A nurse is providing discharge teaching to a client who has asthma and a new prescription for ﬂuticasone/salmeterol. For which of the following adverse eﬀects should the nurse instruct the client to report to the provider?

Dry oral mucous membranes

White coating in the mouth

Sedation

Increased appetite

Answer and Explanation

The Correct Answer is B

White coating in the mouth, also known as oral candidiasis or thrush, is a serious adverse eﬀect of ﬂuticasone/salmeterol, which is a combination of an inhaled corticosteroid and a long-acting beta2 agonist. It is caused by fungal infection of the oral cavity due to suppression of the normal ﬂora by the corticosteroid component. The client should report this symptom to the provider, as it may require antifungal treatment and discontinuation of the medication.

a) Dry oral mucous membranes is a common and mild adverse eﬀect of ﬂuticasone/salmeterol, which can be relieved by drinking water, chewing sugarless gum, or using artificial saliva. It does not require reporting to the provider or stopping the medication.
c) Sedation is not an adverse eﬀect of ﬂuticasone/salmeterol, but it may be caused by other medications, such as antihistamines, opioids, or benzodiazepines. The client should avoid driving or operating machinery if sedated and consult with the provider about possible drug interactions.
d) Increased appetite is not an adverse eﬀect of ﬂuticasone/salmeterol, but it may be caused by other factors, such as stress, boredom, or hormonal changes. The client should maintain a balanced diet and exercise regularly to prevent weight gain and promote health.

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Correct Answer is C

Explanation

Increased anteroposterior diameter of the chest, also known as barrel chest, is a common finding in clients who have COPD with emphysema. It is caused by chronic air trapping and hyperinﬂation of the lungs, which results in fattening of the diaphragm and widening of the rib cage.

a) Oxygen saturation level 96% is within the normal range of 95% to 100% and does not indicate hypoxemia or impaired gas exchange. Clients who have COPD with emphysema typically have lower oxygen saturation levels, ranging from 88% to 92%.
b) Respiratory alkalosis is a condition in which the blood pH is elevated due to decreased carbon dioxide levels. It is caused by hyperventilation, which can occur in response to hypoxia, anxiety, or pain. Clients who have COPD with emphysema usually have respiratory acidosis, which is a condition in which the blood pH is lowered due to increased carbon dioxide levels. It is caused by hypoventilation, which results from impaired lung function and airway obstruction.
d) Petechiae on chest are small red or purple spots on the skin caused by bleeding from capillaries. They are not a typical finding in clients who have COPD with emphysema, unless they have severe coughing episodes or coagulation disorders. They can indicate infection, inﬂammation, trauma, or vascular disease.

A. "Expect your sputum cultures to be negative after 6 months of therapy." B. "Drink at least 8 ounces of water when you take the pyrazinamide tablet." C. "Provide a sputum specimen every 2 weeks to the clinic for testing." D. "Take isoniazid with an antacid."

Correct Answer is B

Explanation

Answer: B

Rationale:

A) "Expect your sputum cultures to be negative after 6 months of therapy":

While sputum cultures may become negative after a period of effective therapy, it is not always guaranteed to happen within exactly 6 months. Tuberculosis (TB) treatment usually involves several months of medication, and sputum cultures are monitored periodically to assess treatment efficacy, not solely at the 6-month mark.

B) "Drink at least 8 ounces of water when you take the pyrazinamide tablet":

Drinking plenty of water with pyrazinamide is important to prevent dehydration and to help minimize potential side effects, such as hyperuricemia or gout. Adequate hydration can also aid in the effective elimination of the medication from the body, thus reducing the risk of adverse effects.

C) "Provide a sputum specimen every 2 weeks to the clinic for testing":

Sputum specimens are typically provided less frequently than every 2 weeks, usually monthly, to monitor the progress of TB treatment. Testing frequency may vary depending on the client's condition and the healthcare provider's recommendations.

D) "Take isoniazid with an antacid":

Isoniazid should not be taken with antacids, as antacids can interfere with the absorption of isoniazid. It is usually advised to take isoniazid on an empty stomach, and clients should be instructed to wait at least 1 hour after taking isoniazid before consuming antacids.

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A nurse is providing discharge teaching to a client who has asthma and a new prescription for ﬂuticasone/salmeterol. For which of the following adverse eﬀects should the nurse instruct the client to report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that he has a frequent productive cough and is short of breath. The nurse should anticipate which of the following assessment findings for this client?

Correct Answer is C

Explanation

A nurse is teaching a client who has tuberculosis and is to start medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?

Correct Answer is B

Explanation

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