Questions: A nurse is teaching a child how to use a metered-dose inhaler (MDI). Which of the following statements by the child indicates an understanding of the teaching? "I will hold the inhaler at a 45° angle to release the medication." "I will tilt my head forward while inhaling the medication." "I will hold my breath for 10 seconds after inhaling the medication." "I will wait 5 minutes before taking a second puff of the medication."

The answer is the third one: "I will hold my breath for 10 seconds after inhaling the medication."

Explanation for each option:

1. "I will hold the inhaler at a $45^{\circ}$ angle to release the medication."

   • This statement is incorrect. The correct technique involves holding the inhaler upright and placing the mouthpiece in the mouth, ensuring a good seal with the lips.

2. "I will tilt my head forward while inhaling the medication."

   • This statement is incorrect. The correct technique involves tilting the head slightly back to open the airway, making it easier to inhale the medication deeply into the lungs.

3. "I will hold my breath for 10 seconds after inhaling the medication."

   • This statement is correct. Holding the breath for about 10 seconds allows the medication to settle in the lungs and be more effective.

4. "I will wait 5 minutes before taking a second puff of the medication."

   • This statement is incorrect. The usual recommendation is to wait about 1 minute between puffs, not 5 minutes.

Summary: The correct statement indicating an understanding of the proper use of a metered-dose inhaler (MDI) is: "I will hold my breath for 10 seconds after inhaling the medication." This ensures that the medication is properly absorbed in the lungs.