A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
Rinses the mouth after each use.
Stores the medication at room temperature.
Attaches a spacer device to the inhaler.
Primes the inhaler with 7 pumps.
The Correct Answer is D
Choice A reason:
Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.
Choice B reason:
Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.
Choice C reason:
Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.
Choice D reason:
Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Phenazopyridine does not eliminate urinary bacteria. It is not an antibiotic and does not have antibacterial properties. Instead, it is used to relieve symptoms such as pain, burning, and discomfort caused by irritation of the urinary tract. Therefore, this choice is incorrect.
Choice B reason:
Using phenazopyridine after voiding or after sexual intercourse is not a standard recommendation. This medication is typically taken after meals to reduce stomach upset. It is not specifically indicated for use after sexual intercourse, and this choice does not align with the typical usage instructions for phenazopyridine.
Choice C reason:
Phenazopyridine does not calm spasms in the urinary tract. Its primary function is to provide symptomatic relief from pain, burning, and discomfort in the urinary tract. It does not have antispasmodic properties, so this choice is also incorrect.
Choice D reason:
Phenazopyridine provides an analgesic effect for irritated bladder mucosa. It works by numbing the lining of the urinary tract, which helps to alleviate pain and discomfort associated with conditions like cystitis. This is the correct therapeutic effect of the medication.

Correct Answer is C
Explanation
Choice A reason: Administering potassium is not the primary action for treating digoxin toxicity. While hypokalemia can exacerbate digoxin toxicity, the initial step is to assess and stabilize the patient’s overall condition, including acid-base and electrolyte balance. Potassium administration may be considered if hypokalemia is present, but it is not the first-line treatment.
Choice B reason: Cardioversion is not typically used to treat digoxin toxicity. Digoxin toxicity can cause various arrhythmias, but the treatment focuses on stabilizing the patient and addressing the toxicity itself2. Cardioversion may be considered in life-threatening arrhythmias, but it is not the primary intervention.
Choice C reason: Checking acid-base and electrolyte values is crucial in managing digoxin toxicity. Digoxin toxicity can lead to electrolyte imbalances, particularly hyperkalemia, which can be life-threatening. Assessing and correcting these imbalances is essential for stabilizing the patient and preventing further complications.
Choice D reason: Giving digoxin by another route to slow absorption is not an appropriate action. The primary treatment for digoxin toxicity involves stopping the medication and administering digoxin-specific antibody fragments (Fab) if necessary. These antibodies bind to digoxin, neutralizing its effects and allowing for its excretion.
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