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The client in the intensive care department has a nasogastric tube for continuous feedings. The nurse is preparing to administer nifedipine (Procardia XL) via the N/G tube. Which procedure should the nurse follow?
- A. Crush the medication and dissolve it in water.
- B. Administer and flush the N/G tube with cranberry juice.
- C. Give the medication orally with pudding.
- D. Do not administer the medication and notify the HCP.
Correct Answer: D
Rationale: Procardia XL is extended-release and cannot be crushed or given via NG tube; HCP notification is needed for an alternative form.
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A 60-year-old client has been hospitalized for deep vein thrombosis. The client is to be discharged on warfarin (Coumadin) 5 mg PO daily. Which statement that the client makes indicates the best understanding of the medication routine?
- A. I will take aspirin for my arthritis.
- B. I love to eat spinach salads.
- C. I will get a blood test next week.
- D. I made an appointment to have my teeth pulled.
Correct Answer: C
Rationale: Warfarin requires regular INR monitoring via blood tests to ensure therapeutic anticoagulation levels.
An adult client is seen in the clinic, and sulfisoxazole (Gantrisin) is prescribed. Which information is most appropriate for the nurse to include in the teaching?
- A. Limit your fluid intake to four glasses a day.
- B. If it upsets your stomach, try taking it with an antacid.
- C. Avoid going out in the sun while taking this drug.
- D. Take the tablets with orange juice or milk.
Correct Answer: C
Rationale: Sulfisoxazole causes photosensitivity; avoiding sun exposure is critical to prevent skin reactions.
The nurse administered an IV broad-spectrum antibiotic scheduled every six (6) hours to the client with a systemic infection at 0800. At 1000, the culture and sensitivity prompted the HCP to change the IV antibiotic. When transcribing the new antibiotic order, when would the initial dose be administered?
- A. Schedule the dose for 1400.
- B. Schedule the dose for the next day.
- C. Check with the HCP to determine when to start.
- D. Administer the dose within one (1) hour of the order.
Correct Answer: D
Rationale: New antibiotic orders for active infections require prompt administration (within 1 hour) to maintain therapeutic levels, per sepsis guidelines.
The client is receiving thrombolytic therapy for a diagnosed myocardial infarction (MI). Which assessment data indicate the therapy is successful?
- A. The client's ST segment is becoming more depressed.
- B. The client is exhibiting reperfusion dysrhythmias.
- C. The client's cardiac isoenzyme CK-MB is not elevated.
- D. The D-dimer is negative at two (2) hours post-MI.
Correct Answer: B
Rationale: Reperfusion dysrhythmias (e.g., PVCs) indicate restored coronary flow, a sign of thrombolytic success. ST depression, normal CK-MB, or D-dimer are not specific.
A young adult, 20 years old, who is hospitalized for the first time with schizophrenia, is receiving chlorpromazine (Thorazine) 75 mg PO tid. The client is to go home for a weekend pass. Which statement that the client makes indicates a need for nursing intervention?
- A. I won't drink any alcohol this weekend.
- B. It will be good to taste home-cooked food again.
- C. We plan to go dancing.
- D. I'm looking forward to a relaxing weekend at the beach.
Correct Answer: C
Rationale: Chlorpromazine causes orthostatic hypotension and photosensitivity. Dancing may exacerbate hypotension, requiring caution and education.