Question

A nurse is caring for a client who 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?

Answer 1

Correct Answers:

“Crushing the medication would release all the medication at once, rather than over time."

Rationale :

🔶 Enteric-coated medications are designed to dissolve in the intestines rather than the stomach to prevent gastric irritation and allow for delayed, controlled absorption.

🔶 Crushing the medication destroys the protective coating, causing the drug to release immediately, which can lead to toxicity or reduced effectiveness.

🔶 The sudden release may also increase gastrointestinal side effects such as ulceration or stomach upset.

🔶 Nurses should encourage alternative forms such as liquid preparations or consult the provider for a different route of administration.

🔶 Client education on the importance of taking medications as formulated promotes safe and effective therapy.

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Answer 2

Correct Answers:

Drink a glass of water after taking the medication.

Rationale :

💠 Calcium carbonate antacids can cause constipation, and adequate fluid intake helps reduce this adverse effect by promoting bowel motility.

💠 Taking the antacid with water also aids in optimal dissolution and absorption in the stomach.

💠 Antacids should not be taken with dairy products because calcium from dairy can increase the risk of hypercalcemia and kidney stones.

💠 High sodium intake can worsen fluid retention, but this is not directly related to antacid use, making hydration the priority recommendation.

💠 Lifestyle and dietary measures, such as maintaining a high-fiber diet, further reduce constipation risk while on calcium carbonate therapy.

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Answer 3

Correct Answers:

Stop the infusion.

Rationale :

🔷 Stopping the infusion immediately is the priority because the client is showing signs of a possible anaphylactic reaction, including itching at the IV site, dizziness, and shortness of breath.

🔷 Continuing the medication can worsen the hypersensitivity response, leading to bronchospasm, hypotension, and cardiovascular collapse.

🔷 After stopping the infusion, the nurse can maintain IV access with normal saline to allow for emergency medication administration (e.g., epinephrine, antihistamines).

🔷 The other interventions, such as auscultating breath sounds or notifying the provider, are appropriate but must follow immediate discontinuation of the offending agent.

🔷 Early recognition and stopping the trigger medication are key to preventing severe complications.

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Answer 4

Correct Answers:

Check the client's vital signs.

Rationale :

📌Nausea, weakness, and anorexia are early signs of digoxin toxicity, which can lead to life-threatening arrhythmias.

📌 The nurse must first check vital signs, especially apical pulse, because digoxin can cause bradycardia and hypotension.

📌 If the pulse is below 60 bpm, the nurse should withhold the drug and notify the provider immediately.

📌 Assessing vital signs promptly provides essential information to determine whether toxicity management (e.g., holding digoxin or administering digoxin immune Fab) is required.

📌 Monitoring and recognizing early signs of toxicity are crucial to preventing cardiac complications in heart failure clients.

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Answer 5

Correct Answers:

Suppress respiratory effort.

Rationale :

♦ Pancuronium is a neuromuscular blocking agent that induces skeletal muscle paralysis, including the diaphragm and intercostal muscles.

♦ In clients with ARDS on mechanical ventilation, it is used to suppress spontaneous respiratory effort, allowing synchronized ventilatory support and improved oxygenation.

♦ This medication does not sedate or relieve pain, so sedation and analgesia should be administered concurrently.

♦ By eliminating respiratory muscle activity, it reduces oxygen consumption and prevents asynchrony with the ventilator.

♦ Continuous respiratory and cardiac monitoring is required because the client will depend entirely on mechanical ventilation.

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Answer 6

Correct Answers:

“Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level."

Rationale :

🔵 Warfarin inhibits vitamin K-dependent clotting factors, but its anticoagulant effect is delayed (3–5 days) until existing clotting factors are depleted.

🔵 Heparin provides immediate anticoagulation by activating antithrombin III, which inhibits thrombin and factor Xa.

🔵 Overlapping therapy prevents new clot formation while waiting for warfarin to reach a therapeutic INR (2–3 for most conditions).

🔵 Once the INR is therapeutic, heparin can be discontinued to avoid excessive anticoagulation.

🔵 This overlap is a standard practice to ensure continuous protection against thromboembolic events.

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Answer 7

Correct Answers:

50

Rationale :

✍️Calculation Formula:

(Desired Dose ÷ Available Dose) × Volume.

(250 mg ÷ 25 mg) × 5 mL

10 × 5

50 mL.

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Answer 8

Correct Answers:

33

Rationale :

✍🏿 Formula:

(Total Volume × Drop Factor) ÷ Time (minutes).

(100 mL × 10 gtt/mL) ÷ 30 min

1000 ÷ 30

33.3

33 gtt/min.

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Answer 9

Correct Answers:

20

Rationale :

🔷 Calculation Formula:

(Desired Dose ÷ Available Dose) × Volume.

(800 mg ÷ 200 mg) × 5 mL

4 × 5

20 mL.

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Answer 10

Correct Answers:

25

Rationale :

✏️ Formula:

(Total Volume × Drop Factor) ÷ Time (minutes).

(100 mL × 15 gtt/mL) ÷ 60 min

1500 ÷ 60

25 gtt/min.

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Custom: N303 Final 7/06

No.

1 :
A nurse is caring for a client who 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?

2 :
A nurse is completing a medication history for a client who reports using calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication?

4 :
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

5 :
A nurse is caring for a client who has acute respiratory distress syndrome (ARDS), and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

9 :
A nurse is preparing to administer erythromycin ethylsuccinate 800 mg PO every 4 hr. Available is erythromycin ethylsuccinate 200 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

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Custom: N303 Final 7/06

No.

1 : A nurse is caring for a client who 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?

2 : A nurse is completing a medication history for a client who reports using calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication?

4 : A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

5 : A nurse is caring for a client who has acute respiratory distress syndrome (ARDS), and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

9 : A nurse is preparing to administer erythromycin ethylsuccinate 800 mg PO every 4 hr. Available is erythromycin ethylsuccinate 200 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

1 :
A nurse is caring for a client who 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?

2 :
A nurse is completing a medication history for a client who reports using calcium carbonate antacid. Which of the following recommendations should the nurse make about taking this medication?

4 :
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

5 :
A nurse is caring for a client who has acute respiratory distress syndrome (ARDS), and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

9 :
A nurse is preparing to administer erythromycin ethylsuccinate 800 mg PO every 4 hr. Available is erythromycin ethylsuccinate 200 mg/5mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)