A healthcare professional is providing discharge teaching to a client who has a new prescription for enoxaparin. Which of the following instructions should the healthcare professional include?
- A. Administer the injection into the abdomen.
- B. Avoid massaging the injection site after administration.
- C. Expect mild bruising at the injection site.
- D. Avoid alternating injection sites between the arms.
Correct Answer: A
Rationale: Administering enoxaparin into the abdomen is recommended to ensure proper absorption and effectiveness. Massaging the injection site after administration should be avoided as it can increase the risk of bleeding or bruising. Mild bruising at the injection site is common with enoxaparin and should be expected. Alternating injection sites, especially between arms, is not suitable for enoxaparin administration. Consistent administration into the abdomen is preferred for consistent absorption of the medication.
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When preparing to administer medication to a client, what action should the nurse take first?
- A. Verify the client's identity.
- B. Check the medication expiration date.
- C. Review the client's medical history.
- D. Obtain the client's vital signs.
Correct Answer: A
Rationale: Verifying the client's identity is the initial and most critical step in medication administration. It is crucial to confirm that the right medication is being given to the correct patient. Checking the client's identity helps prevent medication errors and ensures patient safety. Checking the medication expiration date (choice B) is important but should come after verifying the client's identity. Reviewing the client's medical history (choice C) is valuable but not the first step in medication administration. Obtaining the client's vital signs (choice D) is essential in some situations but is usually not the first action needed before administering medication.
A nurse is assessing a client who has a new prescription for enalapril. Which of the following findings is a priority for the nurse to report to the provider?
- A. Frequent urination
- B. Dry cough
- C. Tremors
- D. Dizziness
Correct Answer: D
Rationale: The correct answer is D: Dizziness. Dizziness is a sign of hypotension, a potential adverse effect of enalapril. Enalapril is an ACE inhibitor commonly prescribed for hypertension. Hypotension is a serious side effect that can lead to complications such as falls and injuries. Reporting dizziness promptly is crucial to prevent any harm to the client. Choices A, B, and C are not directly associated with enalapril use and are less concerning compared to the potential implications of hypotension indicated by dizziness.
A client with schizophrenia taking clozapine is being assessed by a nurse. Which of the following findings is the priority for the nurse to report to the provider?
- A. Elevated blood pressure
- B. Fever
- C. Weight gain
- D. Dry mouth
Correct Answer: B
Rationale: The priority finding for the nurse to report to the provider is B: Fever. Fever can be an indication of agranulocytosis, a potentially life-threatening condition associated with clozapine. Agranulocytosis is characterized by a significant decrease in white blood cells, making the client susceptible to severe infections. Prompt reporting of fever is crucial to prevent serious complications. Elevated blood pressure (Choice A), weight gain (Choice C), and dry mouth (Choice D) are important to monitor but are not as immediately concerning as fever, which could indicate a severe adverse reaction requiring urgent medical attention.
A client has a new prescription for furosemide. Which of the following statements should the nurse include in the teaching?
- A. Take the medication in the morning.
- B. Monitor for muscle weakness.
- C. Eat foods high in potassium.
- D. Expect weight gain.
Correct Answer: C
Rationale: The correct statement that the nurse should include in the teaching for a client prescribed furosemide is to eat foods high in potassium. Furosemide can lead to potassium depletion (hypokalemia) due to increased urine output. Consuming potassium-rich foods like bananas, oranges, spinach, and potatoes can help prevent this electrolyte imbalance. Choices A, B, and D are incorrect because taking furosemide in the morning, monitoring for muscle weakness, and expecting weight gain are not directly related to the potential side effects or necessary dietary adjustments when taking furosemide.
A client is being taught about the use of an albuterol inhaler. Which of the following instructions should be included?
- A. Use the inhaler every 4 hours around the clock.
- B. Shake the inhaler well before use.
- C. Rinse your mouth with water after each use.
- D. Use the inhaler while lying down.
Correct Answer: B
Rationale: Shaking the inhaler well before use is a crucial step in ensuring proper medication delivery. This action helps disperse the medication evenly within the device, optimizing the effectiveness of each dose. It ensures that the client receives the intended amount of medication. The other options are incorrect: Option A suggests a fixed time interval for inhaler use, which may not be suitable for all clients and can lead to overuse. Option C, rinsing the mouth, is more relevant for corticosteroid inhalers to prevent oral thrush. Option D, using the inhaler while lying down, is not recommended as it may lead to improper drug delivery and is not the correct position for inhaler use.
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