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 B

Explanation

This response is empathetic and therapeutic, as it acknowledges the client's feelings and invites her to express her concerns. It also shows respect and interest in the client's perspective.

a) This response is false reassurance and nontherapeutic, as it dismisses the client's feelings and implies

that the surgery will solve everything.

b) This response is self-disclosure and nontherapeutic, as it shifts the focus from the client to the nurse and

does not address the client's fears.

d) This response is minimizing and nontherapeutic, as it tells the client how to feel and does not acknowledge the client's regret or anxiety.

A. Regular moderate exercise B. Maintenance of ideal weight C. Annual inﬂuenza immunization D. Smoking cessation

Correct Answer is D

Explanation

Smoking cessation is the most eﬀective way to prevent chronic bronchitis, which is a type of chronic obstructive pulmonary disease (COPD) characterized by inﬂammation and excess mucus production in the

bronchi. Smoking is the main cause of chronic bronchitis, as it damages the cilia and mucous membranes of the airways, leading to chronic cough, sputum, and infection. Quitting smoking can reduce the risk of developing or worsening chronic bronchitis and improve lung function and quality of life.

a) Regular moderate exercise is beneficial for preventing chronic bronchitis, but not as eﬀective as smoking cessation. Exercise can improve cardiovascular and respiratory health, increase oxygen delivery to the tissues, and enhance immune function. However, exercise alone cannot reverse the damage caused by smoking or prevent further deterioration of the airways.
b) Maintenance of ideal weight is beneficial for preventing chronic bronchitis, but not as eﬀective as smoking cessation. Maintaining a healthy weight can reduce the workload on the heart and lungs, prevent obesity-related complications, and improve self-esteem and well-being. However, weight management alone cannot restore the normal structure and function of the airways or prevent chronic inﬂammation and mucus production.
c) Annual inﬂuenza immunization is beneficial for preventing chronic bronchitis, but not as eﬀective as smoking cessation. Inﬂuenza immunization can protect against viral infections that can trigger or exacerbate chronic bronchitis symptoms, such as fever, cough, wheezes, and dyspnea. However, inﬂuenza immunization cannot prevent other causes of chronic bronchitis, such as bacterial infections, environmental pollutants, or genetic factors.

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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

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Correct Answer is B

Explanation

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Correct Answer is D

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