Nokea
A client is being taught about the use of enoxaparin (Lovenox) for the prevention of deep vein thrombosis. Which instruction should the nurse include in the teaching plan?
- A. Inject the medication subcutaneously.
- B. Avoid massaging the injection site after administration.
- C. Administer the medication at the same time each day.
- D. Do not expel the air bubble from the syringe before injection.
Correct Answer: C
Rationale: Enoxaparin (Lovenox) is administered subcutaneously at the same time each day to maintain consistent blood levels. Injecting the medication into the muscle is incorrect, as it should be given subcutaneously. Massaging the injection site should be avoided to prevent bruising. The air bubble in the prefilled syringe should not be expelled, as it ensures the full dose is administered.
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A client is prescribed calcium gluconate after thyroidectomy. The medication is most likely prescribed to:
- A. Treat thyroid storm.
- B. Prevent cardiac irritability.
- C. Treat hypocalcemic tetany.
- D. Stimulate the release of parathyroid hormone.
Correct Answer: C
Rationale: After a thyroidectomy, the parathyroid glands can be inadvertently removed or damaged, leading to a decrease in calcium levels and potentially causing hypocalcemic tetany. Calcium gluconate is given to supplement calcium levels and prevent or treat hypocalcemia-related symptoms, such as muscle spasms and tetany.
A client is being taught about the use of nitroglycerin (Nitrostat) for angina. Which statement by the client indicates a need for further teaching?
- A. I will sit or lie down when I take the medication.
- B. I can take up to three tablets, 5 minutes apart, if needed.
- C. I will call 911 if my chest pain is not relieved after taking three tablets.
- D. I will keep the medication in its original dark container.
Correct Answer: B
Rationale: The correct administration of nitroglycerin for angina is to take up to three tablets, 5 minutes apart. If the chest pain persists after the third tablet, emergency medical services should be called. Taking more than three tablets or reducing the time interval between doses may lead to hypotension and indicates a need for further teaching.
The client who chronically uses nonsteroidal anti-inflammatory drugs (NSAIDs) has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?
- A. Resolved diarrhea
- B. Relief of epigastric pain
- C. Decreased platelet count
- D. Decreased white blood cell count
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
After administering acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer, the nurse should have which item available for potential use?
- A. Ambu bag
- B. Intubation tray
- C. Nasogastric tube
- D. Suction equipment
Correct Answer: D
Rationale: Acetylcysteine is administered via inhalation as a mucolytic. It helps liquefy secretions, making it easier for the client to clear them. However, in some cases, the increased volume of liquefied secretions may be challenging for the client to manage, leading to the potential need for suction equipment to assist in clearing the airway. Therefore, the nurse should have suction equipment available after administering acetylcysteine to address any issues related to excessive secretions.
Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which of the following food items?
- A. Milk
- B. Water
- C. Apple juice
- D. Orange juice
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.