A patient with Chronic Obstructive Pulmonary Disease (COPD), who smokes two packs of cigarettes daily and is hospitalized due to a respiratory infection, reports difficulty managing respiratory distress at home when using the rescue inhaler.
Which statement from the patient suggests to the nurse that the inhaler is not being used correctly?

“I never use the inhaler unless I am really short of breath.”.

“I have a hard time inhaling and holding my breath after I squeeze the inhaler, but I do my best.”.

“After I squeeze the inhaler and swallow, I always feel a slight wave of nausea, but it goes away.”.

“I always shake the inhaler several times before I start.”.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Using the inhaler only when the patient is really short of breath is not an incorrect use of the inhaler. However, it might indicate that the patient is not managing their COPD effectively, as rescue inhalers like albuterol are meant to be used for quick relief of acute symptoms.

Choice B rationale

Having a hard time inhaling and holding the breath after squeezing the inhaler might suggest that the patient is not using the inhaler correctly. However, the patient’s statement that they “do their best” suggests that they are aware of the correct technique and are trying to follow it.

Choice C rationale

Swallowing after squeezing the inhaler is a clear indication of incorrect use. The medication from the inhaler is meant to be inhaled into the lungs, not swallowed. Swallowing the medication would lead to less of it reaching the lungs, reducing its effectiveness. The wave of nausea the patient experiences could be a side effect of swallowing the medication.

Choice D rationale

Shaking the inhaler several times before starting is actually part of the correct technique for using many types of inhalers.

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Correct Answer is B

Explanation

Choice A rationale

Hematocrit is a measure of the proportion of red blood cells in the blood. While it can be affected by various conditions, it is not the most relevant lab value to check when purulent drainage is noticed at a postoperative patient’s dressing site.

Choice B rationale

Neutrophil count is a measure of the number of neutrophils, a type of white blood cell, in the blood. An elevated neutrophil count can indicate an infection, making it the most relevant lab value to check in this scenario.

Choice C rationale

Platelet count is a measure of the number of platelets in the blood. While platelets play a crucial role in blood clotting, they are not directly related to infection and therefore not the most relevant lab value to check in this scenario.

Choice D rationale

Serum sodium level is a measure of the amount of sodium in the blood. While it can be affected by various conditions, it is not the most relevant lab value to check when purulent drainage is noticed at a postoperative patient’s dressing site.

A. Frequency that the problem occurs. B. Related personal values. C. Relevance to the situation. D. Past experience with similar problems.

Correct Answer is C

Explanation

Choice A rationale

While the frequency of a problem can provide some context, it is not the most important consideration when gathering evidence for evidence-based decision-making. The frequency of a problem does not necessarily correlate with the quality or relevance of the evidence available.

Choice B rationale

Personal values are important in decision-making processes, but they are subjective and can vary greatly among individuals. Therefore, they are not the most important consideration when gathering objective, scientific evidence for evidence-based practice.

Choice C rationale

Relevance to the situation is the most important consideration when gathering evidence. Evidence must be directly applicable to the specific problem and context in order to be useful in informing decision-making. This includes considering the specific characteristics of the patient population, the nature of the problem, and the setting in which care is being provided.

Choice D rationale

Past experience with similar problems can provide valuable insights and context, but it is not the most important consideration. Past experiences are individual and subjective, and what worked in one situation may not work in another. Evidence-based practice requires the use of current, high-quality research evidence, which may or may not align with past experiences.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While changing a postoperative patient’s dressing, the nurse notices purulent drainage at the site.Before reporting this to the healthcare provider, which of the patient’s lab values should the nurse check?

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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What nursing interventions are appropriate for a client starting clonazepam? Select all that apply.

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