Nursing Elites

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

• A. Take the medication with a full glass of water.
• B. Expect results within 30 minutes.
• C. Take this medication at bedtime.
• D. Avoid taking this medication with food.

Correct answer: A

Rationale: The correct instruction for a client prescribed Docusate Sodium is to take the medication with a full glass of water. Docusate sodium is a stool softener, and taking it with water helps to soften the stool and make bowel movements easier. Adequate fluid intake is crucial when taking stool softeners to prevent constipation. Choices B, C, and D are incorrect. B is incorrect because the effects of Docusate Sodium may not be immediate, and it may take a couple of days for the stool softener to work. Choice C is incorrect as there is no specific requirement to take this medication at bedtime. Choice D is incorrect because there is no instruction to avoid taking Docusate Sodium with food.

2. A client is starting a new prescription for furosemide. Which of the following instructions should the nurse include?

• A. Take the medication with food.
• B. Weigh yourself daily.
• C. Take potassium supplements as needed.
• D. Decrease intake of foods high in sodium.

Correct answer: B

Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect. Choice A is incorrect because furosemide is usually recommended to be taken on an empty stomach. Choice C is incorrect because potassium supplements should only be taken if prescribed by a healthcare provider due to the risk of hyperkalemia with furosemide. Choice D is incorrect because decreasing sodium intake is generally a good dietary practice but not a specific instruction related to furosemide therapy.

3. 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.

4. When teaching a client with a new prescription for Furosemide, which instruction should the nurse include?

• A. Take this medication at bedtime.
• B. Avoid eating foods high in potassium.
• C. Change positions slowly.
• D. Take this medication with meals.

Correct answer: C

Rationale: The correct instruction for a client with a new prescription for Furosemide is to change positions slowly. Furosemide is a diuretic that can lead to orthostatic hypotension, causing dizziness and increasing the risk of falls. By advising the client to change positions slowly, the nurse helps prevent these potential adverse effects. Choices A, B, and D are incorrect. Taking Furosemide at bedtime (Choice A) is not necessary as it can be taken at any time of the day. Avoiding foods high in potassium (Choice B) is more relevant for clients taking potassium-sparing diuretics. Taking Furosemide with meals (Choice D) may lead to increased diuretic effects and frequent urination.

5. A client with Addison's disease is being admitted for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. What is the nurse's priority action?

• A. Administering a supplemental dose of hydrocortisone
• B. Instructing the client about coughing and deep breathing
• C. Collecting additional information from the client about his history of Addison's disease
• D. Inserting an indwelling urinary catheter

Correct answer: A

Rationale: The nurse's priority in this situation is to administer a supplemental dose of hydrocortisone. Clients with Addison's disease taking hydrocortisone are at risk of acute adrenal insufficiency during times of stress such as surgery. Administering supplemental doses of hydrocortisone helps prevent acute adrenal insufficiency (adrenal crisis) in these situations, making it the priority action to ensure the client's safety. Instructing the client about coughing and deep breathing is important postoperatively but not the priority at this time. Collecting additional information about the client's history of Addison's disease is important but not the priority action before surgery. Inserting an indwelling urinary catheter is not the priority in this situation.

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