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You are assisting an asthma patient with his prescribed metered-dose inhaler. After the patient exhales, and before inhaling, the patient should put his or her lips around the inhaler, take a deep breath, and depress the inhale. You should:

  1. advise him to exhale forcefully to ensure medication absorption

  2. allow him to breathe room air and assess his oxygen saturation

  3. immediately reapply the oxygen mask and reassess his condition

  4. instruct him to hold his breath for as long as he comfortably can

The correct answer is: instruct him to hold his breath for as long as he comfortably can

After the patient exhales, they should take a deep breath and depress the inhaler. Holding their breath for a few seconds after inhaling helps to ensure that the medication reaches the intended area in the lungs and is fully absorbed. Option A, forcefully exhaling, may cause the medication to be exhaled instead of being absorbed. Option B, assessing oxygen saturation, is not necessary when assisting with a metered-dose inhaler. Option C, immediately reapplying the oxygen mask, may not be necessary unless the patient's condition worsens or if they are experiencing difficulty breathing after using the inhaler. Therefore, the correct answer is D, instructing the patient to hold their breath for as long as they comfortably can after inhaling.