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 healthcare provider is providing discharge instructions to a client who is prescribed Warfarin. Which of the following dietary instructions should the provider include?

• A. Increase your intake of leafy green vegetables.
• B. Avoid foods high in vitamin K.
• C. Increase your intake of dairy products.
• D. Avoid foods high in iron.

Correct answer: B

Rationale: The correct answer is to avoid foods high in vitamin K. Vitamin K can interfere with the effectiveness of Warfarin by counteracting its anticoagulant effects. Foods high in vitamin K, such as leafy green vegetables, should be limited in the diet of individuals taking Warfarin to maintain a consistent level of the medication's effectiveness. Choices A, C, and D are incorrect as increasing intake of leafy green vegetables (choice A) and dairy products (choice C) may increase the intake of vitamin K, which is not recommended, and avoiding foods high in iron (choice D) is not directly related to Warfarin therapy.

3. A client has a new prescription for Aspirin for the prevention of myocardial infarction. Which of the following findings should be identified as an adverse effect?

• A. Nausea
• B. Bruising
• C. Dizziness
• D. Dry mouth

Correct answer: B

Rationale: Bruising is an adverse effect to be monitored when a client is prescribed Aspirin for the prevention of myocardial infarction due to its association with increased bleeding risk. Aspirin's antiplatelet effect can lead to bruising and other signs of bleeding, necessitating close observation to prevent complications. Nausea, dizziness, and dry mouth are not typically recognized adverse effects of Aspirin therapy for myocardial infarction prevention.

4. A client with increased intracranial pressure is receiving Mannitol. Which finding should the nurse report to the provider?

• A. Blood glucose 150 mg/dL
• B. Urine output 40 mL/hr
• C. Dyspnea
• D. Bilateral equal pupil size

Correct answer: C

Rationale: The correct answer is C: Dyspnea. Dyspnea is a concerning finding in a client receiving Mannitol as it can be a manifestation of heart failure, which is an adverse effect of the medication. The nurse should promptly notify the provider, discontinue the Mannitol, and initiate appropriate interventions to address the dyspnea and monitor the client's condition closely. Choice A, Blood glucose of 150 mg/dL, is within normal limits and not directly related to Mannitol administration. Choice B, Urine output of 40 mL/hr, could indicate decreased renal perfusion, but it is not the most critical finding compared to dyspnea. Choice D, Bilateral equal pupil size, is a normal neurological finding and not directly related to Mannitol therapy.

5. What is one of the therapeutic uses of Valproate?

• A. Suppression of seizure activity
• B. Replacement of hypothyroidism to restore normal hormone balance
• C. Maintenance of blood glucose
• D. Lowering of blood pressure

Correct answer: A

Rationale: Valproate, also known as Valproic acid, is commonly used in medicine for the suppression of seizure activity. It is an anticonvulsant medication that helps manage and prevent seizures in various conditions such as epilepsy. While it is not used for replacing hypothyroidism, maintaining blood glucose levels, or lowering blood pressure, its primary therapeutic use is in managing seizures.

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