A client with chronic obstructive pulmonary disease (COPD) smokes two packs of cigarettes per day and is admitted to the hospital for a respiratory infection. The client reports difficulty controlling respiratory distress at home when using the rescue inhaler. Which comment from the client indicates to the nurse that the client is not using the inhaler properly

A. The statement indicates that the client is swallowing the medication rather than inhaling it, which suggests improper use of the inhaler. B. Difficulty inhaling and holding breath can occur with proper use but does not necessarily indicate incorrect technique. C. While using the inhaler only when very short of breath may not be optimal management, it does not indicate incorrect use of the inhaler itself. D. Shaking the inhaler before use is a correct technique to ensure proper medication delivery.