Question 1

Digoxin is being prescribed for a patient with cardiac disease. The nurse should instruct the patient?

Accepted Answer

Answer reason: Teaching the patient to check their pulse supports safe self-administration at home and prompts holding the dose and contacting the provider if the pulse is below the prescribed parameter (commonly

Question 2

The mother of a toddler, who is diagnosed with type 1 diabetes mellitus, asks a nurse if her child would benefit from an insulin infusion pump. Which statement should be the basis for the nurse’s response?

Accepted Answer

Answer reason: Because toddlers cannot self-manage, parents must reliably monitor glucose frequently, count carbohydrates, and adjust boluses/basal delivery in response to meals, activity, and illness. This option captures the key prerequisite for successful pump therapy: consistent monitoring and timely dose adjustments to avoid DKA from infusion interruption. In contrast, saying toddlers are too young is inaccurate, and the other statements do not address the core management and safety requirement that determines benefit.

Question 3

A patient is prescribed gabapentin 100mg TID. How many times per day will this patient receive this medication?

Accepted Answer

Answer reason: “TID” means three times daily (typically spaced about every 8 hours), so the patient will receive three doses in 24 hours. This directly matches the prescriber’s intended administration schedule and supports safe medication administration. Options implying once or twice daily correspond to QD or BID, and four times daily corresponds to QID, making them incorrect.

Question 4

Correct angle for IM injection is?

Accepted Answer

Answer reason: A 90-degree insertion angle provides the most direct path to the muscle and helps ensure appropriate depth when correct needle length is selected. Shallower angles are used for other routes (e.g., 45° for many subcutaneous injections and ~15° for intradermal), which would risk under-delivery into subcutaneous or dermal layers. Using the proper angle supports intended pharmacokinetics and decreases complications such as leakage and inadequate dosing.

Question 5

The nurse is observing a staff member provide education to a client who is prescribed norethindrone, a progesterone-only form of oral contraception. Which of the following statements by the staff member would require the nurse to intervene?

Accepted Answer

Answer reason: " Progestin-only pills rely on strict adherence and adequate hormone levels, and drug interactions that reduce circulating progestin can increase the risk of contraceptive failure. Teaching that antibiotics never require backup contraception is unsafe because certain antimicrobials (notably enzyme inducers such as rifampin/rifabutin) can decrease hormonal contraceptive effectiveness, and clients should be counseled to use backup when interacting drugs are prescribed. The other statements reflect appropriate counseling: taking the pill at the same time daily is essential, breakthrough bleeding can occur, and missed-dose guidance includes prompt dosing with short-term backup. This incorrect reassurance could lead to unintended pregnancy, so the nurse should intervene.

Question 6

A nurse receives a prescription for an intramuscular (IM) injection for a 9-month-old client. Which site does the nurse prepare for administration?

Accepted Answer

Answer reason: At 9 months, the vastus lateralis is typically the safest and most developed muscle for routine IM injections and many immunizations. The dorsogluteal site is avoided in young children due to proximity to the sciatic nerve and variable subcutaneous fat thickness. The deltoid generally does not have sufficient muscle mass until older childhood, and ventrogluteal, while safe in many ages, is less commonly chosen than the thigh in infants because the thigh is more reliably developed and easier to landmark.

Question 7

The nurse is teaching a client with newly diagnosed Type 1 Diabetes Mellitus about insulin administration. Which statement by the client indicates the need for further teaching?

Accepted Answer

Answer reason: " Type 1 diabetes requires continuous basal insulin to prevent ketosis, and illness typically increases counterregulatory hormones that raise glucose and ketone production. Skipping insulin during sick days places the client at high risk for diabetic ketoacidosis even when oral intake is reduced. Sick-day management generally emphasizes continuing insulin (often with dose adjustment), frequent glucose/ketone monitoring, hydration, and contacting the provider for abnormal readings. Rotating sites, proper storage before opening, and checking glucose prior to dosing are appropriate self-management behaviors.

Question 8

The nurse is providing instruction to a patient on self-administration of lispro (Humalog) insulin. The nurse will stress which time frames to administer the injection of lispro insulin?

Accepted Answer

Answer reason: Insulin lispro is a rapid-acting insulin with onset in minutes, so it should be timed close to meals to match postprandial glucose rise and reduce hypoglycemia risk. Administering shortly before eating ensures carbohydrate intake is available as the insulin begins working. Giving it 30 minutes before breakfast is more consistent with regular insulin timing and increases the chance of hypoglycemia if the meal is delayed. Fixed times such as “daily at noon” or “nightly prior to bedtime snack” ignore meal-dependent dosing principles for rapid-acting insulin.

Question 9

The nurse is preparing to infuse prescribed cisplatin to a client with cancer. Which priority assessment should the nurse make before administration?

Accepted Answer

Answer reason: Patency assessment confirms blood return as appropriate for the access type, absence of pain/swelling, and that the device can deliver the drug as intended. While cisplatin is associated with electrolyte abnormalities (including hyponatremia) and myelosuppression risk, those labs guide ongoing monitoring and dose/hold decisions rather than preventing an immediate administration-related injury at the bedside. Cancer staging informs treatment planning but does not affect the immediate safe administration check right before infusion.

Question 10

A nurse is preparing to administer insulin to a patient. At what angle should this medication be given?

Accepted Answer

Answer reason: Using an angled approach helps ensure the needle enters the subcutaneous layer, especially in patients with limited subcutaneous fat or when using longer needles. A 45° angle is a standard technique to reduce the risk of inadvertent intramuscular administration, which could speed absorption and increase hypoglycemia risk. Very shallow angles like 5°–15° are more consistent with intradermal techniques, and 30° is classically used for intradermal injections such as TB testing.

Question 11

The nurse is preparing to hang the next bag of intravenous heparin for a patient with a deep vein thrombosis. What takes priority prior to hanging the new bag?

Accepted Answer

Answer reason: g., aPTT or anti-Xa, per protocol). Verifying these values helps prevent major harm from over-anticoagulation (hemorrhage) or under-anticoagulation (extension of thrombosis). Bag changes are a common point for dosing errors, so safety requires a dose/lab check as part of safe medication administration. While checking the IV site and assessing for bleeding are important ongoing assessments, they do not replace verifying that the next infusion rate/dose is appropriate based on current results. Measuring calf circumference and auscultating lungs may be relevant to DVT/PE assessment, but they are not the key safety step immediately before hanging the next heparin bag.

Question 12

Which site is most commonly used for intramuscular injections?

Accepted Answer

Answer reason: For routine adult immunizations and many common outpatient IM medications, the upper arm is most frequently chosen because it is easy to expose and landmark, enabling rapid administration and observation. The abdomen is primarily a subcutaneous site rather than intramuscular. Although ventrogluteal is considered a very safe IM site and preferred for larger-volume/deep IM injections, it is less commonly used in everyday practice than the upper arm for routine shots.

Question 13

The nurse is ordered to administer ampicillin capsule TID p.o. The nurse should give the medication?

Accepted Answer

Answer reason: o. means by mouth (orally). The option that directly translates both abbreviations without adding extra instructions is the safest and most accurate interpretation for administration. Options that specify timing with meals are not implied by TID p.o. and could change absorption for some drugs. The “two times a day” choices are incorrect because they correspond to BID, not TID.

Question 14

A client with osteoporosis is prescribed alendronate (Fosamax). Which instruction should the nurse include?

Accepted Answer

Answer reason: Alendronate can cause significant esophageal irritation and must be taken in a way that promotes rapid passage into the stomach while maximizing absorption. Using a full glass (6–8 oz) of plain water helps the tablet reach the stomach and reduces the risk of esophagitis/ulceration. It should be taken on an empty stomach and the client should remain upright for at least 30 minutes; therefore bedtime dosing and lying down are unsafe. Taking it with food decreases absorption and reduces therapeutic benefit.

Question 15

What is a common reason for administering an intradermal injection?

Accepted Answer

Answer reason: This route is commonly used for allergy testing and certain skin tests because the dermis has a rich supply of immune cells and limited vascular absorption, improving observation of local reactions. Insulin is administered subcutaneously for systemic absorption, not intradermally. Pain management is typically achieved via oral, IV, IM, or regional routes rather than intradermal administration.

Question 16

The nurse sees an order for sliding scale insulin that should be administered in approximately twenty minutes. What should the nurse do next?

Accepted Answer

Answer reason: Sliding-scale insulin dosing is based on the patient’s current capillary blood glucose, so the immediate priority is to obtain an accurate point-of-care reading close to the administration time. Checking now allows the nurse to match the ordered scale to the patient’s present glucose and reduces risk of hypo- or hyperglycemia from using outdated values. Storing a labeled insulin dose in the patient’s room is unsafe and increases medication error risk and improper storage concerns. Reviewing prior 24-hour doses may help evaluate glycemic control but does not determine the correct dose for the next scheduled sliding-scale administration.

Question 17

The nurse is supervising a student administering prescribed ciprofloxacin eye drops. It would indicate the correct technique if the student?

Accepted Answer

Answer reason: Eye drops are administered into the lower conjunctival sac to maximize local absorption while minimizing corneal irritation and injury. The cornea is highly sensitive, and placing drops directly onto it can cause discomfort, reflex blinking, and reduced medication contact time. Clients should be instructed to close the eye gently (not squeeze) to avoid forcing medication out and increasing systemic absorption through the nasolacrimal duct. The left lateral position with knees bent is unrelated to ophthalmic medication administration and reflects incorrect positioning for this procedure.

Question 18

INTRAVENOUS injection is given at which angle?

Accepted Answer

Answer reason: An angle around 10–15° is standard to minimize transfixing the vein and to reduce infiltration/extravasation risk. Larger angles increase the likelihood of puncturing through the vein or entering deeper tissues. By contrast, 45° is more typical for subcutaneous injections and 90° for intramuscular injections, reflecting the different target tissue depths.

Question 19

When educating a patient about their new prescription for aspart insulin, the nurse should advise the patient to inject this insulin?

Accepted Answer

Answer reason: Insulin aspart is a rapid-acting insulin with onset in minutes and an early peak, so dosing should be timed with food intake to match postprandial glucose rise and reduce hypoglycemia risk. Giving it shortly before meals ensures carbohydrate absorption begins as the insulin starts lowering glucose. Administering it 30 minutes before eating is more consistent with regular insulin and increases the chance the insulin effect will begin before food is available. “After meals” can delay coverage of the post-meal glucose spike, and “once daily regardless of meals” describes long-acting basal insulins, not rapid-acting mealtime insulin.

Question 20

A client with stable angina is being discharged home with a prescription for a transdermal nitroglycerin patch. The nurse is reinforcing discharge instructions on the medication with the client. Which statement by the client indicates that teaching has been effective?

Accepted Answer

Answer reason: " Transdermal nitrates require proper application technique to ensure consistent absorption and to prevent local skin irritation. Rotating application sites decreases dermatitis and helps maintain reliable drug delivery. Concurrent use of phosphodiesterase-5 inhibitors such as sildenafil is contraindicated with nitrates due to risk of profound hypotension. Headache is a common expected adverse effect from vasodilation and is generally managed (e.g., with mild analgesics) rather than stopping therapy, and the patch is typically left in place during normal activities unless specifically directed otherwise.

Question 21

The nurse administers a buccal medication in which location?

Accepted Answer

Answer reason: The correct location is the pocket between the cheek and gum, where the medication is held to dissolve and be absorbed. Options describing deltoid, rectal, and vaginal locations represent intramuscular or other non-oral mucosal routes, not buccal delivery. A common administration error is swallowing or chewing, which reduces mucosal absorption and changes onset/effect.

Question 22

The nurse educates a patient to remain upright following administration of alendronate to avoid which possible complication?

Accepted Answer

Answer reason: Keeping the patient upright and taking the dose with a full glass of water promotes rapid passage into the stomach and reduces esophageal exposure. This teaching specifically targets prevention of pill-induced esophagitis/esophageal ulceration, a well-known adverse effect of oral bisphosphonates. The other options are not the classic complication prevented by upright positioning after this medication.

Question 23

The nurse is reading the revised medication prescriptions for a client recently admitted with type 1 diabetes mellitus. Which prescription should the nurse question and report to the health care provider?

Accepted Answer

Answer reason: NPH is an intermediate-acting insulin suspension and should be given subcutaneously; IV administration risks unpredictable absorption/precipitation and dangerous hypoglycemia. A scheduled basal dose with glargine at bedtime and pre-meal aspart are consistent with a basal-bolus regimen for type 1 diabetes. A common distractor is the IV regular insulin correction order, which can be appropriate when carefully protocolized and monitored.

Question 24

Which of the following principles of parenteral drug administration is a priority for the nurse to consider before administering a parenteral injection to a 2-year-old child?

Accepted Answer

Answer reason: In toddlers, the vastus lateralis is a recommended, well-developed muscle with fewer nearby major nerves and blood vessels compared with alternative sites. Pain-reduction strategies (e.g., topical anesthetic) can be helpful but do not supersede correct site selection for safety. Volume guidance varies by route and medication, and “up to 1 mL” is not a universal principle that applies to all parenteral injections in this age group.

Question 25

The nurse is ordered to administer iron dextran IM to a client with iron deficiency unresolved by oral iron supplements. The medication is not appropriately administered if which action by the nurse is demonstrated?

Accepted Answer

Answer reason: Needle withdrawal 0.5 inch every 10 seconds Deep IM iron dextran should be administered using proper IM technique (including Z-track) to deposit the drug into muscle and prevent tracking into subcutaneous tissue and skin staining. With IM injections, the needle is typically removed smoothly after allowing a brief dwell time so medication disperses in the muscle. Gradually withdrawing the needle in increments is not a standard or recommended IM practice and can increase tissue trauma and allow medication to track along the needle path. Z-track and a 90-degree insertion angle are appropriate for iron dextran IM administration, and a brief wait (e.g., about 10 seconds) before withdrawal supports medication deposition.

Question 26

The nurse is supervising a newly hired nurse administer prescribed medications via a double-lumen nasogastric tube (NGT) with an air vent. Which action by the newly hired nurse requires follow-up? The newly-hired nurse?

Accepted Answer

Answer reason: An air vent (pigtail) on a double-lumen NGT is designed to remain patent to allow atmospheric air into the stomach and prevent gastric mucosa from being pulled into the drainage lumen, reducing trauma. Instilling water into the air vent can occlude it, defeat the anti-reflux/anti-suction mechanism, and increase risk of ineffective decompression and mucosal injury. Standard medication administration best practices include using liquid formulations when possible, giving each drug separately, and flushing between medications to prevent interactions and tube clogging. Therefore the action involving the air vent indicates incorrect technique and needs immediate correction and teaching.

Question 27

The nurse in the community health clinic is caring for a patient newly diagnosed with chlamydia. The nurse prioritizes solutions to address the outcome statement: The patient's sexually transmitted infection (STI) symptoms will resolve within two weeks. Which action should the nurse implement first to address this expected outcome?

Accepted Answer

Answer reason: Giving the medication to the patient is the most immediate, direct intervention that reduces bacterial load and inflammation, which drives symptom improvement and lowers transmission risk. Partner notification/treatment is important to prevent reinfection and community spread, but it does not address the patient’s current symptoms as immediately as initiating the patient’s therapy. Education and emotional support are supportive measures but do not achieve the physiologic outcome of clearing the infection.

Question 28

The nurse should schedule a patient's next injection how long after receiving their first injection of medroxyprogesterone?

Accepted Answer

Answer reason: To sustain therapeutic hormone levels and contraceptive efficacy, repeat dosing is scheduled every 12 weeks (with a commonly accepted administration window shortly before/after that date depending on protocol). Scheduling earlier than this is unnecessary and increases exposure without benefit, while later timing risks declining drug levels and unintended pregnancy. This is a medication administration timing question where accurate interval scheduling is essential for effectiveness and safety.

Question 29

Patients who self-administer insulin should be taught to rotate injection sites to prevent which complication?

Accepted Answer

Answer reason: Rotating sites prevents these localized adipose hypertrophy changes and helps maintain more predictable insulin uptake and glycemic control. Infection is more directly prevented by aseptic technique (clean skin/needle hygiene) rather than site rotation alone. Phlebitis is associated with IV therapy, and Stevens-Johnson syndrome is a severe medication hypersensitivity reaction not prevented by changing injection locations.

Question 30

Which of the following angles of insertion is appropriate for a patient receiving subcutaneous insulin?

Accepted Answer

Answer reason: Insulin is commonly administered subcutaneously at 45–90°, with steeper angles used when there is adequate subcutaneous fat and shorter needles. Among the given choices, 75° is the only angle that falls within the accepted subcutaneous injection range. Very shallow angles like 5–35° risk intradermal placement, which can alter absorption and cause more local irritation.

Question 31

A nurse cares for a client who is prescribed daily enteric-coated aspirin. Which statement made by the client requires teaching?

Accepted Answer

Answer reason: " Enteric-coated medications are designed to pass through the stomach intact to reduce gastric irritation and release the drug in the intestine. Crushing an enteric-coated aspirin destroys this protective coating, increasing risk of stomach irritation, dyspepsia, and GI bleeding while also altering intended absorption. Taking it with water and maintaining a consistent dosing time are appropriate administration practices for daily therapy. Monitoring for GI-related symptoms (e.g., black/tarry stools or significant bowel pattern changes) is prudent because aspirin can cause GI mucosal injury and bleeding.

Question 32

The nurse receives a prescription for IV push 2 mg diazepam and is unsure whether this is the appropriate dose for this medication. Which of the following is the best action for the nurse to take?

Accepted Answer

Answer reason: When unsure about a medication dose, the nurse should first consult a reliable, evidence-based reference. This ensures independent verification before escalating concerns. Asking others without verification or immediately calling the provider/pharmacist is not the first step in safe medication practice.

Question 33

A graduate nurse (GN) is preparing to administer quetiapine XR to a patient with severe depression. Which of the following actions by the GN would require further teaching by the nurse preceptor?

Accepted Answer

Answer reason: Quetiapine XR is an extended-release formulation and must not be crushed, as this alters drug release and can lead to toxicity or reduced effectiveness. The other actions reflect safe medication practices.

Question 34

A nurse is teaching the parents of an infant with diabetes about insulin, a drug used to treat the disorder. Which statement indicates a need for further teaching?

Accepted Answer

Answer reason: Insulin should never be shaken because vigorous shaking can denature the protein structure and alter its effectiveness. Instead, insulin (especially cloudy types like NPH) should be gently rolled between the hands to mix it properly. Option A is not standard practice but warming insulin slightly to room temperature may reduce discomfort. Option C is correct technique. Option D is correct for proper insulin storage.

Question 35

The nurse determines further teaching is necessary when a client on anticoagulant therapy for deep vein thrombosis makes which statement?

Accepted Answer

Answer reason: Aspirin has antiplatelet effects and increases bleeding risk when combined with anticoagulants. This indicates incorrect understanding. The other statements reflect appropriate care and safety measures.

Question 36

A client is prescribed depot medroxyprogesterone acetate. Which statement made by the client concerns the nurse?

Accepted Answer

Answer reason: " Depot medroxyprogesterone acetate (DMPA) must be administered on a strict schedule to maintain contraceptive efficacy, typically every 12–13 weeks (about every 3 months). Receiving injections only twice yearly creates a prolonged gap that increases the risk of ovulation and unintended pregnancy, which is a patient-safety concern requiring immediate teaching and schedule correction. By contrast, spotting/irregular bleeding and weight gain are common expected effects early in therapy and are usually managed with reassurance and monitoring. The client also correctly identifies DMPA as a contraceptive, so that statement is not concerning.

Question 37

The nurse is teaching a client with diabetes mellitus (type two) newly prescribed rapid-acting insulin. Which of the following information should the nurse include?

Accepted Answer

Answer reason: " Rapid-acting insulins have a very fast onset, so they should be taken immediately before a meal or when the meal begins to better match postprandial glucose absorption and reduce hypoglycemia risk if the meal is delayed. Teaching that it can be given while actively eating reflects that flexibility and helps patients avoid dosing without assured carbohydrate intake. Giving it 20–30 minutes before meals is typical of short-acting regular insulin, not rapid-acting formulations, and increases the chance of insulin-peaking before food is absorbed. Bedtime dosing to prevent overnight spikes is a role more consistent with intermediate/long-acting basal insulin rather than rapid-acting mealtime insulin.

Question 38

A nurse is preparing to administer an influenza vaccine to a patient. At what angle should this vaccine be given?

Accepted Answer

Answer reason: Most influenza vaccines for adults are given intramuscularly (commonly in the deltoid), so the correct technique is a perpendicular needle entry. A 45-degree angle is typical for subcutaneous injections and would risk placing the vaccine into subcutaneous tissue rather than muscle. A 5-degree angle is consistent with intradermal injections, and 30 degrees is not a standard angle for routine vaccine injection technique.

Question 39

A nurse is caring for a client who has a new prescription for enoxaparin. Which of the following should the nurse include in the client teaching?

Accepted Answer

Answer reason: " Enoxaparin is a low-molecular-weight heparin given subcutaneously, and correct technique reduces local tissue injury and bleeding. The preferred site is the abdomen with injections placed away from the umbilicus to avoid bruising and inconsistent absorption from scarred or highly vascular tissue. Teaching should also emphasize not rubbing the site because it increases hematoma formation, making the “massage” option unsafe. Routine “medication level” monitoring is not typically required for standard dosing, and aspirin increases bleeding risk when combined with anticoagulants.

Question 40

A nurse is providing teaching to a client who has been prescribed Amiodarone for Ventricular arrhythmias. Which statement should the nurse include in the teaching plan?

Accepted Answer

Answer reason: " Amiodarone has characteristic adverse effects that are important for safety teaching, including photosensitivity and blue-gray skin discoloration with longer-term exposure. Counseling the client to expect/report this change helps promote adherence and prompts sun-protection behaviors to reduce photosensitivity reactions. Administration instructions are typically to take it consistently with regard to food rather than specifically on an empty stomach, so that option is not reliably correct. Weight gain is not a hallmark adverse effect of this medication and is more suggestive of other problems (e.g., fluid retention or thyroid dysfunction) than a routine expected effect.

Question 41

A nurse is caring for a client in active labor. The cervix is dilated to 6 cm, contractions are occurring every 3 minutes, and the client reports increasing pain and pressure. Which of the following nursing actions is most appropriate?

Accepted Answer

Answer reason: Providing ordered analgesia addresses escalating pain and can improve the client’s ability to relax and participate effectively in labor while ongoing maternal-fetal assessment continues. Bearing down is typically discouraged until full dilation to reduce cervical edema and maternal fatigue, so coaching pushing now is inappropriate. Preparing for delivery becomes the priority closer to transition/second stage (e.g., complete dilation or clear signs of imminent birth), and fundal massage is a postpartum intervention for uterine atony rather than an intrapartum action.

Question 42

The nurse should educate a patient taking warfarin to maintain a consistent intake of which substance?

Accepted Answer

Answer reason: Keeping intake consistent helps maintain a stable INR and reduces the risk of either bleeding (if intake drops) or clotting (if intake increases). This teaching is especially important because many leafy green vegetables and some supplements contain substantial amounts of the nutrient. The other listed macronutrients do not directly antagonize warfarin’s mechanism in the same clinically significant way.

Question 43

When providing teaching for the patient with iron-deficiency anemia who has been prescribed iron supplements, you should include taking the iron with which beverage?

Accepted Answer

Answer reason: A vitamin C–containing beverage improves bioavailability and supports better correction of iron-deficiency anemia. Calcium-containing beverages can bind iron and reduce absorption, so they are avoided around dosing. Water is acceptable but does not provide the absorption benefit seen with an acidic, vitamin C–rich drink.

Question 44

A nurse is preparing to administer medication and finds a full piggyback infusion hanging at the client’s bedside. What is the appropriate action to be taken by the nurse?

Accepted Answer

Answer reason: A full piggyback infusion suggests that a previously scheduled dose may have been missed or not administered. Before taking action, the nurse must verify what occurred to avoid medication errors such as duplication or omission. Restarting or discarding the medication without clarification can compromise patient safety, and escalation is unnecessary until the situation is assessed.

Question 45

An external insulin pump is prescribed for a client with diabetes mellitus. When the client asks the nurse about the functioning of the pump, the nurse bases the response on which information about the pump?

Accepted Answer

Answer reason: It administers a small continuous dose of shortduration insulin subcutaneously. The client can self-administer an additional bolus dose from the pump before each meal. Insulin pumps provide continuous subcutaneous insulin infusion using rapid-acting (short-duration) insulin to mimic basal pancreatic secretion, with patient-initiated boluses for meals and corrections. This mechanism explains why a steady, small basal rate is delivered around the clock and why pre-meal boluses are programmed by the client. Options describing NPH are incorrect because intermediate-acting insulin is not used in pumps due to unpredictable absorption and risk of hypoglycemia. The pump is external and not surgically attached to the pancreas, so statements implying pancreatic infusion are inaccurate.

Question 46

A nurse is reviewing a new prescription for gabapentin with a patient who has diabetic neuropathy. Which statement by the patient requires immediate intervention by the nurse?

Accepted Answer

Answer reason:  Antacids containing aluminum or magnesium can reduce gabapentin absorption when taken together, leading to decreased therapeutic effect for neuropathic pain. The nurse should intervene to teach proper spacing (commonly taking gabapentin at least 2 hours after an antacid) to maintain efficacy. The other statements reflect appropriate safety knowledge: sedation can be minimized by bedtime dosing, peripheral edema/weight gain should be reported, and abrupt discontinuation can precipitate withdrawal or seizures. Because this is a new prescription, correcting this interaction promptly prevents ineffective pain control and unnecessary dose escalation.

Question 47

The nurse should never give potassium by?

Accepted Answer

Answer reason: Giving potassium by IV push delivers an immediate concentrated dose to the heart, creating a high risk of ventricular arrhythmias and cardiac arrest. Safe IV administration requires dilution and controlled rate via infusion/drip (often with a pump) with appropriate monitoring. Oral tablets and properly diluted IV infusions are acceptable routes when clinically indicated, but rapid undiluted bolus administration is contraindicated.

Question 48

To avoid fecal impaction, psyllium (Metamucil) should be administered with at least how many ounces of fluid?

Accepted Answer

Answer reason: Administering each dose with a full glass of water is the key safety step that allows proper gel formation and softer stool transit. In standard nursing medication administration teaching, “a full glass” is at least 8 oz, and clients should also increase daily fluid intake unless contraindicated. Smaller volumes such as 4–6 oz increase the chance the fiber thickens excessively in the esophagus or bowel rather than moving through normally.

Question 49

A nurse is caring for a 31-year-old pregnant client at 18 weeks gestation who has been prescribed ferrous sulfate for iron deficiency anemia. What should the nurse include in the patient's teaching plan to promote safe medication administration?

Accepted Answer

Answer reason: Oral iron commonly causes gastrointestinal adverse effects (especially constipation), so teaching should focus on preventing and managing this predictable side effect to support adherence and safety. Increasing fluids and dietary fiber is an appropriate first-line nursing intervention to reduce constipation risk. Taking iron with milk is incorrect because calcium can decrease iron absorption, reducing therapeutic effectiveness. Drowsiness is not an expected effect of ferrous sulfate, and alcohol such as red wine is unsafe in pregnancy and not an appropriate strategy to improve absorption.

Question 50

A nurse is caring for a school aged child who was recently diagnosed with ADHD. The nurse is providing family teaching. What should the nurse say when the parent asks, "What time of day should I give him his medicine?"?

Accepted Answer

Answer reason: Giving the dose early supports school-time attention and reduces the likelihood of evening rebound hyperactivity interfering with sleep. Later dosing (afternoon/evening/bedtime) increases risk of difficulty falling asleep and poorer nighttime rest. Morning dosing also allows caregivers to monitor for early adverse effects (e.g., appetite suppression, tachycardia) during waking hours.

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