The nurse knows that teaching about the use of the spirometer incentive is effective when the client seals the lips around the mouthpiece and:

inhales slowly to raise the ball to the desired level, and attempts to keep the ball raised for several seconds

blows into the mouthpiece with a long slow expiration to keep the ball at the base of the spirometer.

begins breathing with a rapid, forceful inspiration to raise the ball as high as possible.

exhales slowly to raise the ball to the desired level, and quickly inhales to raise the ball again.

Answer and Explanation

The Correct Answer is A

Choice A rationale: Inhaling slowly to raise the ball to the desired level and attempting to keep the ball raised for several seconds is the correct technique for using an incentive spirometer.

Choice B rationale: Blowing into the mouthpiece with a long slow expiration is not the correct technique for using an incentive spirometer.

Choice C rationale: Beginning breathing with a rapid, forceful inspiration is not the recommended technique for using an incentive spirometer.

Choice D rationale: Exhaling slowly to raise the ball and quickly inhaling is not the correct technique for using an incentive spirometer.

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Correct Answer is ["B","D","E"]

Explanation

Choice A rationale: Acetaminophen 500 mg PO is subject to the first pass effect as it is absorbed through the gastrointestinal system.

Choice B rationale: Dulcolax suppository is not subject to the first pass effect as it is administered rectally.

Choice C rationale: Aspirin 10 mg PO is subject to the first pass effect as it is absorbed through the gastrointestinal system.

Choice D rationale: Fentanyl 25 mcg/h via transdermal patch avoids the first pass effect as it is absorbed through the skin.

Choice E rationale: Morphine 0.4 mg IV avoids the first pass effect as it is administered intravenously.

A. Use a small gauge needle B. Use the Z-track method C. Administer at a 45-degree angle D. Apply ice to the injection site

Correct Answer is B

Explanation

Choice A rationale: Using a small gauge needle may reduce pain but does not specifically address tissue irritation.

Choice B rationale: The Z-track method is used to reduce irritation and prevent leakage of irritating medications into the subcutaneous tissues.

Choice C rationale: Administering at a 45-degree angle is a common angle for intramuscular injections but does not specifically address tissue irritation.

Choice D rationale: Applying ice to the injection site is not a standard practice for reducing tissue irritation with intramuscular injections.

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The nurse knows that teaching about the use of the spirometer incentive is effective when the client seals the lips around the mouthpiece and:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is administering medications to a client who has severe liver damage. Which medications, as ordered below, will avoid the first pass effect? (SELECT ALL THAT APPLY)

Correct Answer is ["B","D","E"]

Explanation

The nurse must give a client an intramuscular injection of a medication which is very irritating to the subcutaneous tissues. To attempt to reduce irritation of the tissues, which action should the nurse take?

Correct Answer is B

Explanation

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