A client with chronic obstructive pulmonary disease receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Primes the inhaler with 7 pumps

Attaches spacer device to the inhaler

Stores the medication at room temperature

Rinses the mouth after each use

Answer and Explanation

The Correct Answer is A

Choice A reason: Priming an ipratropium inhaler typically requires 2 pumps, not 7, to ensure proper dosing. Excessive priming wastes medication and may reduce the inhaler’s lifespan. This action indicates misunderstanding of device preparation, necessitating further teaching to ensure effective administration and therapeutic outcomes.

Choice B reason: Attaching a spacer device enhances ipratropium delivery by improving aerosol deposition in the lungs, especially in COPD patients with poor inhalation technique. This is correct, as spacers reduce oropharyngeal deposition, minimizing side effects and maximizing bronchodilation, requiring no additional teaching.

Choice C reason: Storing ipratropium at room temperature is correct, as extreme temperatures can degrade the medication’s efficacy. This action aligns with manufacturer guidelines, ensuring the inhaler’s stability and effectiveness, indicating proper understanding and eliminating the need for further teaching on storage.

Choice D reason: Rinsing the mouth after ipratropium use is appropriate, as it reduces local side effects like dry mouth or throat irritation from residual medication. This correct action prevents complications, showing proper technique and understanding, so no additional teaching is required for this step.

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Correct Answer is A

Explanation

Choice A reason: Rinsing the mouth after using a corticosteroid inhaler prevents oral candidiasis, a common side effect from residual steroid deposition. This ensures safe asthma management, as fungal infections compromise adherence and health, making it the priority teaching point for proper inhaler use.

Choice B reason: Using the inhaler only during asthma attacks applies to rescue inhalers, not maintenance corticosteroids, which are used daily. This is incorrect, as rinsing the mouth is essential for corticosteroid inhalers to prevent oral thrush, ensuring safe and effective asthma control.

Choice C reason: Storing inhalers in a refrigerator is unnecessary and may degrade some medications. Room-temperature storage is standard. Rinsing the mouth after corticosteroid inhaler use is critical to prevent oral candidiasis, making it the priority teaching point for asthma management.

Choice D reason: Shaking the inhaler only once may be insufficient for proper aerosolization in some devices. Rinsing the mouth after corticosteroid inhaler use is the priority, as it prevents oral thrush, a significant side effect, ensuring safe and consistent asthma therapy.

A. Chest x-ray B. Electrocardiogram C. D-dimer blood test D. Arterial blood gas

Correct Answer is C

Explanation

Choice A reason: Chest x-ray may show nonspecific findings in pulmonary embolism but is not diagnostic. D-dimer, a fibrin degradation product, is highly sensitive for detecting thrombosis, guiding further imaging like CT pulmonary angiography, making it the priority test in suspected cases.

Choice B reason: Electrocardiogram may show tachycardia or right heart strain in pulmonary embolism but is nonspecific. D-dimer is a sensitive screening test, indicating clot presence, which prompts definitive imaging, making it the preferred initial diagnostic step in suspected pulmonary embolism.

Choice C reason: D-dimer blood test is the most sensitive screening tool for pulmonary embolism, detecting fibrin degradation from clots. Elevated levels prompt CT pulmonary angiography for confirmation, guiding urgent treatment to prevent further embolization, making it the critical test to anticipate.

Choice D reason: Arterial blood gas may reveal hypoxemia in pulmonary embolism but is nonspecific, as other conditions cause similar findings. D-dimer is more diagnostic, identifying clot presence, guiding imaging, and ensuring timely intervention, making it the priority test in suspected cases.

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A client with chronic obstructive pulmonary disease receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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