Which patient using an inhaler would benefit $\mathbf{most}$ from using a spacer?

A) A 15 year old with a repaired cleft palate who is alert
B) A 25 year old with limited coordination of the extremities
C) A 50 year old with hearing impairment who uses a hearing aid
D) A 72 year old with left-sided hemiparesis using a dry powder inhaler

A spacer is indicated for a patient who has difficulty coordinating the steps, like patients with limited mobility/coordination. An alert adolescent with a repaired cleft palate would not need a spacer. Hearing impairment may make teaching the patient to use the inhaler difficult, but it does not indicate the need for a spacer. Although a patient with left-sided hemiparesis could have coordination problems, a patient using a dry powder inhaler does not require the use of spacers.