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?

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.

Clients using the discus may experience decreased blood pressure.

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

Answer and Explanation

The Correct Answer is D

Choice A reason: This is not a correct instruction for the nurse to provide to the client's caregivers. When using the discus, the client should breathe out slowly and gently away from the mouthpiece, not into it. Breathing out rapidly into the mouthpiece can cause the powder to disperse and reduce the amount of medication delivered to the lungs. The client should also rinse the mouthpiece with water after each use and dry it thoroughly.

Choice B reason: This is not a correct instruction for the nurse to provide to the client's caregivers. The discus is not intended for use during an acute asthma attack, as it does not provide immediate relief of bronchospasm. The discus is a combination of fluticasone, a corticosteroid that reduces inflammation, and salmeterol, a long-acting beta-agonist that relaxes the airway muscles. The discus is a maintenance therapy that should be used regularly to prevent asthma symptoms and exacerbations. The client should also have a rescue inhaler, such as albuterol, for quick relief of asthma attacks.

Choice C reason: This is not a correct instruction for the nurse to provide to the client's caregivers. Clients using the discus may experience increased blood pressure, not decreased, as a possible side effect of salmeterol. Salmeterol can stimulate the beta receptors in the heart and blood vessels, causing tachycardia, palpitations, and hypertension. The nurse should monitor the client's blood pressure and heart rate regularly and report any abnormal findings to the healthcare provider.

Choice D reason: This is the correct instruction for the nurse to provide to the client's caregivers. The discus should not be used more than twice daily, as it can increase the risk of adverse effects and reduce the effectiveness of the medication. The discus should be used once in the morning and once in the evening, about 12 hours apart, to provide optimal control of asthma symptoms. The nurse should teach the client and the caregivers how to use the discus correctly and safely, and to follow the prescribed dosage and schedule.

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Correct Answer is D

Explanation

Choice A reason: This is not a correct instruction for the nurse to provide to the client. Stopping the oral contraceptive immediately is not necessary, as it may cause irregular bleeding, hormonal imbalance, or unwanted pregnancy. The client should continue taking the oral contraceptive as prescribed, but use an additional form of contraception, such as condoms or spermicides, while taking erythromycin.

Choice B reason: This is not a correct instruction for the nurse to provide to the client. Avoiding prolonged exposure to direct sunlight is not related to the interaction between oral contraceptive and erythromycin. This instruction may be relevant for other antibiotics, such as tetracyclines or sulfonamides, that can cause photosensitivity and increase the risk of sunburn. The client should protect the skin from sun exposure as part of general health promotion, but it is not specific to erythromycin therapy.

Choice C reason: This is not a correct instruction for the nurse to provide to the client. Taking the medications at least 12 hours apart is not sufficient to prevent the interaction between oral contraceptive and erythromycin. Erythromycin is a macrolide antibiotic that can reduce the effectiveness of oral contraceptive by increasing its metabolism and clearance. The client should take the medications as prescribed, but use an additional form of contraception, such as condoms or spermicides, while taking erythromycin.

Choice D reason: This is the correct instruction for the nurse to provide to the client. Using an additional form of contraception is the best way to prevent pregnancy while taking erythromycin and oral contraceptive. Erythromycin can decrease the efficacy of oral contraceptive by increasing its metabolism and clearance. The client should use a barrier method or a spermicide, in addition to the oral contraceptive, while taking erythromycin and for at least one week after finishing the antibiotic course.

A. Take medication on an empty stomach. B. Consume foods that are high in iodine. C. Administer levothyroxine at bedtime. D. Avoid the use of iron supplements.

Correct Answer is A

Explanation

Choice A reason: Taking levothyroxine on an empty stomach ensures better absorption and prevents interference from food or other medications. The client should take levothyroxine at least 30 minutes before breakfast or four hours after the last meal of the day.

Choice B reason: Consuming foods that are high in iodine is not recommended for clients taking levothyroxine, as it may affect the thyroid function and the dosage of the medication. Foods that are high in iodine include seafood, seaweed, dairy products, and iodized salt.

Choice C reason: Administering levothyroxine at bedtime is not advisable, as it may cause insomnia, anxiety, or palpitations. Levothyroxine is best taken in the morning, as it mimics the natural secretion of thyroid hormones.

Choice D reason: Avoiding the use of iron supplements is not necessary for clients taking levothyroxine, as long as they are taken at different times. Iron supplements can interfere with the absorption of levothyroxine, so they should be taken at least four hours apart.

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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?

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Naxlex Comprehensive Predictor Exams

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Correct Answer is D

Explanation

A client receives a new prescription for levothyroxine. Which statement made by the client indicates to the nurse that the education was effective?

Correct Answer is A

Explanation

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