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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.
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A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will drink orange juice when I take this medication.
- B. I will remain seated for 30 minutes after I take my medication.
- C. I will take this medication right before I go to bed.
- D. I can take this medication just once a month.
Correct Answer: C
Rationale: The correct answer is C: "I will take this medication right before I go to bed." Alendronate should be taken on an empty stomach, in the morning, at least 30 minutes before the first food, drink, or medication of the day. Taking it before bed ensures the client has an empty stomach. Choice A is incorrect because orange juice can interfere with alendronate absorption. Choice B is incorrect as sitting upright for 30 minutes after taking the medication is the recommended action. Choice D is incorrect as alendronate is typically taken weekly, not monthly.
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.
A nurse is caring for a client who has a new prescription for valproic acid. The nurse should review which of the following baseline laboratory values prior to administering the medication?
- A. Arterial blood gases
- B. Liver function tests
- C. Troponin levels
- D. Blood glucose levels
Correct Answer: B
Rationale: The correct answer is B: Liver function tests. Valproic acid is known to potentially cause hepatotoxicity, so it is essential to assess baseline liver function tests before administering the medication. Monitoring liver function tests can help identify any pre-existing liver conditions and prevent further liver damage. Arterial blood gases (A) are not directly related to valproic acid administration. Troponin levels (C) are used to assess heart muscle damage, which is not a concern with valproic acid. Blood glucose levels (D) are not specifically relevant to valproic acid therapy.
A nurse is preparing to administer medications to a client. Which of the following client identifiers should the nurse use to verify that the correct client is receiving the medication? (Select all that apply.)
- A. Date of birth
- B. Facility identification number
- C. Name
- D. Physical location
- E. Room number
Correct Answer: A, B, C
Rationale: The correct identifiers for verifying the client are date of birth, facility identification number, and name. Date of birth ensures the client's age and helps avoid mix-ups with clients of the same name. Facility identification number uniquely identifies the client within the facility. Name is crucial for confirming the client's identity verbally. Physical location and room number are not reliable identifiers as clients may move within the facility. Overall, using a combination of unique identifiers helps prevent medication errors and ensures the correct client receives the right medication.
A nurse is talking with a client who takes NSAIDs routinely to treat osteoarthritis and has a new prescription for misoprostol. The client asks the nurse why he needs the second medication. Which of the following is an appropriate response?
- A. Misoprostol will help prevent stomach ulcers, which can develop from taking NSAIDs for a long time.
- B. Misoprostol helps protect you against the effects long-term NSAID use can have on your kidney function.
- C. Misoprostol will boost the effectiveness of the NSAIDs, so you can get the same pain relief with lower dosages.
- D. Misoprostol is a very effective antacid that will help reduce the stomach irritation you can get from NSAIDs.
Correct Answer: A
Rationale: The correct answer is A because misoprostol is often prescribed along with NSAIDs to help prevent stomach ulcers that can develop from long-term NSAID use. NSAIDs can irritate the stomach lining and increase the risk of ulcers. Misoprostol works by reducing the production of stomach acid and protecting the stomach lining. Choices B, C, and D are incorrect because misoprostol is specifically used to protect the stomach from NSAID-related ulcers, not to protect kidney function, boost NSAID effectiveness, or act as an antacid.