# A nurse teaches a client about fluticasone inhaler self-care. Which client statement indicates effective teaching to prevent a common adverse effect?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391772&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A nurse teaches a client about fluticasone inhaler self-care. Which client statement indicates effective teaching to prevent a common adverse effect?

## Option

1. "I will take this inhaler only when I have shortness of breath."
2. "I will rinse my mouth with water and spit after each use to prevent oral thrush and hoarseness." **✔ Correct answer**
3. "I will use this inhaler before exercise to prevent symptoms."
4. "I will increase the dose if my peak flow drops below 50% of baseline."

**Correct answer: 2**

## Explanation

Correct (2): Inhaled corticosteroids deposit on oral and pharyngeal mucosa, predisposing to oropharyngeal candidiasis (thrush) and dysphonia (hoarseness). Rinse and spit after each use; using a spacer also reduces deposition. (1) ICS is a controller, not reliever. (3) Albuterol (SABA) is used pre-exercise. (4) Acute dose changes belong to the asthma action plan with provider.

## In-depth explanation

Memory Tip ICS = "Inhale, Rinse, Spit." Spacer + rinse reduce thrush risk dramatically. Treat oral thrush with nystatin swish-and-swallow if it develops.

## Clinical scenario

Scenario 26-year-old female with persistent asthma is starting fluticasone DPI 100 mcg BID as a controller. Outpatient teaching about technique and self-care.

## Key concepts

- **Oropharyngeal candidiasis** — White plaques on tongue/throat from ICS deposition; treat with nystatin oral suspension.
- **Inhaled corticosteroid** — Fluticasone, budesonide, beclomethasone, mometasone, ciclesonide; daily controllers for persistent asthma.
- **Dysphonia** — Hoarseness from ICS deposition on vocal cords; reduced by rinsing and spacer use.

## Related questions

- [A nurse is caring for an alert adult client with type 1 diabetes who reports tremors, swea…](https://mymerci.kr/pages/nclex_q.php?qn_id=360524&lang=en)
- [A 68-year-old client with COPD is admitted with shortness of breath and SpO2 86% on room a…](https://mymerci.kr/pages/nclex_q.php?qn_id=362940&lang=en)
- [A 58-year-old client arrives at the emergency department with crushing substernal chest pa…](https://mymerci.kr/pages/nclex_q.php?qn_id=362976&lang=en)
- [A 72-year-old client is brought to the emergency department by family who report that the …](https://mymerci.kr/pages/nclex_q.php?qn_id=363003&lang=en)
- [A 79-year-old client is admitted from a long-term care facility with diarrhea, decreased o…](https://mymerci.kr/pages/nclex_q.php?qn_id=363089&lang=en)
- [A 76-year-old female with chronic heart failure and atrial fibrillation receives digoxin 0…](https://mymerci.kr/pages/nclex_q.php?qn_id=374883&lang=en)
- [A 70-year-old client on long-term digoxin therapy reports new yellow-green halos around li…](https://mymerci.kr/pages/nclex_q.php?qn_id=374884&lang=en)
- [A 58-year-old client with type 2 diabetes mellitus and migraine prophylaxis is taking prop…](https://mymerci.kr/pages/nclex_q.php?qn_id=374893&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=391772&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=391772&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=391772&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=391772&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=391772&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._