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 A

Explanation

Choice A reason: Hyperthyroidism increases metabolic rate, causing tachycardia and potential arrhythmias due to elevated thyroid hormone levels stimulating cardiac beta-receptors. Monitoring heart rate and rhythm is critical to detect cardiovascular complications, guiding urgent treatment to prevent heart failure or atrial fibrillation.

Choice B reason: High-calorie snacks address weight loss in hyperthyroidism but are secondary to cardiovascular risks. Tachycardia and arrhythmias pose immediate threats, making heart rate monitoring the priority, as uncontrolled hyperthyroidism can lead to life-threatening cardiac events before nutritional needs are addressed.

Choice C reason: Supplemental oxygen is not routinely needed in hyperthyroidism unless respiratory distress occurs, which is rare. Elevated heart rate and arrhythmias are more immediate concerns, as hyperthyroidism’s cardiac effects are primary, making heart monitoring critical to prevent acute cardiovascular complications.

Choice D reason: Restricting fluid intake is inappropriate, as hyperthyroidism increases metabolism, risking dehydration. Heart rate monitoring is prioritized, as tachycardia and arrhythmias are direct, life-threatening effects of excess thyroid hormone, requiring immediate assessment to guide antithyroid therapy and prevent cardiac crises.

A. Suggest that the client also plan to eat frequent small meals to reduce discomfort B. Remind the client to switch to decaffeinated coffee and tea C. Review with the client the need to avoid foods rich in milk and cream D. Reinforce the teaching by asking the client to make a list of snack foods high in dairy content

Correct Answer is A

Explanation

Choice A reason: Frequent small meals reduce gastroesophageal reflux by minimizing gastric distension, which decreases pressure on the lower esophageal sphincter. This prevents acid reflux into the esophagus, alleviating heartburn and irritation, making it an effective dietary strategy for managing GERD symptoms.

Choice B reason: Switching to decaffeinated coffee and tea may reduce reflux triggers, as caffeine relaxes the lower esophageal sphincter. However, small meals are more effective, as they directly reduce gastric volume and sphincter pressure, providing broader symptom relief than caffeine avoidance alone.

Choice C reason: Avoiding milk and cream is relevant for some GERD patients, as high-fat foods delay gastric emptying, increasing reflux. However, frequent small meals address the root cause of reflux by reducing gastric pressure, making this a more universally effective strategy than specific food avoidance.

Choice D reason: Listing high-dairy snack foods reinforces avoidance but is less direct than recommending small meals. Dairy may trigger reflux in some, but frequent small meals broadly reduce gastric distension and sphincter pressure, offering a more immediate and effective GERD management strategy.

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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

The nurse is caring for a client with a new diagnosis of hyperthyroidism. Which intervention should the nurse prioritize?

Correct Answer is A

Explanation

The nurse is teaching a client with gastroesophageal reflux disease about dietary modifications. Which instruction should the nurse include?

Correct Answer is A

Explanation

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