A client is prescribed albuterol (Proventil) via a metered-dose inhaler. Which action should the nurse take to ensure effective use of this medication?

Correct Answer: B

Rationale: The correct answer is B: Have the client hold their breath for 10 seconds after inhaling the medication. This action promotes medication deposition in the lungs by allowing the albuterol to reach deeper into the airways. Holding the breath for 10 seconds ensures better absorption and effectiveness of the medication. Explanation of Incorrect Choices: A: Inhaling quickly may cause the medication to not reach the lower airways effectively. C: Exhaling immediately after inhaling the medication can decrease the amount of medication reaching the lungs. D: Using the inhaler only when experiencing symptoms may lead to ineffective management of respiratory conditions.

Correct Answer: D

Rationale: The correct answer is D because a sudden decrease in respiratory rate to 10 breaths per minute in a client with COPD receiving oxygen therapy can indicate respiratory depression or impending respiratory arrest, which are life-threatening emergencies. Immediate action is necessary to prevent further complications. A: An oxygen saturation of 90% is below the normal range but not an immediate concern unless it continues to decrease. B: A respiratory rate of 22 breaths per minute is within the normal range and does not require immediate action. C: Shortness of breath is common in clients with COPD and may not require immediate action unless it is severe or worsening rapidly.

Correct Answer: A

Rationale: The correct answer is A: Decreased breath sounds on the affected side. In a pleural effusion, fluid accumulates in the pleural space, leading to decreased air entry and diminished breath sounds on auscultation. This occurs because the fluid dampens the transmission of sound through the lungs. B: Hyperresonance on percussion of the affected side is not expected in pleural effusion, as it is typically associated with conditions like pneumothorax. C: Increased tactile fremitus on the affected side is not a typical finding in pleural effusion. Tactile fremitus may be decreased due to the presence of fluid. D: Tracheal deviation toward the affected side is more commonly seen in conditions like tension pneumothorax, not pleural effusion.

Correct Answer: B

Rationale: The correct answer is B because pursed-lip breathing involves inhaling slowly through the nose and exhaling slowly through pursed lips, which helps improve lung function and relaxes the client. Choice A is incorrect because breathing in quickly through the mouth is not part of pursed-lip breathing technique. Choice C is incorrect as holding breath before exhaling is not recommended in pursed-lip breathing. Choice D is partially correct but lacks the emphasis on inhaling slowly through the nose. Therefore, the most effective statement indicating correct teaching is choice B.

Correct Answer: A

Rationale: The correct answer is A: Albuterol (Proventil). Albuterol is a short-acting beta agonist bronchodilator that provides quick relief during an asthma exacerbation by relaxing the smooth muscles in the airways. This helps to rapidly open up the airways and improve breathing. Administering albuterol first is crucial in managing acute asthma symptoms. Summary of other choices: B: Ipratropium (Atrovent) is an anticholinergic bronchodilator that is often used in combination with albuterol for asthma exacerbations, but albuterol is preferred for initial rapid relief. C: Salmeterol (Serevent) is a long-acting beta agonist used for maintenance treatment of asthma, not for acute exacerbations. D: Fluticasone (Flovent) is an inhaled corticosteroid used for long-term control of asthma symptoms and prevention of exacerbations