Correct Answer: C

Rationale: Holding the breath for 5-10 seconds after inhaling the medication allows the medication to deposit in the lungs, maximizing its effectiveness for asthma control.
Choice A is incorrect because the inhaler should be shaken well before use, but not necessarily before attaching it to the spacer; shaking ensures proper mixing of the medication.
Choice B is incorrect because inhaling slowly and deeply (not quickly) through the spacer ensures better medication delivery to the lungs.
Choice D is incorrect because the spacer should be cleaned with mild soap and water, not alcohol wipes, to avoid damaging it or leaving residue.

Correct Answer: A

Rationale: A heart rate of 56/min is below the normal range (60-100/min) and may indicate digoxin toxicity, especially in heart failure clients, as digoxin slows the heart rate by enhancing vagal tone; this requires immediate reporting to the provider.
Choice B is wrong because a blood pressure of 140/90 mm Hg, while elevated, is not directly related to digoxin toxicity and should be monitored but is not the priority.
Choice C is wrong because a weight gain of 0.5 kg in 24 hours is not significant enough to indicate fluid overload in heart failure; a gain of >1 kg (2.2 lb) in 24 hours would be more concerning.
Choice D is wrong because a potassium level of 4.2 mEq/L is within the normal range (3.5-5.0 mEq/L), and while hypokalemia increases digoxin toxicity risk, this level is not concerning.

Correct Answer: C

Rationale: Monitoring for dizziness or drowsiness is important with buspirone, a non-benzodiazepine anxiolytic, as these are common side effects that may affect safety or require dose adjustment.
Choice A is incorrect because buspirone is taken regularly (2-3 times daily), not as needed, to achieve steady-state anxiety control.
Choice B is incorrect because buspirone takes 2-4 weeks to provide significant anxiety relief, not immediate relief.
Choice D is incorrect because buspirone should not be discontinued abruptly, even if symptoms resolve, to avoid withdrawal or relapse; it requires provider guidance.

Correct Answer: C

Rationale: Taking levothyroxine in the morning on an empty stomach (30-60 minutes before food or other medications) ensures optimal absorption and efficacy for treating hypothyroidism.
Choice A is wrong because taking levothyroxine with a meal can reduce absorption, decreasing its effectiveness; it should be taken on an empty stomach.
Choice B is wrong because it typically takes 4-6 weeks for levothyroxine to stabilize thyroid hormone levels and for symptoms to improve, not 1 week.
Choice D is wrong because thyroid function tests are typically checked every 6-8 weeks initially to adjust the dose, then every 6-12 months once stable, not automatically every 12 months.

Correct Answer: A

Rationale: A respiratory rate of 10/min is below the normal range (12-20/min) and indicates potential magnesium sulfate toxicity, which can lead to respiratory depression or arrest. This finding should be reported immediately to the provider, and the infusion may need to be stopped.
Choice B is wrong because a blood pressure of 150/90 mm Hg, while elevated, is not unexpected in preeclampsia and does not indicate immediate toxicity; it should be monitored, but it is not the priority.
Choice C is wrong because a urine output of 40 mL/hr is within the acceptable range (at least 30 mL/hr) for a client receiving magnesium sulfate and does not indicate renal compromise.
Choice D is wrong because deep tendon reflexes of 2+ are normal and do not suggest magnesium toxicity, which would present with absent or diminished reflexes.