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 Ferrous sulfate. Which of the following instructions should be included?

• A. Take this medication with milk.
• B. Take this medication on an empty stomach.
• C. Take this medication before bedtime.
• D. Take this medication with antacids.

Correct answer: B

Rationale: The correct answer is B: 'Take this medication on an empty stomach.' Ferrous sulfate is best absorbed on an empty stomach. Instruct the client to take it 1 hour before or 2 hours after meals to maximize absorption and avoid interactions with food or beverages that may decrease absorption. Choice A is incorrect because taking Ferrous sulfate with milk can decrease its absorption. Choice C is incorrect as there is no specific benefit to taking it before bedtime. Choice D is incorrect as antacids can interfere with the absorption of Ferrous sulfate.

3. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take one tablet at the first sign of chest pain.
• B. If pain is not relieved, take another tablet in 10 minutes.
• C. You can take up to five tablets in 15 minutes.
• D. Swallow the tablet with water.

Correct answer: A

Rationale: The correct instruction for a client with a new prescription for nitroglycerin sublingual tablets is to take one tablet at the first sign of chest pain. If the pain is not relieved after 5 minutes, the client should call 911 and take a second tablet. Taking more than the recommended dose can lead to serious side effects, and swallowing the tablet would not provide the rapid effect needed in cases of chest pain. Choice A is correct because it aligns with the standard protocol for nitroglycerin use in treating angina. Choice B is incorrect as the second tablet should be taken after 5 minutes, not 10 minutes. Choice C is incorrect as taking up to five tablets in 15 minutes is excessive and can result in serious complications. Choice D is incorrect as nitroglycerin sublingual tablets should be placed under the tongue for rapid absorption, not swallowed.

4. A nurse is teaching a client who has a new prescription for Spironolactone. Which of the following adverse effects should the nurse instruct the client to monitor?

• A. Hyperkalemia
• B. Hypoglycemia
• C. Hypocalcemia
• D. Hyponatremia

Correct answer: A

Rationale: Spironolactone is a potassium-sparing diuretic, so the nurse should monitor the client for hyperkalemia, which can cause muscle weakness and cardiac dysrhythmias.

5. When reviewing a client's health record, a nurse notes a new prescription for Lisinopril 10 mg PO once daily. The nurse should identify this as which type of prescription?

• A. Single
• B. Stat
• C. Routine
• D. Standing

Correct answer: C

Rationale: A routine prescription indicates medications to be administered on a regular schedule without a termination date or a specific number of doses. In this case, Lisinopril 10 mg PO once daily falls under a routine prescription, meaning the nurse will administer this medication daily until the provider discontinues it. Choices A, B, and D are incorrect: A 'single' prescription is for a one-time dose, 'stat' prescriptions are for immediate administration, and 'standing' prescriptions are pre-authorized for administration as needed within specified parameters.

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