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An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote the best absorption of the medication, what information should the nurse include in the discharge instructions?
- A. The best time to take the tablet is at bedtime.
- B. Crush the tablets and mix with pudding.
- C. Wait 2 hours after meals to take the tablet.
- D. Take the tablet with a daily multivitamin.
Correct Answer: C
Rationale: Ferrous sulfate is best absorbed on an empty stomach, 2 hours after meals (C). Bedtime dosing (A) isn’t specific to absorption. Crushing enteric-coated tablets (B) disrupts their protective coating. Multivitamins (D) may contain minerals that reduce iron absorption.
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A patient with peptic ulcer disease has been prescribed cimetidine. Which statement made by the patient indicates the need for further instruction by the nurse?
- A. Decrease cigarette use to a pack per day.
- B. Notify the healthcare provider of lethargy.
- C. Take the medication an hour after antacids.
- D. Monitor for any signs of sexual dysfunction.
Correct Answer: C
Rationale: Cimetidine should be taken with meals or immediately after, not 1 hour after antacids (C), which interferes with absorption. Reducing smoking (A) is insufficient; cessation is ideal. Lethargy (B) and sexual dysfunction (D) are valid monitoring points.
The nurse is preparing a discharge teaching plan for a patient who is taking ciprofloxacin hydrochloride tablets due to suspected anthrax exposure. What instructions should be included in the teaching plan?
- A. Crush and mix the tablets with pudding if you have trouble swallowing the tablets.
- B. Increase fluid intake while taking the medication.
- C. Use nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve mild joint aches and pains caused by the medication.
- D. Report any tendon pain or swelling to the healthcare provider immediately.
- E. Limit exposure to sunlight and avoid tanning beds.
Correct Answer: B,D,E
Rationale: Ciprofloxacin requires high fluid intake (B) to prevent crystalluria, immediate reporting of tendon pain/swelling (D) due to rupture risk, and sun protection (E) due to photosensitivity. Crushing tablets (A) alters release, risking side effects. NSAIDs (C) increase seizure risk with ciprofloxacin.
Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer’s Disease. The patient’s daughter tells the nurse that she plans to start administering the drug when her mother’s symptoms worsen, hoping to avoid nursing home placement. How should the nurse respond?
- A. Affirm the decision to use the medication when the symptoms start to worsen.
- B. Explain that the drug should be used early in the disease process.
- C. Assess the patient’s current mental status before deciding to support the decision.
- D. Confirm that the daughter is aware of the progressive nature of the disease.
Correct Answer: B
Rationale: Rivastigmine is most effective early in Alzheimer’s (B) to slow symptom progression. Delaying until worsening (A) reduces benefits. Mental status assessment (C) informs but doesn’t guide timing. Discussing disease progression (D) is secondary to medication timing.
An adult patient at an outpatient clinic has been prescribed the antibiotic tetracycline HCI. What should the nurse include in the patient’s teaching plan?
- A. Consume with milk or antacids to prevent gastrointestinal irritation.
- B. Protect your skin from sunlight while on this medication.
- C. Enhance gastrointestinal absorption by taking with orange juice.
- D. Return to the clinic weekly for serum drug level checks.
Correct Answer: B
Rationale: Tetracycline causes photosensitivity, increasing sunburn risk, so sun protection (B) is essential. Milk/antacids (A) reduce absorption by chelating tetracycline. Orange juice (C) contains calcium, impairing absorption. Weekly drug level checks (D) are not required for tetracycline.
Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client?
- A. Instruct the client to request assistance when ambulating to the bathroom.
- B. Administer a stool softener/laxative at the same time as the analgesic.
- C. Tell the client to notify the nurse if the pain is not relieved.
- D. Advise the client that the medication should start to work in about 30 minutes.
Correct Answer: A
Rationale: Codeine, an opioid, causes drowsiness and dizziness, increasing fall risk. Instructing the client to request assistance when ambulating (A) is the highest priority for safety. Stool softeners (B) address constipation but are secondary. Notifying about unrelieved pain (C) and onset time (D) are important but not immediate safety concerns.