To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client’s caregivers?

Explain that the client should not use the discus more than twice daily.

Clients using the discus may experience decreased blood pressure.

When using the discus, have the client breathe out rapidly into the mouthpiece.

Offer the discus to the client for use during an acute asthma attack.

Answer and Explanation

The Correct Answer is A

Choice A Reason:

The fluticasone propionate and salmeterol discus inhalation system is designed to be used twice daily, approximately 12 hours apart. Using it more frequently can increase the risk of side effects without providing additional benefits. The medication is intended to provide long-term control of asthma symptoms, not immediate relief during an acute attack.

Choice B Reason:

There is no significant evidence to suggest that using the fluticasone propionate and salmeterol discus inhalation system causes decreased blood pressure. The primary side effects are related to the respiratory system, such as throat irritation, hoarseness, and oral thrush. Therefore, this instruction is not relevant to the proper use of the medication.

Choice C Reason:

When using the discus, the client should breathe out gently and away from the mouthpiece before inhaling the medication. Breathing out rapidly into the mouthpiece can cause the medication to be expelled from the device, reducing its effectiveness. Proper technique involves exhaling gently, then inhaling quickly and deeply through the mouthpiece.

Choice D Reason:

The fluticasone propionate and salmeterol discus inhalation system is not intended for use during an acute asthma attack. It is a maintenance medication designed to prevent asthma symptoms over time. For acute asthma attacks, a short-acting bronchodilator, such as albuterol, should be used. Using the discus during an acute attack will not provide the rapid relief needed.

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Correct Answer is C

Explanation

Choice A Reason:

Depression screening is important for overall health and well-being, especially in weight management programs where mental health can significantly impact outcomes. However, it is not the primary measure for determining the effectiveness of orlistat. Orlistat works by inhibiting the absorption of fats from the diet, leading to weight loss. Therefore, while mental health monitoring is crucial, it does not directly measure the medication’s effectiveness.

Choice B Reason:

Daily calorie count is a useful tool in weight management programs to ensure that clients are adhering to a calorie-restricted diet. However, it is not a direct measure of the effectiveness of orlistat. While calorie counting can help manage weight, the primary goal of orlistat is to reduce fat absorption, which is better reflected in changes in body weight and BMI.

Choice C Reason:

Body mass index (BMI) is a key indicator of weight management and is directly related to the effectiveness of orlistat. BMI is calculated based on height and weight, providing a clear measure of changes in body weight over time. Monitoring BMI helps determine if the client is losing weight as expected, making it the most appropriate assessment for evaluating the effectiveness of orlistat.

Choice D Reason:

Serum protein levels are important for assessing nutritional status and overall health. However, they do not directly measure the effectiveness of orlistat in a weight management program. Orlistat’s primary function is to reduce fat absorption, and its effectiveness is better assessed through changes in body weight and BMI rather than serum protein levels.

A. Low-density lipoprotein (LDL). B. High-density lipoprotein (HDL). C. Prothrombin time (PT). D. Creatine phosphokinase (CK).

Correct Answer is A

Explanation

Choice A reason:

Low-density lipoprotein (LDL) is often referred to as “bad” cholesterol because high levels can lead to plaque buildup in arteries and result in heart disease and stroke. Atorvastatin is a statin medication that works by reducing the production of cholesterol in the liver, specifically targeting LDL cholesterol. Lowering LDL levels is a primary goal in managing and reducing the risk of coronary artery disease.

Choice B reason:

High-density lipoprotein (HDL) is known as “good” cholesterol because it helps remove other forms of cholesterol from the bloodstream. While atorvastatin can also help increase HDL levels, the primary indicator of its effectiveness in reducing the risk of coronary artery disease is the reduction in LDL levels.

Choice C reason:

Prothrombin time (PT) is a measure of how long it takes blood to clot. It is not directly related to the effectiveness of atorvastatin in managing cholesterol levels or reducing the risk of coronary artery disease. PT is more relevant in the context of anticoagulant therapy.

Choice D reason:

Creatine phosphokinase (CK) is an enzyme found in the heart, brain, and skeletal muscles. Elevated CK levels can indicate muscle damage, which can be a side effect of statin therapy. However, CK levels are not used to measure the effectiveness of atorvastatin in lowering cholesterol or reducing the risk of coronary artery disease.

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To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client’s caregivers?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving orlistat as part of a weight management program. Which ongoing assessment should be included in the plan of care to determine the effectiveness of the medication?

Correct Answer is C

Explanation

The nurse is reviewing the client’s laboratory values. Which serum laboratory value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?

Correct Answer is A

Explanation

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