To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

When using the discus, have the client breathe out rapidly into the mouthpiece.

Offer the discus to the client for use during an acute asthma attack.

Clients using the discus may experience decreased blood pressure.

Explain that the client should not use the discus more than twice daily.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not a correct instruction for the nurse to provide to the client's caregivers. When using the discus, the client should breathe out slowly and gently away from the mouthpiece, not into it. Breathing out rapidly into the mouthpiece can cause the powder to disperse and reduce the amount of medication delivered to the lungs. The client should also rinse the mouthpiece with water after each use and dry it thoroughly.

Choice B reason: This is not a correct instruction for the nurse to provide to the client's caregivers. The discus is not intended for use during an acute asthma attack, as it does not provide immediate relief of bronchospasm. The discus is a combination of fluticasone, a corticosteroid that reduces inflammation, and salmeterol, a long-acting beta-agonist that relaxes the airway muscles. The discus is a maintenance therapy that should be used regularly to prevent asthma symptoms and exacerbations. The client should also have a rescue inhaler, such as albuterol, for quick relief of asthma attacks.

Choice C reason: This is not a correct instruction for the nurse to provide to the client's caregivers. Clients using the discus may experience increased blood pressure, not decreased, as a possible side effect of salmeterol. Salmeterol can stimulate the beta receptors in the heart and blood vessels, causing tachycardia, palpitations, and hypertension. The nurse should monitor the client's blood pressure and heart rate regularly and report any abnormal findings to the healthcare provider.

Choice D reason: This is the correct instruction for the nurse to provide to the client's caregivers. The discus should not be used more than twice daily, as it can increase the risk of adverse effects and reduce the effectiveness of the medication. The discus should be used once in the morning and once in the evening, about 12 hours apart, to provide optimal control of asthma symptoms. The nurse should teach the client and the caregivers how to use the discus correctly and safely, and to follow the prescribed dosage and schedule.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is D

Explanation

Choice A reason: This is not the first action for the nurse to implement. Determining when the last dose was administered is important to prevent overdose and adverse effects of pain medication, but it is not the most immediate intervention. The nurse should first assess the client's pain level and intensity using a pain scale, such as a numeric or a visual analog scale, to determine the appropriate dose and frequency of pain medication.

Choice B reason: This is not the first action for the nurse to implement. Encouraging the client to use diversional thoughts to manage pain is a nonpharmacological strategy that may help reduce the perception of pain and enhance coping, but it is not the most effective intervention. The nurse should first assess the client's pain level and intensity using a pain scale, and then provide pharmacological and nonpharmacological interventions as needed.

Choice C reason: This is not the first action for the nurse to implement. Reviewing the history for a past use of recreational drugs is relevant to identify the risk of addiction, tolerance, or withdrawal from pain medication, but it is not the most urgent intervention. The nurse should first assess the client's pain level and intensity using a pain scale, and then consider the client's history and preferences when selecting the type and dose of pain medication.

Choice D reason: This is the first action for the nurse to implement. Asking the client to rate the current level of pain using a pain scale is the most appropriate and accurate way to assess the client's pain and its impact on the client's recovery and quality of life. The nurse should use a pain scale that is suitable for the client's age, cognitive ability, and language, and ask the client to rate the pain at rest and with movement. The nurse should also ask the client about the location, quality, duration, and aggravating or relieving factors of the pain. The nurse should use the pain assessment as the basis for planning and implementing pharmacological and nonpharmacological interventions for pain management.

A. Take medication on an empty stomach. B. Consume foods that are high in iodine. C. Administer levothyroxine at bedtime. D. Avoid the use of iron supplements.

Correct Answer is A

Explanation

Choice A reason: Taking levothyroxine on an empty stomach ensures better absorption and prevents interference from food or other medications. The client should take levothyroxine at least 30 minutes before breakfast or four hours after the last meal of the day.

Choice B reason: Consuming foods that are high in iodine is not recommended for clients taking levothyroxine, as it may affect the thyroid function and the dosage of the medication. Foods that are high in iodine include seafood, seaweed, dairy products, and iodized salt.

Choice C reason: Administering levothyroxine at bedtime is not advisable, as it may cause insomnia, anxiety, or palpitations. Levothyroxine is best taken in the morning, as it mimics the natural secretion of thyroid hormones.

Choice D reason: Avoiding the use of iron supplements is not necessary for clients taking levothyroxine, as long as they are taken at different times. Iron supplements can interfere with the absorption of levothyroxine, so they should be taken at least four hours apart.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?

Correct Answer is D

Explanation

A client receives a new prescription for levothyroxine. Which statement made by the client indicates to the nurse that the education was effective?

Correct Answer is A

Explanation

A client who receives multiple antihypertensive medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse's decision to hold the client's scheduled antihypertensive medications?

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?

A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?

The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

A client with a seizure disorder is seen at the clinic for a follow-up visit and a prescription renewal for phenytoin. Which assessment finding warrants immediate intervention by the nurse?

A client with nasal congestion receives a prescription for phenylephrine 10 mg by mouth every 4 hours. Which client condition should the nurse report to the healthcare provider before administering the medication?

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?