A client with chronic obstructive pulmonary disease receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Primes the inhaler with 7 pumps

Attaches spacer device to the inhaler

Stores the medication at room temperature

Rinses the mouth after each use

Answer and Explanation

The Correct Answer is A

Choice A reason: Priming an ipratropium inhaler typically requires 2 pumps, not 7, to ensure proper dosing. Excessive priming wastes medication and may reduce the inhaler’s lifespan. This action indicates misunderstanding of device preparation, necessitating further teaching to ensure effective administration and therapeutic outcomes.

Choice B reason: Attaching a spacer device enhances ipratropium delivery by improving aerosol deposition in the lungs, especially in COPD patients with poor inhalation technique. This is correct, as spacers reduce oropharyngeal deposition, minimizing side effects and maximizing bronchodilation, requiring no additional teaching.

Choice C reason: Storing ipratropium at room temperature is correct, as extreme temperatures can degrade the medication’s efficacy. This action aligns with manufacturer guidelines, ensuring the inhaler’s stability and effectiveness, indicating proper understanding and eliminating the need for further teaching on storage.

Choice D reason: Rinsing the mouth after ipratropium use is appropriate, as it reduces local side effects like dry mouth or throat irritation from residual medication. This correct action prevents complications, showing proper technique and understanding, so no additional teaching is required for this step.

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Correct Answer is C

Explanation

Choice A reason: Hemoccult tests detect blood in sputum, indicating hemoptysis, a TB symptom, but do not confirm Mycobacterium tuberculosis infection. Sputum culture is required for definitive diagnosis, as hemoccult only identifies bleeding, which is nonspecific and can occur in other respiratory conditions.

Choice B reason: Chest x-ray or CT scans show pulmonary abnormalities like cavitary lesions in TB but are not confirmatory. Radiographic findings suggest TB but require microbiological confirmation via sputum culture, as similar patterns occur in other lung diseases, making imaging supportive but not diagnostic.

Choice C reason: Sputum culture positive for Mycobacterium tuberculosis is the gold standard for TB diagnosis. It directly identifies the pathogen, confirming active infection. Other tests like skin tests or imaging are suggestive but not definitive, as they cannot distinguish active TB from latent or other conditions.

Choice D reason: A positive PPD skin test indicates TB exposure or latent infection but does not confirm active disease. False positives occur with prior BCG vaccination or nontuberculous mycobacteria. Sputum culture is needed to verify active TB, making the skin test less definitive.

A. Sexual dysfunction B. Hypotension C. Hyperglycemia D. Peripheral edema

Correct Answer is A

Explanation

Choice A reason: Sexual dysfunction is a common SSRI side effect, as increased serotonin inhibits sexual arousal and orgasm. Monitoring is critical, as it affects adherence in depression treatment, requiring dose adjustments or alternative therapies, making it the priority side effect to assess.

Choice B reason: Hypotension is less common with SSRIs, though orthostatic changes may occur. Sexual dysfunction is more frequent, impacting quality of life and treatment adherence in depression, making it the priority to monitor, as it directly affects patient compliance and outcomes.

Choice C reason: Hyperglycemia is not a typical SSRI side effect, though metabolic changes are rare. Sexual dysfunction is a prevalent issue, reducing adherence in depression treatment, making it the priority to monitor, as it significantly impacts patient satisfaction and therapy continuation.

Choice D reason: Peripheral edema is rare with SSRIs, which primarily affect serotonin pathways. Sexual dysfunction is a common side effect, compromising adherence in depression management, making it the priority to monitor, as it directly influences treatment success and patient well-being.

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A client with chronic obstructive pulmonary disease receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Nursing Test Bank

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