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 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 a new prescription for an antihypertensive medication is being provided discharge instructions by a nurse. Which of the following statements should the nurse give?

• A. Be sure to limit your potassium intake while taking the medication.
• B. You should check your blood pressure every 8 hours while taking this medication.
• C. Your medication dosage will be increased if you develop tachycardia.
• D. Change positions slowly when you move from sitting to standing.

Correct answer: D

Rationale: The correct statement for the nurse to provide is to instruct the client to change positions slowly when moving from sitting to standing. This is crucial because antihypertensive medications can cause orthostatic hypotension, leading to dizziness or lightheadedness when changing positions quickly. Checking blood pressure every 8 hours is unnecessary and could lead to over-monitoring. There is no direct relationship between the medication and potassium intake. Increasing the medication dosage due to tachycardia is not a typical response and may not be accurate.

4. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. To ensure the insulin is available when food is digested, the client should take this medication 30 minutes before each meal. This timing aligns the medication with the expected postprandial rise in blood glucose levels, optimizing its effectiveness in controlling blood sugar levels. Choices A, C, and D are incorrect because taking Repaglinide with meals, just before bed, or as soon as waking up does not align with the medication's mechanism of action and timing needed for optimal effectiveness.

5. A client has been prescribed a calcium channel blocker for angina. The nurse knows this medication should NOT be used with caution in combination with which drug classes?

• A. NSAIDs
• B. Cardiac glycosides
• C. Beta blockers
• D. None of the above

Correct answer: C

Rationale: Calcium channel blockers and beta blockers should be used with caution together because they can both suppress heart function, potentially leading to bradycardia, heart block, or heart failure. NSAIDs and cardiac glycosides do not have significant interactions with calcium channel blockers in the same way, so they are not typically a cause for concern when combined.

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