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A nurse is reinforcing discharge teaching with a client who has a new diagnosis of type 2 diabetes mellitus and a prescription for exenatide. Which of the following instructions should the nurse include in the teaching?
- A. Contact the provider if you experience unexplained muscle pain.
- B. Inject the medication into the subcutaneous tissue of your abdomen.
- C. Take the medication at bedtime.
- D. Discard excess medication after 60 days.
Correct Answer: B
Rationale: The correct answer is B: Inject the medication into the subcutaneous tissue of your abdomen. Exenatide is a medication used to treat type 2 diabetes and is administered by subcutaneous injection. Injecting it into the abdomen allows for better absorption. It is important for the nurse to instruct the client on the correct administration technique to ensure the medication is effective.
Incorrect choices:
A: Contact the provider if you experience unexplained muscle pain - Although monitoring for side effects is important, muscle pain is not a common side effect of exenatide.
C: Take the medication at bedtime - Exenatide is typically taken before meals, not at bedtime.
D: Discard excess medication after 60 days - Exenatide must be refrigerated and has a shorter shelf life once opened, typically 30 days, not 60.
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A nurse is preparing to administer acetaminophen 650 mg rectally. Which of the following actions should the nurse take?
- A. Insert the suppository 5 cm (2 in) into the client's rectum.
- B. Lubricate the flat end of the suppository prior to administration.
- C. Have the client lie on his left side for 5 min after insertion.
- D. Hold the suppository for 1 min to warm it prior to insertion.
Correct Answer: C
Rationale: The correct answer is C: Have the client lie on his left side for 5 min after insertion. This position promotes optimal absorption of the medication. When the client lies on the left side, gravity helps keep the suppository in place and allows it to dissolve and be absorbed more effectively through the rectal mucosa. This position also helps prevent the suppository from being expelled prematurely.
Choice A is incorrect because inserting the suppository 5 cm (2 in) is not necessary for proper administration. Choice B is incorrect as lubricating the suppository is not essential for rectal administration. Choice D is incorrect because warming the suppository is not required and may not be safe. Choices E, F, and G are not provided, so they are not applicable in this scenario.
A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?
- A. Hepatic enzymes process medications more rapidly.
- B. Gastric emptying rate increases.
- C. Brain receptors become less sensitive to medications.
- D. Renal excretion time slows for medication.
Correct Answer: D
Rationale: The correct answer is D: Renal excretion time slows for medication. As individuals age, there is a decline in renal function, leading to a decrease in glomerular filtration rate and renal blood flow. This results in a slower excretion of medications from the body, leading to potential accumulation and increased risk of toxicity. Choices A, B, and C are incorrect as hepatic enzymes may actually decrease in function with age, gastric emptying rate tends to slow down, and brain receptors can become more sensitive rather than less sensitive to medications in older adults.
A nurse is caring for a client who has a new diagnosis of schizophrenia. Which of the following medications should the nurse expect to administer?
- A. Levodopa
- B. Baclofen
- C. Fenofibrate
- D. Risperidone
Correct Answer: D
Rationale: The correct answer is D: Risperidone. Risperidone is an antipsychotic medication commonly used to treat schizophrenia by helping to manage symptoms such as hallucinations and delusions. Levodopa (A) is used for Parkinson's disease, Baclofen (B) is a muscle relaxant, and Fenofibrate (C) is used to lower cholesterol. Administering any of these medications to a client with schizophrenia would not address their symptoms effectively.
A nurse is reinforcing teaching with a client who has motion sickness and a new prescription for a transdermal patch of scopolamine. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Bruising
- C. Jaundice
- D. Drowsiness
Correct Answer: D
Rationale: The correct answer is D: Drowsiness. Scopolamine is an anticholinergic medication commonly used to treat motion sickness. One of the common side effects of anticholinergics is drowsiness. This occurs due to the central nervous system depressant effects of the medication. Monitoring for drowsiness is important as it can impact the client's ability to drive or operate machinery safely.
A: Diarrhea is not a common side effect of scopolamine.
B: Bruising is not a common side effect of scopolamine.
C: Jaundice is not a common side effect of scopolamine.
A nurse is reinforcing teaching with a client who will be self-administering enoxaparin subcutaneously using prefilled syringes. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will use my upper arms for injections.
- B. I will massage the site after injecting the medication.
- C. I will expel the air bubble from the syringe before injecting the medication.
- D. I will pinch up the skin before injecting the medication.
Correct Answer: D
Rationale: Correct Answer: D. "I will pinch up the skin before injecting the medication."
Rationale: Pinching up the skin before injecting enoxaparin helps ensure proper subcutaneous injection technique, reducing the risk of injecting into muscle or causing discomfort. Pinching up the skin creates a subcutaneous tissue fold, providing a proper injection site and allowing for the medication to be delivered effectively. This step also minimizes the risk of bruising and ensures the medication is absorbed appropriately.
Summary of other choices:
A: Incorrect - Using upper arms for injections is not recommended for subcutaneous injections like enoxaparin.
B: Incorrect - Massaging the site after injecting can disrupt the medication's absorption and is not recommended.
C: Incorrect - Expelling air bubbles is important for intramuscular injections but not necessary for subcutaneous injections like enoxaparin.