A nurse is teaching a client who has asthma about how to use a metered-dose inhaler with a spacer. Which of the following pieces of information should the nurse include in the teaching?

"The spacer should make a whistling sound as you inhale."

"Hold your breath for 10 seconds once you inhale."

"Clean the spacer daily with cold water."

"Wait 30 seconds between puffs."

Answer and Explanation

The Correct Answer is B

Choice A reason: The statement that "the spacer should make a whistling sound as you inhale" is not accurate. A whistling sound from the spacer may indicate that the air is being inhaled too quickly and that the user needs to slow down. The purpose of the spacer is to hold the medication released from the inhaler so that it can be inhaled more easily and effectively into the lungs, not to produce a whistling sound.

Choice B reason: Holding one's breath for 10 seconds after inhaling the medication allows for better deposition of the medication in the lungs. This pause gives the medication time to settle in the airways rather than being exhaled too quickly. It is a recommended practice to maximize the effectiveness of the inhaled medication.

Choice C reason: Cleaning the spacer is important to ensure that it works correctly and is free of any residue or debris that could obstruct the medication's path. However, the instruction to "clean the spacer daily with cold water" is incomplete. After rinsing with cold water, the spacer should be left to air dry without rinsing or wiping, as this can create static that affects medication delivery.

Choice D reason: Waiting 30 seconds between puffs is recommended to allow the user to breathe normally for a short period and to prepare for the next dose of medication. This time interval helps to ensure that the second puff is not rushed and that the medication from the first puff has had time to act.

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Correct Answer is A

Explanation

Choice A reason: Glycosylated hemoglobin, also known as hemoglobin A1C, reflects the average blood glucose levels over the past two to three months. It is a crucial indicator of long-term glycemic control in individuals with diabetes. The American Diabetes Association recommends that the A1C level be checked at least two times a year in patients who are meeting treatment goals and have stable glycemic control. An A1C level below 7% is generally considered good control, and achieving this target can reduce microvascular complications of diabetes.

Choice B reason: Postprandial blood glucose levels indicate the amount of glucose in the blood after a meal. While it's an important measure, it reflects only the immediate response to food intake and does not provide information about long-term glycemic control.

Choice C reason: Fasting blood glucose levels measure the amount of glucose in the blood after an overnight fast. This test is used to detect diabetes or prediabetes but is less effective than the A1C test for monitoring long-term glycemic control.

Choice D reason: The oral glucose tolerance test (OGTT) measures blood glucose levels before and two hours after consuming a glucose-rich drink. This test is primarily used for diagnosing diabetes and gestational diabetes, not for long-term monitoring.

A. Constipation B. Decreased tear production C. Mouth ulcers D. Peripheral neuropathy

Correct Answer is C

Explanation

Choice A reason: Constipation can be a side effect of many cancer treatments, including radiation therapy. However, it is not commonly associated with targeted radiation therapy to the neck. Constipation is more often related to opioid pain medications, decreased physical activity, or dietary changes that a patient may experience during cancer treatment.

Choice B reason: Decreased tear production is not a typical side effect of targeted radiation therapy to the neck. This condition, known as dry eye syndrome, is more commonly associated with radiation therapy that affects the eye or orbital area directly.

Choice C reason: Mouth ulcers, also known as mucositis, are a common adverse effect of radiation therapy to the neck. Radiation can damage the mucosal lining of the mouth, leading to painful sores that can affect a patient's ability to eat, speak, and swallow. These ulcers typically develop one to two weeks after starting treatment and may persist for some time after the treatment ends.

Choice D reason: Peripheral neuropathy, which involves damage to the peripheral nerves and often results in symptoms like numbness, tingling, or pain in the hands and feet, is not a common side effect of radiation therapy to the neck. It is more frequently associated with certain chemotherapeutic agents or radiation therapy to areas of the body where peripheral nerves are located.

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A nurse is teaching a client who has asthma about how to use a metered-dose inhaler with a spacer. Which of the following pieces of information should the nurse include in the teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

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