Respiratory Question #5


The nurse is caring for a client with a diagnosis of chronic obstructive pulmonary disease (COPD). The nurse received a new order for a metered-dose inhaler (MDI) and immediately notifies the health care provider because of which important finding?


  1. The client has severe arthritis in both hands.
    • Rationale:
  2. The client is a smoker.
    • Rationale:
  3. Long-acting anticholinergic should be contraindicated in persons with COPD.
    • Rationale:
  4. The client is hard of hearing.
    • Rationale:



A client with severe arthritis may not be able to manipulate a MDI effectively, and the health provider needs to be aware since arthritis may interfere with proper administration of the inhaled therapy, resulting in insufficient or over-dosage. Physical impairment needs individualized considerations and perhaps a different type of delivery device. While complications occur as a result of smoking, it will not be the most important finding associated with using a MDI. Answer C is not appropriate to contact the health provider since long-acting anticholinergics will probably be a type of medication ordered and used for COPD. Being hard of hearing may not affect using the MDI.

Learning Outcomes

Test Taking Tip

Video Rationale