A client who has dysphagia after a cerebral vascular accident (CVA) receives a new prescription for lansoprazole capsules via nasogastric tube (NGT). Which action should the nurse implement prior to administering the medication?

Mix the capsule granules with water.

Request the pharmacist to provide tablets.

Open the capsule to crush the granules.

Sprinkle the granules in applesauce.

Answer and Explanation

The Correct Answer is A

A. Mix the capsule granules with water: Lansoprazole capsules contain granules that are typically not intended to be crushed or chewed. The appropriate method for administering these granules via an NGT is to mix them with water to ensure they are delivered properly. This approach aligns with the medication’s guidelines for administration through a tube.
B. Request the pharmacist to provide tablets: While tablets might be a suitable alternative, it is not the immediate action required if the client already has capsules. The focus should be on appropriately administering the prescribed form.
C. Open the capsule to crush the granules: Crushing or opening capsules is generally not recommended unless specifically instructed by the manufacturer or pharmacist. This can alter the drug’s effectiveness and release properties.
D. Sprinkle the granules in applesauce: Lansoprazole granules are not meant to be mixed with food like applesauce. They should be mixed with water to ensure proper dissolution and administration.

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Correct Answer is A

Explanation

A) Teach the client self-injection skills for daily subcutaneous administration: Insulin glargine is a long-acting insulin that is typically administered once daily via subcutaneous injection. Teaching the client how to properly administer insulin injections is crucial for managing type 2 diabetes effectively. Proper technique and routine are essential for ensuring correct dosing and preventing complications.

B) Demonstrate how to select dose based on before-meal blood sugar readings: Insulin glargine is not used for adjusting doses based on pre-meal blood sugar readings; it provides a steady baseline of insulin coverage throughout the day. Dose adjustments for type 2 diabetes are generally not based on meal-time glucose readings with long-acting insulin.
C) Explain to the family how to inject this medication for severe hypoglycemia: Insulin glargine is used to maintain long-term glucose control and is not typically used in emergency situations like severe hypoglycemia. Emergency treatment for severe hypoglycemia generally involves glucose administration rather than insulin injections.
D) Provide information on increasing medication dosage if ketoacidosis occurs: Insulin glargine is not adjusted based on acute conditions such as ketoacidosis. Management of diabetic ketoacidosis involves more immediate insulin and fluid management strategies, and dosage adjustments should be guided by a healthcare provider, not based on routine discharge instructions.

A. Administer an oral analgesic and evaluate its effectiveness before applying the new patch. B. Apply the new patch in a different location after removing the original patch. C. Remove the patch and consult with the healthcare provider about the client's pain resolution. D. Place the patch on the client's shoulder and leave both patches in place for 12 hours.

Correct Answer is B

Explanation

A) Administer an oral analgesic and evaluate its effectiveness before applying the new patch: This action is unnecessary because the client reports no pain. Administering an oral analgesic would not be appropriate when the client denies pain and the previous fentanyl patch is intact.
B) Apply the new patch in a different location after removing the original patch: This is the correct action. Fentanyl patches should be replaced with new ones in a different location to prevent overdosing and ensure proper absorption. The old patch should be removed to avoid accumulation of excess medication.
C) Remove the patch and consult with the healthcare provider about the client's pain resolution: There is no need to consult the healthcare provider or remove the patch if the client denies pain and the patch is intact. The issue is with replacing the patch rather than evaluating pain.
D) Place the patch on the client's shoulder and leave both patches in place for 12 hours: This is unsafe. Applying a new patch without removing the old one can lead to overdose due to excessive fentanyl. The old patch must be removed before placing a new one.

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A client who has dysphagia after a cerebral vascular accident (CVA) receives a new prescription for lansoprazole capsules via nasogastric tube (NGT). Which action should the nurse implement prior to administering the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning discharge teaching for a client with type 2 diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse plan to include in the discharge teaching?

Correct Answer is A

Explanation

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

Correct Answer is B

Explanation

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