfarin. Which laboratory value should the nurse monitor to assess the medication’s effectiveness?

Correct Answer is B

Explanation

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