A nurse is teaching a client who has a new prescription for metformin extended-release tablets.
Which of the following statements by the client indicates an understanding of the teaching?

"I will take the medication in the morning.”

"I will expect to gain weight.”

"I will take the medication on an empty stomach.”

"I will avoid crushing this medication.”

Answer and Explanation

The Correct Answer is D

Choice A rationale:

The statement, "I will take the medication in the morning," indicates lack of understanding. Metformin is usually taken with large meals, and taking it in the morning is not the best timing.

Choice B rationale:

The statement, "I will expect to gain weight," is incorrect. Weight gain is not an expected side effect of metformin. In fact, metformin is often associated with weight loss or weight maintenance, especially in individuals with diabetes, as it helps improve insulin sensitivity and glucose metabolism.

Choice C rationale:

The statement, "I will take the medication on an empty stomach," is incorrect for extended-release metformin tablets. Unlike immediate-release metformin, extended-release tablets should be taken with meals to reduce the risk of gastrointestinal side effects.

Choice D rationale:

The statement, "I will avoid crushing this medication," is correct. Metformin extended-release tablets should never be crushed or broken, as it can affect the way the medication is released into the body. Crushing or breaking the tablet can lead to a sudden release of a large amount of metformin, potentially causing an overdose.

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Correct Answer is D

Explanation

Choice A rationale:

Hanging the transfusion with dextrose 5% in 0.9% sodium chloride is incorrect. Packed red blood cells (PRBCs) are transfused with normal saline (0.9% sodium chloride) and not with dextrose-containing solutions. Using dextrose can cause the red blood cells to hemolyze.

Choice B rationale:

Infusing the transfusion over 5 hours is incorrect. PRBC transfusions are typically administered over 2-4 hours, not 5 hours. Infusing the blood too slowly may cause the patient discomfort and may also increase the risk of bacterial growth in the blood product.

Choice C rationale:

Using a 20-gauge IV catheter to transfuse the blood is incorrect. While a 20-gauge IV catheter is suitable for most blood transfusions, it may not be appropriate for older adults or patients with fragile veins. A smaller gauge, such as 22 or 24, might be more suitable to prevent phlebitis and ensure a steady flow without damaging the blood cells.

Choice D rationale:

Monitoring vital signs every hour throughout the transfusion is the correct action. During a blood transfusion, it's crucial to monitor the patient's vital signs frequently to detect any adverse reactions promptly. Vital signs, including blood pressure, heart rate, respiratory rate, and temperature, should be assessed before the transfusion, 15 minutes after starting the transfusion, and then hourly thereafter. This vigilant monitoring helps in identifying potential transfusion reactions, such as fever, chills, or hypotension, allowing for immediate intervention if needed.

A. February 1 B. February 8 C. February 15 D. February 22

Correct Answer is C

Explanation

February 15.

A. February 1 is not the correct EDB according to Nägele's rule. Nägele's rule states that to estimate the EDB, subtract three months from the LMP and add seven days and one year. Therefore, May 8 minus three months is February 8, plus seven days is February 15, plus one year is February 15 of the following year.
B. February 8 is not the correct EDB according to Nägele's rule. Nägele's rule states that to estimate the EDB, subtract three months from the LMP and add seven days and one year. Therefore, May 8 minus three months is February 8, plus seven days is February 15, minus seven days is February 8, plus one year is February 8 of the following year.
C. February 15 is the correct EDB according to Nägele's rule. Nägele's rule states that to estimate the EDB, subtract three months from the LMP and add seven days and one year. Therefore, May 8 minus three months is February 8, plus seven days is February 15, plus one year is February 15 of the following year.
D. February 22 is not the correct EDB according to Nägele's rule. Nägele's rule states that to estimate the EDB, subtract three months from the LMP and add seven days and one year. Therefore, May 8 minus three months is February 8, plus seven days is February 15, plus seven days is February 22, plus one year is February 22 of the following year.

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A nurse is teaching a client who has a new prescription for metformin extended-release tablets. Which of the following statements by the client indicates an understanding of the teaching?

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A nurse is teaching a client who has a new prescription for metformin extended-release tablets.
Which of the following statements by the client indicates an understanding of the teaching?