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 D

Explanation

Choice A reason: Epinephrine is primarily used in emergency situations for its vasoconstrictive and bronchodilatory effects, particularly in cases of anaphylaxis or cardiac arrest. It is not typically used to manage symptoms associated with brainstem contusions or to regulate urinary output.

Choice B reason: Furosemide is a loop diuretic commonly prescribed to reduce fluid retention in conditions such as heart failure or renal disease. Given that the client has already produced a large volume of urine (4,000 mL in 24 hours, which is above the normal range of 800 to 2,000 milliliters per day), administering furosemide would not be appropriate as it would likely exacerbate the excessive urinary output.

Choice C reason: Nitroprusside is a potent vasodilator used to treat acute hypertensive crises. It has no role in the management of thirst or regulation of urinary output and is not indicated for the treatment of brainstem contusions.

Choice D reason: Desmopressin is a synthetic analogue of the naturally occurring antidiuretic hormone vasopressin. It is used to treat conditions characterized by excessive urination, such as diabetes insipidus, and to manage polyuria and polydipsia (excessive thirst) following head trauma or surgery in the pituitary region. In the context of a brainstem contusion with a reported high urinary output, desmopressin would be the appropriate medication to prescribe to reduce urine volume and address the client's thirst.

A. Blood pressure 138/76 mm Hg B. Temperature 36.3°C (97.3°F) C. Heart rate 48/min D. Respiratory rate 10/min

Correct Answer is C

Explanation

Choice A reason : A blood pressure of 138/76 mm Hg is within the higher range of normal and is not typically considered an adverse effect of metoprolol, which is used to lower blood pressure.

Choice B reason : A temperature of 36.3°C (97.3°F) is within the normal range and is not an adverse effect of metoprolol.

Choice C reason : A heart rate of 48/min is considered bradycardia and can be an adverse effect of metoprolol, which is a beta-blocker that can slow down the heart rate.

Choice D reason : A respiratory rate of 10/min is on the lower end of the normal range but is not a typical adverse effect of metoprolol. However, if the patient shows signs of respiratory distress, it should be addressed.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a contusion of the brainstem and reports thirst. The client's urinary output was 4,000 mL over the past 24 hours. The nurse should anticipate a prescription for which of the following intravenous (IV) medications?

Correct Answer is D

Explanation

A nurse is assessing a client who has heart failure and a new prescription for metoprolol. Which of the following findings should the nurse identify as an adverse effect of the medication?

Correct Answer is C

Explanation

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