The client with COPD is prescribed salmeterol diskus inhaler and fluticasone rotadisk inhaler. Which instruction should the nurse include to prevent the client from developing oropharyngeal candidiasis?
"Drink a glass of water before taking your medications."
"Rinse your mouth after using your inhaler medications."
"Wait at least one minute before taking the next medication."
"Close your mouth tightly around the inhaler."
The Correct Answer is B
A. "Drink a glass of water before taking your medications.": Drinking water before inhalation is not the primary preventive step for thrush.
B. "Rinse your mouth after using your inhaler medications.": Rinsing and spitting after inhaled corticosteroids (fluticasone) reduces residual steroid in the oropharynx and lowers the risk of oropharyngeal candidiasis.
C. "Wait at least one minute before taking the next medication.": Waiting between puffs of bronchodilator doses is appropriate, but this instruction doesn’t specifically prevent thrush from inhaled steroids.
D. "Close your mouth tightly around the inhaler.": Proper inhaler technique varies by device; while a good seal is important for some inhalers, it does not replace rinsing to prevent candidiasis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "The medication should stop the pain right away": Famotidine reduces acid production but does not provide immediate pain relief like antacids might.
B. "The medication coats the lining of my stomach.": Coating agents (sucralfate, bismuth) coat the mucosa; famotidine is an H2 blocker that decreases acid secretion.
C. "I will monitor for bleeding from my nose.": Nosebleeds are not a typical effect to monitor specifically with famotidine.
D. "I will take my pill 1 hour before meals.": Taking an H2 blocker before meals can reduce meal-stimulated acid secretion and is appropriate patient teaching.
Correct Answer is A
Explanation
A. Metformin (Glucophage), a sulfonylurea decreases hepatic glucose production: Metformin is a biguanide, not a sulfonylurea. Metformin is generally held perioperatively (and around contrast or if renal function may be impaired) because of the rare risk of lactic acidosis and because fasting/contrast/renal changes increase that risk.
B. Bisacodyl (Dulcolax) a cathartic laxative: Acceptable pre-op in some cases (stool evacuation may be desired for bowel surgery), not the highest immediate concern.
C. Clopidogrel (Plavix) a platelet aggregate inhibitor: Might be held depending on bleeding risk, but it's not automatically contraindicated unless specified by the surgical team.
D. Ticarcillin (Timentin), an extended-spectrum antibiotic: Antibiotics are often continued or given perioperatively per surgical prophylaxis orders; not automatically contraindicated.
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