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: Teaching mask use, hand washing, and distancing is important for preventing COVID-19 spread but is secondary to immediate isolation. Suspected cases require prompt separation to minimize transmission risk, as symptoms like fever and anosmia suggest high infectivity, making isolation the priority action.

Choice B reason: Counseling family to monitor symptoms is a follow-up measure, not the immediate priority. Isolation prevents active transmission in the emergency department, where the client is currently located. Family monitoring is relevant post-discharge but secondary to containing the virus in the acute setting.

Choice C reason: Isolation is the most critical action for a suspected COVID-19 case, as symptoms like fever, anosmia, and aches indicate potential infectivity. Separating the client from others without proper PPE prevents airborne and droplet transmission, protecting patients and staff in the emergency department, making it the priority.

Choice D reason: Reporting COVID-19 results to health authorities is mandatory but occurs after test confirmation. Immediate isolation prevents transmission in the emergency department while awaiting results. Reporting is a secondary administrative action, as the priority is containing the virus in the acute care setting.

A. Obtain an arterial blood gas prior to the procedure B. Perform the drainage immediately after meals C. Instruct the client to breathe shallow and fast D. Explain that the client may be placed in five positions

Correct Answer is D

Explanation

Choice A reason: Obtaining an arterial blood gas assesses oxygenation and acid-base status, useful in COPD management, but is not required before postural drainage. This invasive procedure is unnecessary for routine drainage, which mobilizes secretions. Explaining positions prepares the client, enhancing cooperation and effectiveness.

Choice B reason: Performing drainage after meals risks aspiration or vomiting, as a full stomach increases intra-abdominal pressure in COPD patients. Postural drainage is most effective when performed on an empty stomach, making this approach incorrect. Patient education on positioning is the priority.

Choice C reason: Shallow, fast breathing is counterproductive in COPD, as it reduces tidal volume and worsens hypercapnia. Postural drainage requires slow, deep breaths to mobilize secretions and improve ventilation. Explaining positions ensures proper technique, making this breathing instruction incorrect.

Choice D reason: Explaining that the client may be placed in five positions (e.g., prone, supine, lateral) prepares them for postural drainage, which uses gravity to mobilize lung secretions in COPD. This education enhances compliance and effectiveness, as proper positioning is critical for therapeutic success, making it the correct approach.

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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

Naxlex Comprehensive Predictor Exams

A client presents to the emergency department with muscle aches, headache, fever, and describes a recent loss of taste and smell. The nurse obtains a nasal swab for COVID-19 testing. Which action is most important for the nurse to take?

Correct Answer is C

Explanation

When performing postural drainage on a client with chronic obstructive pulmonary disease, which approach should the nurse use?

Correct Answer is D

Explanation

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