A nurse is administering an enteric-coated medication to an adult client who has right-sided weakness and is having difficulty swallowing tablet. Which of the following actions should the nurse take?

Administer the tablet to the client with applesauce.

Position the client at a 45 angle

Crush the tablet and mix it in pudding for the client.

Instruct the client to tilt their head back when swallowing

Answer and Explanation

The Correct Answer is A

A. Administer the tablet to the client with applesauce: Administering the tablet with a small amount of soft food like applesauce can help facilitate swallowing without altering the integrity of the enteric coating. This method eases the swallowing process while ensuring the medication is delivered properly.

B. Position the client at a 45-degree angle: Clients who have difficulty swallowing should be positioned in an upright 90-degree sitting position, not at 45 degrees, to reduce the risk of aspiration and promote safer swallowing mechanics.

C. Crush the tablet and mix it in pudding for the client: Enteric-coated tablets should never be crushed, as crushing destroys the protective coating designed to prevent the medication from being released in the stomach, potentially causing irritation or reducing drug effectiveness.

D. Instruct the client to tilt their head back when swallowing: Tilting the head back increases the risk of choking and aspiration, especially in clients with swallowing difficulties. It is safer to encourage tucking the chin slightly down when swallowing to help protect the airway.

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Correct Answer is B

Explanation

A. "I'm sorry to hear that, but I know the dialysis will make you feel better.": This response dismisses the client’s feelings and moves too quickly to reassurance without first exploring the client’s perspective. It can make the client feel unheard and pressured to accept the treatment.

B. "What are your concerns about the dialysis treatments?": This response encourages open communication by inviting the client to express their fears, concerns, or misunderstandings. It shows respect for the client's autonomy and fosters a therapeutic relationship built on trust and understanding.

C. "Do you think your doctor would have recommended dialysis if you didn't need it?": This shifts focus away from the client’s feelings and places undue emphasis on the authority of the provider. It may make the client feel invalidated or coerced rather than supported in making an informed decision.

D. "Most people do get tired of dialysis treatments after a while.": This statement reinforces negative feelings about dialysis and can increase the client’s anxiety or resistance toward the treatment rather than helping them work through their concerns in a constructive manner.

A. Serosanguinous drainage on dressing B. Hypoactive bowel sounds C. Urinary output of 25 mL/hr D. Pain level of 2 on 0 to 10 scale

Correct Answer is C

Explanation

A. Serosanguinous drainage on dressing: Serosanguinous drainage, which is a mixture of clear and blood-tinged fluid, is a common and expected finding in the early postoperative period. It typically indicates normal healing unless the amount becomes excessive or the drainage changes character.

B. Hypoactive bowel sounds: Hypoactive bowel sounds are common within the first 24 to 48 hours following surgery, especially after general anesthesia or abdominal procedures. This finding is expected and does not immediately require provider notification unless accompanied by other concerning signs like severe abdominal distention.

C. Urinary output of 25 mL/hr: Urinary output should be at least 30 mL/hr to indicate adequate kidney perfusion and hydration. An output of 25 mL/hr suggests possible hypovolemia, renal impairment, or urinary retention, and it should be promptly reported to the provider for further evaluation.

D. Pain level of 2 on 0 to 10 scale: A pain score of 2 indicates mild pain, which is manageable and expected after surgery. This level of discomfort does not require urgent reporting to the provider as long as it remains controlled and does not interfere with recovery activities.

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Area assessed	Findings
Neurological	Drowsy but easy to arouse
Vital Signs	Temperature 35.3°C (95.5° F) Heart rate 60/min Respiratory rate 16/min Blood pressure 90/60 mm Hg Oxygen saturation 94% (oxygen at 2 L/min via nasal cannula) Rates pain as 1 on 0/10 pain scale.
Integumentary	Skin cool and moist to touch.
Cardiopulmonary	Heart rate regular. Pedal pulse +1 bilateral. Lungs clear bilateral. Respirations even, nonlabored.
Abdomen	Abdomen soft, nondistended. Bowel sounds hypoactive in all four quadrants. 2x2 gauze with a clear transparent dressing intact to right lower and upper abdominal quadrant. Moderate amount of sanguineous drainage noted on the lower dressing

A nurse is administering an enteric-coated medication to an adult client who has right-sided weakness and is having difficulty swallowing tablet. Which of the following actions should the nurse take?

Nursing Test Bank

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Explanation

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Correct Answer is C

Explanation

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