Question

A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?

Answer 1

Correct Answers:

The client should use an electric razor while on this medication.

Rationale :

🟦 Warfarin is an anticoagulant that increases the risk of bleeding, so clients must reduce everyday injury risks.

🟦 Using an electric razor lowers the chance of cuts and prolonged bleeding compared with a blade razor.

🟦 This teaching supports safer hygiene practices while the client’s clotting ability is intentionally reduced.

🟦 Because warfarin affects vitamin K–dependent clotting factors, even small cuts can bleed longer than expected.

🟦 The nurse should also reinforce monitoring for bleeding signs (e.g., bruising, black stools, hematuria) and keeping follow-up INR checks.

Warfarin increases the risk for deep vein thrombosis.

🟦 Warfarin is prescribed to prevent and treat clots like DVT and PE, not increase them.

🟦 This statement reverses the drug’s purpose and could lead to unsafe nonadherence.

Mild nosebleeds are common during initial treatment.

🟦 Nosebleeds can occur, but they are not considered “expected”; they may indicate excess anticoagulation.

🟦 Any unusual bleeding should be reported because it may reflect an INR that is too high.

If he misses a dose, he should double the dose at the next scheduled time.

🟦 Doubling doses can dangerously raise INR and increase major bleeding risk.

🟦 The client should follow provider instructions for missed doses and never “catch up” without guidance.

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Answer 2

Correct Answers:

"l can inject my Insulin detemir in the evening before bedtime.”

Rationale :

🟩 Insulin detemir is a long-acting (basal) insulin designed to provide steady glucose control over many hours.

🟩 Basal insulins are commonly scheduled once daily at the same time each day, and bedtime dosing is an appropriate routine.

🟩 Evening administration supports overnight coverage and helps reduce fasting hyperglycemia when prescribed as once daily.

🟩 The key is consistency—taking it at a consistent time promotes stable basal insulin levels.

🟩 Even though it’s long-acting, the client must still monitor for hypoglycemia, especially with reduced intake or increased activity.

“I don't have to worry about hypoglycemia while taking insulin detemir."

🟩 Any insulin can cause hypoglycemia, including long-acting detemir.

🟩 The client should know symptoms (sweating, shakiness, confusion) and how to treat low glucose.

“I should inject my insulin detemir 30 min before a meal…”

🟩 Injecting before meals is teaching for short/rapid-acting insulin, not long-acting basal insulin.

🟩 Detemir is not used for immediate meal coverage and won’t match post-meal glucose spikes.

“If my blood sugar is high, I can mix regular insulin with my insulin detemir.”

🟩 Long-acting insulins like detemir are generally not mixed with other insulins in the same syringe due to altered absorption.

🟩 Correction doses are usually managed with prescribed rapid/short-acting insulin separately, per provider plan.

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Answer 3

Correct Answers:

0.1

Rationale :

✍️Order: 5 mg IM

✍️Available: 50 mg/mL

✍️Formula:

🟨mL to give = (Desired dose ÷ Concentration)

🟨Desired dose = 5 mg

🟨Concentration = 50 mg per 1 mL

🟨mL = 5 mg ÷ 50 mg/mL

👉 0.1 mL

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Answer 4

Correct Answers:

Administration of sodium polystyrene sulfonate

Rationale :

🟧 Hyperkalemia is dangerous because high potassium can trigger life-threatening dysrhythmias.

🟧 Sodium polystyrene sulfonate is a potassium-binding resin that removes potassium via the GI tract through cation exchange.

🟧 This therapy helps lower serum potassium, targeting the underlying problem rather than just symptoms.

🟧 It is used when the goal is actual potassium reduction, often alongside monitoring of ECG and repeat potassium labs.

🟧 Teaching includes watching for GI effects and ensuring the client understands this is aimed at potassium elimination.

Increased dietary intake of potassium-rich foods

🟧 This would worsen hyperkalemia by adding more potassium to the bloodstream.

🟧 Dietary potassium is restricted—not increased—when potassium levels are high.

Administration of calcium gluconate

🟧 Calcium gluconate helps stabilize the cardiac membrane, protecting the heart during severe hyperkalemia.

🟧 It does not remove potassium from the body, so it is not the best “potassium-lowering” treatment option.

Fluid restriction

🟧 Fluid restriction does not correct hyperkalemia and may reduce renal excretion if it contributes to low urine output.

🟧 Management focuses on shifting/removing potassium and protecting the heart, not restricting fluids as a primary measure.

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Answer 5

Correct Answers:

Albuterol

Rationale :

🟥 An acute asthma attack requires a rapid-acting bronchodilator to quickly open constricted airways.

🟥 Albuterol is a short-acting beta₂-agonist (SABA) that relaxes bronchial smooth muscle within minutes.

🟥 This directly improves airflow and reduces wheezing, shortness of breath, and chest tightness during an attack.

🟥 SABAs are the standard rescue meds taught for symptom relief, especially for sudden bronchospasm.

🟥 The child should also be taught to track frequency of use because frequent rescue use may indicate poor control and need for plan adjustment.

Montelukast

🟥 Montelukast is used for long-term control and prevention, not rapid relief during an acute attack.

🟥 It does not act quickly enough to abort bronchospasm in real time.

Cromolyn

🟥 Cromolyn is a mast cell stabilizer used preventively and must be taken before triggers.

🟥 It is not effective for immediate bronchodilation during an active attack.

Fluticasone

🟥 Fluticasone is an inhaled corticosteroid for long-term inflammation control, not acute symptom rescue.

🟥 It does not produce rapid airway opening during an attack.

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Answer 6

Correct Answers:

Take the medication in the evening hours.

Rationale :

✅ Simvastatin works best when taken in the evening because the body makes most cholesterol at night, so the medication is timed to block cholesterol production when it is highest.

✅ Taking it at night improves the drug’s ability to lower LDL (“bad” cholesterol) and reduce cardiovascular risk over time.

✅ This instruction supports consistent therapeutic levels and helps the client get the maximum lipid-lowering benefit from each dose.

✅ Evening dosing is a common teaching point for shorter-acting statins like simvastatin, which depend more on timing than longer-acting statins.

✅ Consistent evening use also supports adherence by linking the medication to a daily routine (e.g., bedtime).

“Have a meal or a snack when taking the medication.”

✅Simvastatin may be taken with or without food, so a snack is not required.

✅Making food “mandatory” can confuse the client and may reduce adherence if they skip meals.

“Swallow the tablet with a glass of grapefruit juice.”

✅Grapefruit can increase simvastatin levels, raising the risk of myopathy/rhabdomyolysis.

✅The client should avoid grapefruit products while taking simvastatin.

“Follow each tablet with an antacid tablet.”

✅Antacids are not routinely needed with simvastatin and can create unnecessary medication use.

✅This instruction does not improve simvastatin effectiveness and may complicate the regimen.

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Answer 7

Correct Answers:

Diarrhea

Rationale :

✅ Diarrhea is a common and important adverse effect of colchicine because the medication frequently irritates the GI tract.

✅ Colchicine can cause abdominal cramping, nausea, vomiting, and diarrhea, and diarrhea is often the earliest sign that the dose may be too strong.

✅ Ongoing diarrhea can lead to dehydration and electrolyte imbalance, so the client should report persistent symptoms promptly.

✅ Severe GI symptoms can indicate toxicity, especially if the client is older or has kidney/liver impairment (drug may accumulate).

✅ Teaching should emphasize monitoring stool pattern and maintaining hydration while also recognizing that worsening diarrhea may require dose adjustment.

“Increased appetite.”

✅Colchicine does not typically stimulate appetite; GI upset more often causes decreased appetite.

✅This finding is not a classic adverse effect for teaching.

“Tinnitus.”

✅Tinnitus is more associated with salicylate toxicity (e.g., high-dose aspirin), not colchicine.

✅ It would not be expected as a routine colchicine side effect.

“Urinary retention.”

✅Urinary retention is more consistent with anticholinergic effects or certain opioids.

✅It is not a typical colchicine adverse effect.

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Answer 8

Correct Answers:

History of vitamin K deficiency

Rationale :

✔️Aspirin increases bleeding risk by inhibiting platelet aggregation, and vitamin K deficiency already impairs clotting factor production, creating a high bleeding risk.

✔️With low vitamin K, the body cannot effectively produce clotting factors (II, VII, IX, X), so adding aspirin can further reduce the ability to stop bleeding.

✔️This combination raises concern for easy bruising, GI bleeding, nosebleeds, and prolonged bleeding time, which is clinically significant.

✔️The nurse should report this history because the provider may recommend a safer analgesic option (often acetaminophen for OA pain when bleeding risk is high).

✔️The key safety issue is that aspirin affects platelets, while vitamin K deficiency affects clotting factors—together they increase hemorrhage risk.

“Prior reports of amenorrhea.”

✔️Amenorrhea is not a direct contraindication to aspirin use for pain control.

✔️It does not automatically indicate bleeding risk or aspirin intolerance.

“Current diagnosis of glaucoma.”

✔️Glaucoma is not a standard contraindication to aspirin; it does not typically worsen intraocular pressure.

✔️This history would not be the priority concern for aspirin safety.

“Report of recent migraine headaches.”

✔️Migraines are not a contraindication to aspirin and some clients even use NSAIDs for headache relief.

✔️The priority safety issue remains bleeding risk rather than migraine history.

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Answer 9

Correct Answers:

"l can keep the current vial of insulin in use stored at room temperature."

Rationale :

♦️ Insulin that is currently in use may be stored at room temperature to reduce injection discomfort and improve patient comfort.

♦️Room-temperature storage is acceptable as long as the insulin is kept away from direct sunlight, heat, or freezing temperatures, which can reduce potency.

♦️Most insulins have a limited “in-use” timeframe (often about 28 days, though it can vary by product), and the nurse should follow facility policy and manufacturer guidance.

♦️Proper storage helps maintain drug effectiveness, ensuring predictable glucose control and reducing the risk of hyperglycemia from degraded insulin.

♦️Teaching should stress labeling the vial with the date opened and inspecting for changes (cloudiness in clear insulin, clumping, or discoloration).

“I will discard the current vial of insulin after six doses have been withdrawn.”

♦️Insulin is not discarded based on number of doses; it is discarded based on expiration date and in-use timeframe.

♦️Discarding after six doses wastes medication and is not evidence-based.

“I will store unopened vials of insulin in the freezer.”

♦️Freezing insulin can destroy potency, making it ineffective and unsafe.

♦️Unopened insulin should be refrigerated—not frozen.

“I will return any unused vials of insulin to the pharmacy once they have been on the unit for 1 month.”

♦️Returning insulin is not the key storage concept; the priority is correct temperature control and expiration/in-use dating.

♦️Insulin kept on the unit may remain appropriate if stored correctly and not expired.

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Answer 10

Correct Answers:

“I will contact my provider if I become pregnant while taking this medication."

Rationale :

➡️ Lisinopril (an ACE inhibitor) is contraindicated in pregnancy because it can cause serious fetal harm, especially affecting fetal kidney development.

➡️ACE inhibitors can lead to oligohydramnios, fetal renal failure, and other complications, making pregnancy reporting an urgent safety priority.

➡️The client must notify the provider immediately so the medication can be stopped and replaced with a safer alternative.

➡️This teaching supports prevention of teratogenic effects and protects maternal-fetal health outcomes.

➡️The nurse should reinforce the need for reliable contraception and prompt reporting of any suspected pregnancy.

“I can expect my voice to be hoarse while taking this medication.”

➡️A mild cough can occur with ACE inhibitors, but hoarseness can also suggest angioedema involvement of the airway—this is not something to “expect.”

➡️Any swelling/airway symptoms require urgent evaluation.

“I should check my pulse before each dose of this medication.”

➡️Pulse checks are more relevant for drugs like beta-blockers or digoxin.

➡️Lisinopril teaching focuses more on blood pressure, kidney function, and potassium.

“I should use salt substitutes while taking this medication.”

➡️Many salt substitutes contain potassium, and lisinopril can increase potassium levels.

➡️This combination can cause hyperkalemia, so salt substitutes should be avoided unless approved.

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QLexNursing

1 :
A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?

2 :
A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for insulin detemir injections once daily. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is preparing to administer haloperidol 5 mg IM to a client. Available is haloperidol 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

4 :
Which of the following is a treatment option for hyperkalemia?

5 :
A nurse is reinforcing teaching to a school-age child who has asthma. Which of the following medications should the nurse instruct the child to use to abort an ongoing attack?

6 :
A nurse is reinforcing teaching with a client who has a prescription for simvastatin. Which of the following instructions should the nurse provide?

7 :
A nurse in a provider's office is reinforcing teaching with a client who is to start taking colchicine orally for gout. The nurse should tell the client that which of the following findings is an adverse effect of colchicine?

9 :
A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

10 :
A nurse is reinforcing teaching with a client who has a prescription for lisinopril. Which of the following statements indicates an understanding of the teaching?

QLexNursing

1 : A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?

2 : A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for insulin detemir injections once daily. Which of the following statements by the client indicates an understanding of the teaching?

3 : A nurse is preparing to administer haloperidol 5 mg IM to a client. Available is haloperidol 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

4 : Which of the following is a treatment option for hyperkalemia?

5 : A nurse is reinforcing teaching to a school-age child who has asthma. Which of the following medications should the nurse instruct the child to use to abort an ongoing attack?

6 : A nurse is reinforcing teaching with a client who has a prescription for simvastatin. Which of the following instructions should the nurse provide?

7 : A nurse in a provider's office is reinforcing teaching with a client who is to start taking colchicine orally for gout. The nurse should tell the client that which of the following findings is an adverse effect of colchicine?

9 : A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

10 : A nurse is reinforcing teaching with a client who has a prescription for lisinopril. Which of the following statements indicates an understanding of the teaching?

1 :
A nurse is reinforcing teaching for a client who has a new prescription for warfarin. Which of the following information should the nurse include?

2 :
A nurse is reinforcing teaching for a client who has diabetes mellitus and has a prescription for insulin detemir injections once daily. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is preparing to administer haloperidol 5 mg IM to a client. Available is haloperidol 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth/whole number. Use a leading zero if it applies. Do not use a trailing zero.)

4 :
Which of the following is a treatment option for hyperkalemia?

5 :
A nurse is reinforcing teaching to a school-age child who has asthma. Which of the following medications should the nurse instruct the child to use to abort an ongoing attack?

6 :
A nurse is reinforcing teaching with a client who has a prescription for simvastatin. Which of the following instructions should the nurse provide?

7 :
A nurse in a provider's office is reinforcing teaching with a client who is to start taking colchicine orally for gout. The nurse should tell the client that which of the following findings is an adverse effect of colchicine?

9 :
A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

10 :
A nurse is reinforcing teaching with a client who has a prescription for lisinopril. Which of the following statements indicates an understanding of the teaching?