Nursing Elites

1. A client has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

• A. Crushing the medication might cause you to have a stomachache or indigestion.
• B. Crushing the medication is a good idea, and I can mix it in some ice cream for you.
• C. Crushing the medication would release all the medication at once, rather than over time.
• D. Crushing is unsafe, as it destroys the ingredients in the medication.

Correct answer: A

Rationale: Crushing an enteric-coated medication can cause it to break down in the stomach instead of the intestines, potentially leading to gastrointestinal distress like stomachache or indigestion. It is important to take enteric-coated medications whole to ensure they are properly absorbed in the intestines and to prevent irritation to the stomach.

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

• A. Increase your intake of bran fiber.
• B. Monitor your heart rate before taking the medication.
• C. Take the medication with antacids.
• D. Avoid drinking orange juice.

Correct answer: B

Rationale: When a client is prescribed Digoxin, it is essential to monitor their heart rate before each dose. Changes such as a heart rate below 60 bpm should be reported to the healthcare provider promptly. This is crucial because Digoxin can affect heart rhythm, and monitoring the heart rate helps in identifying any potential issues early on.

3. A client has a new prescription for Maraviroc to treat HIV infection. The healthcare provider should monitor the client for which of the following adverse reactions?

• A. Liver failure
• B. Kidney failure
• C. Pancreatitis
• D. Severe allergic reactions

Correct answer: D

Rationale: The correct answer is D: Severe allergic reactions. Maraviroc, used to treat HIV infection, can lead to severe allergic reactions, including hepatotoxicity. While liver failure is a potential adverse effect, it is often preceded by hepatotoxicity manifestations like jaundice or right upper quadrant pain. Kidney failure and pancreatitis are not typically associated with Maraviroc use. Therefore, monitoring for signs of severe allergic reactions and hepatotoxicity is crucial for early detection and intervention.

4. A client has a prescription for digoxin. The client should be monitored for which of the following findings as an indication of digoxin toxicity?

• A. Visual disturbances
• B. Tachycardia
• C. Increased appetite
• D. Constipation

Correct answer: A

Rationale: Visual disturbances, such as yellow-tinged vision or seeing halos around lights, are common signs of digoxin toxicity. These symptoms should be reported immediately to healthcare providers for further evaluation and management. Tachycardia (Choice B) is not typically associated with digoxin toxicity. Increased appetite (Choice C) and constipation (Choice D) are not common manifestations of digoxin toxicity. Therefore, the correct answer is visual disturbances.

5. A healthcare provider is educating a group of new parents about immunizations. The provider should instruct the parents that the series for which of the following vaccines is completed prior to the first birthday?

• A. Pneumococcal conjugate vaccine
• B. Meningococcal conjugate vaccine
• C. Varicella vaccine
• D. Rotavirus vaccine

Correct answer: D

Rationale: The correct answer is D, Rotavirus vaccine. The series for the Rotavirus vaccine is completed prior to the first birthday as it is only administered to infants less than 8 months of age. This vaccine provides protection against severe diarrhea and vomiting caused by rotavirus infection, which is common in infants and young children. Choices A, B, and C are incorrect because the series for these vaccines extends beyond the first birthday. Pneumococcal conjugate vaccine and Meningococcal conjugate vaccine are typically given in multiple doses up to 2 years of age, while the Varicella vaccine is usually administered between 12 to 15 months of age.

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