A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device. Which statement indicates the client understands the instructions for using this medication?
I should use this medication in its handihaler every day.
I will use my other inhaler in between uses.
When I cough up sputum, the secretions should be less thick.
If I have sudden shortness of breath, I will use this inhaler.
The Correct Answer is A
Choice A rationale
Tiotropium is a long-acting bronchodilator used daily to manage chronic obstructive pulmonary disease (COPD). It helps to relax the muscles around the airways, making it easier to breathe. This medication is not intended for immediate relief of acute symptoms but for long-term control of COPD1.
Choice B rationale
Using another inhaler in between uses of tiotropium is not necessary unless prescribed by a healthcare provider. Tiotropium is meant to be used daily, and other inhalers may be prescribed for different purposes, such as rescue inhalers for sudden symptoms.
Choice C rationale
While tiotropium can help improve breathing and reduce symptoms over time, it is not specifically indicated to reduce the thickness of sputum. Other medications or treatments may be needed to address sputum consistency.
Choice D rationale
Tiotropium is not a rescue inhaler and should not be used for sudden shortness of breath. Rescue inhalers, such as albuterol, are designed for immediate relief of acute symptoms.
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Correct Answer is A
Explanation
Choice A rationale
Asking the client to describe the pain is the best approach to assess the quality of pain. This allows the nurse to gather detailed information about the pain’s characteristics.
Choice B rationale
Identifying effective pain relief measures is important but does not directly assess the quality of pain.
Choice C rationale
Observing body language and movement can provide clues about pain but is not as effective as directly asking the client to describe the pain.
Choice D rationale
Providing a numeric pain scale helps quantify the pain but does not provide detailed information about the pain’s quality.
Correct Answer is D
Explanation
Choice A rationale
A chest X-ray or computed tomography (CT) scan can show abnormalities in the lungs that are suggestive of tuberculosis (TB), but they cannot definitively diagnose TB. These imaging tests can reveal changes in the lungs, such as nodules, inflammation, or fluid buildup, which can be caused by TB or other conditions. Therefore, a chest X-ray or CT scan alone is not sufficient to diagnose TB.
Choice B rationale
A hemoccult test on sputum collected from hemoptysis is not a diagnostic test for TB. It is a test for blood in the stool, which can be a symptom of TB but is not specific to TB. Hemoptysis, or coughing up blood, can occur in various conditions, including bronchitis, pneumonia, lung cancer, and TB. The hemoccult test cannot differentiate between these causes, making it an unreliable test for diagnosing TB.
Choice C rationale
A positive purified protein derivative (PPD) skin test indicates exposure to TB but does not confirm active infection. The PPD skin test involves injecting a small amount of tuberculin, a protein derived from Mycobacterium tuberculosis, into the skin. If a person has been exposed to TB, their immune system will react to the tuberculin, causing a raised red bump to appear at the injection site. However, a positive PPD skin test does not necessarily mean that a person has active TB infection. It could also mean that they have been exposed to TB in the past but have successfully fought off the infection. Further testing, such as a sputum culture, is needed to confirm the diagnosis of TB.
Choice D rationale
A sputum culture positive for Mycobacterium tuberculosis is the definitive diagnostic test for TB. It involves collecting a sample of sputum, which is the mucus coughed up from the lungs, and culturing it in a laboratory to see if Mycobacterium tuberculosis, the bacteria that causes TB, grows. This test is highly specific for TB, meaning that a positive result is almost always indicative of TB infection. It is also sensitive, meaning that it can detect TB infection even when there are few bacteria present.