The nurse is observing a patient using a metered-dose inhaler (MDI) to aid in the management of chronic obstructive pulmonary disease (COPD). Which of the following actions, performed by the patient, indicate that further instruction is needed?

The patient shakes the MDI before using

The patient exhales before starting to use the MDI

The patient inspires rapidly when dispensing the medication from the MDI

The patient holds their breath for 10 seconds after inhaling from the MDI

Answer and Explanation

The Correct Answer is C

Choice A reason: Shaking the MDI before use is correct technique as it ensures that the medication is properly mixed.

Choice B reason: Exhaling before using the MDI is proper technique as it prepares the lungs for inhalation of the medication.

Choice C reason: Inspiring rapidly when dispensing the medication is incorrect because it can cause the medication to deposit in the mouth or throat rather than reaching the lungs.

Choice D reason: Holding the breath for 10 seconds after inhaling the medication is correct technique as it allows the medication to settle in the lungs.

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Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

A. Chronic renal disease B. Prolonged vomiting C. Hyperventilation D. Obstructive sleep apnea

Correct Answer is B

Explanation

Choice A reason: Chronic renal disease typically leads to metabolic acidosis, not alkalosis, due to the accumulation of acids that the kidney cannot excrete.

Choice B reason: Prolonged vomiting leads to the loss of hydrochloric acid from the stomach, which can result in metabolic alkalosis due to the imbalance caused by the loss of stomach acid.

Choice C reason: Hyperventilation leads to respiratory alkalosis due to the excessive exhalation of carbon dioxide, reducing hydrogen ion concentration in the blood.

Choice D reason: Obstructive sleep apnea is typically associated with respiratory acidosis, not metabolic alkalosis, due to episodes of hypoventilation during sleep.

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The nurse is observing a patient using a metered-dose inhaler (MDI) to aid in the management of chronic obstructive pulmonary disease (COPD). Which of the following actions, performed by the patient, indicate that further instruction is needed?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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