The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. Which instruction is most important for the nurse to provide the client?

Hold one nostril closed while spraying the other nostril.

Use the inhaler when first awakening in the morning.

Avoid shaking the inhaler immediately before using

Angle the tip of the inhaler upward while spraying.

Answer and Explanation

The Correct Answer is A

A. Hold one nostril closed while spraying the other nostril: Closing one nostril while administering the spray ensures the medication is delivered more effectively into the nasal passages, allowing for better absorption and symptom control by maximizing the contact of the medication with the nasal mucosa.

B. Use the inhaler when first awakening in the morning: The specific timing of intranasal corticosteroid use may vary depending on the healthcare provider's instructions and the client's symptom pattern. While morning use can be beneficial due to peak allergy symptoms, it is not the most critical technique instruction. Proper administration ensures better drug efficacy regardless of timing.

C. Avoid shaking the inhaler immediately before using: Some nasal sprays, especially suspensions, require shaking to evenly distribute the medication. Advising not to shake could lead to inconsistent dosing and reduced effectiveness, depending on the specific medication.

D. Angle the tip of the inhaler upward while spraying: The inhaler tip should be angled slightly outward toward the ear, not straight upward, to target the correct nasal structures. Spraying directly upward could lead to discomfort or less effective drug delivery.

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Correct Answer is A

Explanation

A. Ask the client to describe her dietary intake history for the last several days: Orlistat works by inhibiting fat absorption, and excessive intake of dietary fats can cause oily stools and gas. Assessing the client’s recent diet helps determine if her symptoms are due to high fat consumption, which can then be managed through dietary adjustments.

B. Instruct the client to increase her intake of saturated fats over the next week: Increasing fat intake would likely worsen her symptoms, as orlistat prevents fat absorption, leading to more pronounced gastrointestinal side effects if fat intake remains high.

C. Advise the client to stop taking the drug and contact her healthcare provider (HCP): Stopping orlistat is unnecessary at this stage. Oily stools are a common and expected side effect if dietary fat intake is not controlled, so addressing dietary habits is the first and more appropriate intervention.

D. Obtain a stool specimen to evaluate for occult blood and fat content: There is no indication that the client’s symptoms suggest gastrointestinal bleeding. The oily stools are an anticipated effect of fat malabsorption caused by orlistat, not a sign of occult blood loss.

A. Consult with a pharmacist about scheduling the dose one hour after the client eats. B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk. C. Withhold the medication until the client's breakfast tray is available on the unit. D. Instruct the client that it is necessary to take nothing but water with the medication.

Correct Answer is D

Explanation

A. Consult with a pharmacist about scheduling the dose one hour after the client eats: Risedronate must be taken on an empty stomach with water for proper absorption. Taking it after eating would severely reduce its effectiveness, making pharmacist consultation unnecessary at this point.

B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk: Milk contains calcium, which can bind to risedronate and interfere with its absorption. Providing milk at the time of administration would make the medication much less effective in treating osteoporosis.

C. Withhold the medication until the client's breakfast tray is available on the unit: Administering risedronate with or immediately after food would impair absorption. Delaying the dose until after breakfast would not meet the medication's requirements for maximum efficacy.

D. Instruct the client that it is necessary to take nothing but water with the medication: Risedronate should be taken with a full glass of plain water while fasting to ensure proper absorption. After administration, the client should also remain upright for at least 30 minutes to reduce gastrointestinal irritation.

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The nurse is instructing a client with allergic rhinitis about the correct technique for using an intranasal inhaler. Which instruction is most important for the nurse to provide the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?

Correct Answer is A

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The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?

Correct Answer is D

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