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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Transparent dressings are semi-permeable, suitable for superficial wounds with minimal exudate. Stage 3 pressure injuries, with deeper tissue damage and granulation, require moisture-retentive dressings to support healing. Transparent dressings may not provide the moist environment needed for optimal granulation tissue formation and epithelialization in deeper wounds.
Choice B reason: Hydrocolloid gel dressings maintain a moist wound environment, ideal for stage 3 pressure injuries with granulation tissue. They promote autolytic debridement, support epithelialization, and protect the wound. This is the best choice, as gauze may adhere to granulation tissue, causing trauma during removal, unlike hydrocolloids, which foster healing.
Choice C reason: Leaving the dressing off exposes the wound to infection and drying, which impairs granulation tissue and delays healing. Stage 3 pressure injuries require a moist, protected environment. Consulting the provider may be appropriate for complex cases, but immediate dressing application is standard to maintain optimal wound conditions.
Choice D reason: Increasing dressing change frequency may disrupt granulation tissue and delay healing, especially with gauze, which can adhere to the wound bed. Stage 3 pressure injuries benefit from stable, moist environments provided by advanced dressings like hydrocolloids, not frequent changes that risk trauma and infection.
Correct Answer is A
Explanation
Choice A reason: Sexual dysfunction is a common SSRI side effect, as increased serotonin inhibits sexual arousal and orgasm. Monitoring is critical, as it affects adherence in depression treatment, requiring dose adjustments or alternative therapies, making it the priority side effect to assess.
Choice B reason: Hypotension is less common with SSRIs, though orthostatic changes may occur. Sexual dysfunction is more frequent, impacting quality of life and treatment adherence in depression, making it the priority to monitor, as it directly affects patient compliance and outcomes.
Choice C reason: Hyperglycemia is not a typical SSRI side effect, though metabolic changes are rare. Sexual dysfunction is a prevalent issue, reducing adherence in depression treatment, making it the priority to monitor, as it significantly impacts patient satisfaction and therapy continuation.
Choice D reason: Peripheral edema is rare with SSRIs, which primarily affect serotonin pathways. Sexual dysfunction is a common side effect, compromising adherence in depression management, making it the priority to monitor, as it directly influences treatment success and patient well-being.
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