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: Hypercholesterolemia, or high cholesterol, is not a primary concern when prescribing methylphenidate. While managing cholesterol levels is important for overall cardiovascular health, it does not directly interact with the administration of methylphenidate.

Choice B reason: Hypertension, or high blood pressure, is a critical condition to review before administering methylphenidate. Methylphenidate can increase blood pressure and heart rate, potentially exacerbating pre-existing hypertension. Monitoring and managing blood pressure is essential to prevent complications such as stroke or heart attack.

Choice C reason: Diabetes mellitus is important to manage, but it is not directly affected by methylphenidate. While some medications can influence blood sugar levels, methylphenidate primarily affects the central nervous system and cardiovascular system.

Choice D reason: Bronchitis, an inflammation of the bronchial tubes, is not a primary concern with methylphenidate use. Although respiratory conditions should be managed appropriately, they do not typically interact with the effects of methylphenidate.

A. Monitor skin for excessive bruising. B. Replace salt with a salt substitute. C. Cover your skin before going outside. D. Limit the intake of foods high in potassium.

Correct Answer is D

Explanation

Choice A Reason:

Spironolactone is a potassium-sparing diuretic often prescribed for heart failure. While monitoring for side effects is important, excessive bruising is not a common side effect of spironolactone. Bruising might be more relevant for patients on anticoagulants or those with clotting disorders.

Choice B Reason:

Replacing salt with a salt substitute is not advisable for patients on spironolactone. Many salt substitutes contain potassium chloride, which can lead to hyperkalemia (high potassium levels) when combined with spironolactone. Hyperkalemia can cause serious cardiac issues, including arrhythmias.

Choice C Reason:

Covering the skin before going outside is not specifically related to the use of spironolactone. This advice might be more relevant for medications that cause photosensitivity, such as certain antibiotics or diuretics like hydrochlorothiazide, but not spironolactone.

Choice D Reason:

Limiting the intake of foods high in potassium is crucial for patients taking spironolactone. Spironolactone can increase potassium levels in the blood, and consuming high-potassium foods (like bananas, oranges, and potatoes) can exacerbate this effect, leading to hyperkalemia. Hyperkalemia can be dangerous and cause symptoms such as muscle weakness, fatigue, and cardiac arrhythmias.

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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

A client with narcolepsy receives a new prescription for methylphenidate. Prior to administration of the medication, the nurse should review the medical record for which condition?

Correct Answer is B

Explanation

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in the client’s plan of care?

Correct Answer is D

Explanation

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