The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? (Select all that apply)

I will use this inhaler for asthma attacks.

I will clean the plastic inhaler casing weekly by removing the canister and then washing the casing in warm soapy water. I will then let it dry before reassembling.

I will rinse my mouth with water after using the inhaler and then spit out the water.

I will gargle after using the inhaler and then swallow.

Answer and Explanation

Correct Answer : A,D

Choice A reason: Using a corticosteroid inhaler like fluticasone for asthma attacks is incorrect. Corticosteroids reduce inflammation over days, not immediately, and are for maintenance. Acute attacks require short-acting beta-agonists like albuterol for rapid bronchodilation, indicating a need for further patient education on inhaler roles.

Choice B reason: Cleaning the inhaler casing weekly with warm soapy water is correct. This prevents drug residue buildup, ensuring proper dose delivery and reducing infection risk. Removing the canister and drying the casing properly maintains inhaler function, reflecting appropriate understanding of maintenance.

Choice C reason: Rinsing the mouth with water and spitting it out after using a corticosteroid inhaler is correct. This removes residual drug, preventing oral candidiasis by reducing fungal growth in the oral cavity. It reflects proper understanding of post-inhalation hygiene, requiring no further instruction.

Choice D reason: Gargling and swallowing after using a corticosteroid inhaler is incorrect. Swallowing residual corticosteroid can increase systemic absorption, raising the risk of side effects like adrenal suppression. Rinsing and spitting out is necessary to minimize oral thrush and systemic effects, indicating a need for correction.

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Correct Answer is A

Explanation

Choice A reason: Nystatin lozenges must dissolve slowly in the mouth to ensure prolonged contact with oral mucosa, effectively treating candidiasis by disrupting fungal cell membranes. Slow dissolution maximizes local antifungal activity, targeting Candida albicans in the oral cavity, a common complication of inhaled corticosteroid use.

Choice B reason: Rinsing the mouth with water before using an inhaler is appropriate for corticosteroids to prevent thrush but is irrelevant for nystatin lozenges. Nystatin treats existing oral candidiasis, and rinsing beforehand may reduce its contact time with affected mucosa, decreasing efficacy.

Choice C reason: Rinsing with mouthwash after an inhaler is not standard for nystatin or corticosteroid use. Mouthwash may contain alcohol, irritating oral mucosa or reducing nystatin’s antifungal effect. Rinsing with water after corticosteroids prevents thrush, but this instruction is misapplied to nystatin lozenges.

Choice D reason: Chewing nystatin lozenges is incorrect, as it reduces contact time with oral mucosa, decreasing antifungal efficacy. Swallowing the drug shifts its action to the gastrointestinal tract, ineffective for oral candidiasis. Slow dissolution ensures targeted treatment of Candida in the mouth, preventing recurrence.

A. Resistance of the pneumonia-causing bacteria to the drugs B. Large doses of antibiotics that kill normal vaginal flora C. The infection spreads from the lungs to the new site of infection D. An allergic reaction to the antibiotics

Correct Answer is B

Explanation

Choice A reason: Resistance of pneumonia-causing bacteria does not cause vaginal yeast infections. Resistance reduces antibiotic efficacy against the target pathogen, but yeast infections result from disruption of vaginal flora, allowing Candida overgrowth, not from bacterial resistance in the lungs.

Choice B reason: Antibiotics, especially broad-spectrum ones, kill normal vaginal flora like Lactobacillus, which maintain an acidic environment inhibiting Candida albicans. This disruption allows yeast overgrowth, causing vaginal candidiasis, a common side effect of antibiotic therapy for infections like pneumonia, requiring antifungal treatment.

Choice C reason: Pneumonia pathogens do not spread to cause vaginal yeast infections. Candida, a fungal organism, causes yeast infections due to flora imbalance, not bacterial spread from the lungs. Pneumonia and vaginal infections have distinct etiologies, making this an incorrect cause.

Choice D reason: An allergic reaction to antibiotics may cause rashes or anaphylaxis but not vaginal yeast infections. Yeast infections result from microbial imbalance, not immune-mediated hypersensitivity. Candida overgrowth is a microbial, not allergic, response to antibiotic-induced flora disruption.

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The nurse is providing instructions to a patient who has a new prescription for a corticosteroid metered-dose inhaler. Which statement by the patient indicates that further instruction is needed? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is taking nystatin oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?

Correct Answer is A

Explanation

During antibiotic therapy for pneumonia, a female patient develops a vaginal yeast infection. What caused this?

Correct Answer is B

Explanation

When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food?

A 79-year-old patient is receiving levofloxacin as treatment for a complicated infection. The nurse will monitor for which adverse effect that is associated with this drug?

A patient is taking a combination of antiviral drugs as treatment for early stages of a viral infection. While discussing the drug therapy, the patient asks the nurse if the drugs will kill the virus. When answering, the nurse keeps in mind which fact about antiviral drugs?

The nurse is caring for a client receiving an intravenous heparin infusion. The client has a new prescription for warfarin and asks the nurse why he has to be on two medications. What response by the nurse is appropriate?

After receiving a nebulizer treatment with albuterol, the patient states she is feeling slightly jittery and wonders if she is having a bad reaction. What is the nurse’s best response?

The nurse is reviewing chloroquine with a patient and instructs the patient to watch for and report which potential adverse reactions?

Which of the following antibiotics is known to cause photosensitivity?

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