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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Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A reason: Topical corticosteroids reduce inflammation, scaling, and itching in psoriasis by inhibiting pro-inflammatory cytokines and immune responses in affected skin. They are first-line for plaque psoriasis with silvery scales, effectively managing burning and promoting healing of inflamed, bleeding areas on elbows and palms.

Choice B reason: Topical analgesics relieve pain but do not address psoriasis’s underlying inflammation or scaling. Psoriatic plaques are primarily inflammatory, not neuropathic. Analgesics may reduce burning temporarily but lack the anti-inflammatory action of corticosteroids, making them ineffective for managing chronic psoriatic lesions.

Choice C reason: Topical antibiotics treat bacterial infections, not psoriasis, which is an autoimmune inflammatory condition. Bleeding in psoriasis results from skin fragility, not infection. Antibiotics are unnecessary unless secondary infection is confirmed, making them inappropriate compared to corticosteroids, which target the disease’s inflammatory pathology.

Choice D reason: Colloidal oatmeal-based lotion soothes irritated skin and reduces itching but lacks anti-inflammatory properties to treat psoriasis’s scaling and inflammation. It may provide symptomatic relief but is inadequate for managing chronic plaques, unlike corticosteroids, which directly address the autoimmune-driven inflammation and scaling.

A. Maintain consistent salt intake B. Avoid high-fiber foods C. Increase caffeine consumption D. Limit physical exercise

Correct Answer is A

Explanation

Choice A reason: Consistent salt intake is critical for lithium, as sodium levels affect lithium excretion. Low sodium increases lithium toxicity, causing tremors or confusion. Maintaining stable sodium intake ensures therapeutic levels, making this the priority teaching point for safe lithium therapy.

Choice B reason: Avoiding high-fiber foods is irrelevant to lithium therapy. Fiber affects gastrointestinal health but not lithium pharmacokinetics. Consistent salt intake is essential, as sodium fluctuations alter lithium clearance, risking toxicity, making dietary sodium the priority teaching focus.

Choice C reason: Increasing caffeine is inappropriate, as it may exacerbate bipolar symptoms and increase lithium excretion, risking subtherapeutic levels. Consistent salt intake stabilizes lithium levels, preventing toxicity or inefficacy, making it the critical teaching point for effective bipolar management.

Choice D reason: Limiting physical exercise is unnecessary for lithium therapy. Exercise supports mental health in bipolar disorder but does not directly affect lithium levels. Consistent salt intake is the priority, as sodium balance ensures safe and effective lithium therapy.

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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 with psoriasis returns to the clinic reporting the persistence of several silvery, scaly areas on the elbows and palms that frequently burn and sometimes bleed. Which prescription should the nurse teach the client to use for the skin condition?

Correct Answer is A

Explanation

A client with a history of bipolar disorder is prescribed lithium. Which teaching point should the nurse emphasize?

Correct Answer is A

Explanation

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