A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Rinses the mouth after each use.

Stores the medication at room temperature.

Attaches a spacer device to the inhaler.

Primes the inhaler with 7 pumps.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.

Choice B reason:

Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.

Choice C reason:

Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.

Choice D reason:

Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.

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Correct Answer is B

Explanation

Choice A reason: Insulin glargine is a long-acting insulin used to manage blood glucose levels in patients with diabetes. It is not typically used for the acute management of severe hypoglycemia. Instead, fast-acting glucose sources or glucagon injections are recommended for severe hypoglycemia. Therefore, teaching the family how to inject insulin glargine for severe hypoglycemia is not appropriate.

Choice B reason: Teaching the client self-injection skills for daily subcutaneous administration is crucial. Insulin glargine is administered once daily to provide a steady level of insulin throughout the day and night. Proper self-injection technique ensures that the medication is delivered correctly and effectively, which is essential for managing blood glucose levels in type 2 diabetes.

Choice C reason: While it is important for patients to monitor their blood sugar levels, insulin glargine dosing is typically fixed and not adjusted based on before-meal blood sugar readings. Instead, adjustments to the dose are made based on overall blood glucose trends and A1C levels, under the guidance of a healthcare provider.

Choice D reason: Increasing the dosage of insulin glargine in response to ketoacidosis is not appropriate. Diabetic ketoacidosis (DKA) is a medical emergency that requires immediate treatment with rapid-acting insulin, fluids, and electrolytes. Patients should be instructed to seek emergency medical care if they experience symptoms of DKA.

A. Be aware that difficulty sleeping and weight loss may occur. B. Notify the healthcare provider if experiencing changes in taste. C. Administer each dose with at least 8 ounces of water. D. Consume tyramine-free foods while taking the medicine.

Correct Answer is A

Explanation

Choice A reason: Bupropion is known to cause side effects such as insomnia and weight loss. These side effects are due to its stimulant properties, which can interfere with sleep patterns and suppress appetite1. Patients should be informed about these potential side effects so they can monitor their symptoms and seek medical advice if necessary.

Choice B reason: While changes in taste can occur with some medications, it is not a common side effect of bupropion. Therefore, it is not necessary to specifically instruct patients to notify their healthcare provider about changes in taste when taking bupropion.

Choice C reason: There is no specific requirement to administer bupropion with 8 ounces of water. Bupropion can be taken with or without food, and the amount of water consumed with the medication does not impact its effectiveness.

Choice D reason: Consuming tyramine-free foods is crucial for patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis. However, bupropion is not an MAOI, so this dietary restriction is not applicable.

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A client with a history of chronic obstructive pulmonary disease (COPD) 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

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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