Nursing Elites

1. A client has a new prescription for Enoxaparin. Which of the following instructions should the nurse include?

• A. Massage the injection site after administration.
• B. Aspirate before injecting the medication.
• C. Administer the medication into the abdomen.
• D. Administer the medication via intramuscular injection.

Correct answer: C

Rationale: The correct answer is to administer the medication into the abdomen. Enoxaparin is a medication that is administered subcutaneously, typically in the abdomen to ensure proper absorption. Massaging the injection site should be avoided as it can lead to bruising or bleeding under the skin. Aspirating before injecting the medication is not necessary for subcutaneous injections like Enoxaparin. Administering the medication via intramuscular injection is incorrect as Enoxaparin should be given subcutaneously.

2. A client has a new prescription for levothyroxine. Which of the following instructions should the nurse include?

• A. Take this medication at bedtime.
• B. Take this medication with food.
• C. Take this medication on an empty stomach in the morning.
• D. Take this medication with an antacid.

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance its absorption. This timing allows for optimal absorption and effectiveness of the medication. Taking it with food, at bedtime, or with an antacid may interfere with its absorption and reduce its efficacy.

3. A client with heart failure is receiving instructions about laxative use. The client should be advised to avoid which of the following laxatives?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: Clients with heart failure often have sodium restrictions. Sodium phosphate can lead to fluid retention due to sodium absorption, which is harmful for individuals with heart failure. Therefore, it should be avoided in this population to prevent exacerbating fluid overload. Psyllium, Bisacodyl, and Polyethylene glycol are safer options for individuals with heart failure as they do not pose the risk of exacerbating fluid overload through sodium retention.

4. A client with heart failure is being instructed on laxative use. Which of the following laxatives should the client avoid?

• A. Sodium phosphate
• B. Psyllium
• C. Bisacodyl
• D. Polyethylene glycol

Correct answer: A

Rationale: The correct answer is A: Sodium phosphate. Clients with heart failure often follow a sodium-restricted diet. Sodium phosphate laxatives can lead to sodium absorption, causing fluid retention, which is contraindicated in heart failure. It is crucial to avoid sodium phosphate laxatives in these clients to prevent exacerbation of fluid overload and heart failure symptoms. Psyllium (choice B), Bisacodyl (choice C), and Polyethylene glycol (choice D) are not contraindicated in clients with heart failure and can be used safely for bowel management.

5. A client has a new prescription for Ramelteon and is receiving teaching from a nurse. The nurse should instruct the client to avoid which of the following foods while taking this medication?

• A. Baked potato
• B. Fried chicken
• C. Whole-grain bread
• D. Citrus fruits

Correct answer: B

Rationale: The correct answer is B: Fried chicken. High-fat foods like fried chicken can prolong the absorption of Ramelteon, potentially reducing its effectiveness. It is important to avoid such foods to ensure the medication works as intended.

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