31 Jan Rationale: The client should alwa

1. A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation?

a. Offer the child a choice of taking the medication with juice or water

b. Tell the child it is candy

c. Hide the medications in a large dish of ice cream

d. Tell the child he will have a shot instead

2. A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

a. “Crushing the medication might cause you to have a stomachache or indigestion.

i. Rationale: The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing destroys protection.

b. “Crushing the medication is a good idea, and I can mix it in some ice cream for you.”

c. “Crushing the medication would release all the medication at once, rather than over time.”

d. “Crushing is unsafe, as it destroys the ingredients in the medication.”

3. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first?

a. A. Check the client’s vital signs.

i. Rationale: It is possible that the client’s nausea is secondary to digoxin toxicity. Assess for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication and call the provider if the client’s heart rate is less than 60 bpm.

b. Request a dietitian consult.

c. Suggest that the client rests before eating the meal.

d. Request an order for an antiemetic.

4. A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give?

a. “It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.”

b. “A pharmacist is the person to answer that question.”

c. “Heparin does not dissolve clots. It stops new clots from forming.”

i. Rationale: This statement accurately answers the client’s question.

d. “The oral medication you will take after this IV will dissolve the clot.

5. A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?

a. Thyroid hormone assay

i. Rationale: Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction.

b. Liver function tests:

i. Rationale: LFTs must be monitored before and during valproic acid therapy

c. Erythrocyte sedimentation rate

i. Rationale: This is not a necessary test related to lithium therapy.

d. Brain natriuretic peptide

6. A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching?

a. “If my breathing begins to feel tight, I will use the cromolyn immediately.”

b. “I will be sure to take the albuterol before taking the cromolyn.”

i. Rationale: The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be opened, ensuring that the maximum dose of medication will get to the client’s lungs.

c. “I will use both medications immediately after exercising.”

d. “I will administer the medications 10 minutes apart.”

7. A nurse is completing a medication history for a client who reports using over-the-counter