The patient has a prescription for a medication that is administered via an inhaler. Which of the following will allow the nurse to determine whether the patient requires a spacer for the inhaler?
The dosage of medication required
The coordination of the patient
The schedule of administration
The use of a dry powder inhaler
The Correct Answer is B
A. The dosage of medication required: The dose of the medication does not determine whether a spacer is needed. Spacers assist with delivery and coordination, not with altering the prescribed dose.
B. The coordination of the patient: Proper use of a metered-dose inhaler requires the patient to coordinate pressing the canister and inhaling simultaneously. Patients with impaired hand-lung coordination, such as older adults, children, or those with neurological deficits, may benefit from a spacer, which allows the medication to be inhaled more effectively without precise timing.
C. The schedule of administration: The frequency or timing of medication administration does not impact the need for a spacer. Scheduling affects adherence but not the technical requirement for improved inhalation technique.
D. The use of a dry powder inhaler: Dry powder inhalers do not require a spacer because the medication is activated by the patient’s inspiratory effort. Spacers are specifically used with metered-dose inhalers to improve drug delivery when coordination is limited.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. 90 degrees: The recommended angle for subcutaneous injection using an insulin pen is typically 90 degrees, especially with short needles (4–8 mm). This angle ensures the medication is delivered into the subcutaneous tissue rather than intradermally or intramuscularly, which could alter absorption and efficacy.
B. 45 degrees: A 45-degree angle may be used in patients with very little subcutaneous tissue or when using longer needles to avoid intramuscular injection. However, with most insulin pen needles today, 90 degrees is standard practice.
C. It doesn’t matter: The injection angle is critical for ensuring proper subcutaneous delivery. Administering at an incorrect angle could result in intramuscular injection, faster absorption, or tissue damage, so this is unsafe.
D. 30 degrees: Injecting at 30 degrees is generally reserved for intradermal injections, such as tuberculosis testing, and is not appropriate for insulin pen administration. Using this angle could result in improper dosing and reduced effectiveness.
Correct Answer is C
Explanation
A. Ask the client to state his name and medical record number: Asking the client to state identifiers is appropriate; however, relying solely on verbal confirmation without cross-checking with the armband and source document does not meet full identification standards. Patients may be confused, sedated, or provide incorrect information unintentionally.
B. Check the sign above the bed to the MAR & check the armband: The sign above the bed should never be used as a primary identifier because room assignments can change. While checking the armband is essential, including the bed sign introduces risk and does not align with best-practice identification policies.
C. Compare the source document to the client's armband & ask him to state his name: Best practice requires using at least two identifiers, such as full name and medical record number, and verifying them against the armband and the MAR. Asking the client to state their name rather than confirming it ensures active participation and reduces identification errors.
D. Call the client by name on MAR and observe his response: Calling the client by name and observing a response is insufficient because patients may respond reflexively even if misidentified. This method does not fulfill the requirement of using two independent identifiers to ensure safe medication administration.
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