The teaching plan for the use of a dry powder inhaler for the treatment of asthma should include the warning to rinse the mouth after inhaling the powder.
What does this prevent?
Discoloration of tooth enamel.
Halitosis.
Irritation of oral membranes.
Candidiasis.
The Correct Answer is D
Choice A rationale
Discoloration of tooth enamel is not a primary concern with dry powder inhalers. While some medications can cause oral changes, the main issue with inhaled corticosteroids, often delivered via dry powder inhalers, is localized fungal overgrowth, not direct enamel staining. Good oral hygiene is generally recommended but specifically targets fungal prevention.
Choice B rationale
Halitosis, or bad breath, is not a direct or primary consequence of dry powder inhaler use. While poor oral hygiene can contribute to halitosis, the mechanism for rinsing after inhaler use is to remove residual medication, thereby preventing more significant oral complications like fungal infections.
Choice C rationale
Irritation of oral membranes can occur, but it is not the most significant or common complication that rinsing aims to prevent. Residual powder can cause some local irritation, but the predominant risk with long-term use of inhaled corticosteroids, which are frequently in dry powder inhalers, is opportunistic fungal growth.
Choice D rationale
Rinsing the mouth after using a dry powder inhaler, especially one containing corticosteroids, is crucial to prevent candidiasis. Residual corticosteroid particles in the oral cavity can suppress the local immune response, allowing *Candida albicans*, a yeast normally present in small amounts, to proliferate and cause an oral thrush infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Assessing for general allergies is a good nursing practice but is not the most immediate priority when a client presents with a firm, reddened area after a "few days ago" allergy test, especially in the context of suspected pneumonia. This finding strongly suggests a specific type IV hypersensitivity reaction, common in tuberculosis screening.
Choice B rationale
Requesting records is important for comprehensive care, but delaying immediate action based on a highly suggestive clinical finding is not the best initial response. The appearance of the "allergy test" result is a critical piece of information that warrants immediate action to protect others.
Choice C rationale
A firm, reddened area on an "allergy test" a few days prior, especially with suspected pneumonia, is highly indicative of a positive tuberculin skin test (TST), signifying a past or present *Mycobacterium tuberculosis* infection. This necessitates immediate Airborne Precautions to prevent transmission of potential active tuberculosis, given the pulmonary symptoms.
Choice D rationale
Administering intravenous antibiotics for pneumonia is appropriate if bacterial pneumonia is confirmed. However, the presence of a positive TST-like reaction shifts the immediate priority to preventing airborne transmission of tuberculosis, requiring isolation measures *before* starting broad-spectrum antibiotics for pneumonia, which may not even be the primary issue.
Correct Answer is ["3.5"]
Explanation
Step 1: Convert pounds to kilograms. 55 lb ÷ (2.2 lb/1 kg) = 25 kg.
Step 2: Calculate the total milligrams per 24 hours. 7 mg/kg/24 h × 25 kg = 175 mg/24 h.
Step 3: Calculate the milligrams per dose (q h implies 2 doses per 24 hours). 175 mg/24 h ÷ 2 doses = 87.5 mg/dose.
Step 4: Calculate the volume in milliliters per dose. 87.5 mg ÷ (125 mg/5 mL) = 3.5 mL. 3.5 mL will be administered for each dose.
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