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 C

Explanation

A) Chronotropic effect: This term refers to changes in heart rate. Angiotensin II receptor antagonists like valsartan primarily affect blood pressure and vascular tone, rather than directly altering heart rate.
B) Diuresis: Diuresis involves increased urine production. Although some antihypertensives can have a diuretic effect, valsartan primarily works through mechanisms other than increasing urine output.
C) Vasodilation: Angiotensin II receptor antagonists such as valsartan work by blocking the action of angiotensin II, which leads to vasodilation. This reduction in vascular resistance helps to lower blood pressure and is the primary therapeutic effect of valsartan.
D) Sympatholytic action: This refers to the suppression of sympathetic nervous system activity. Valsartan does not primarily act through sympathetic nervous system modulation but rather through direct vasodilation by blocking angiotensin II receptors.

A. Administer the scheduled dose. B. Discontinue the warfarin schedule. C. Withhold warfarin for 24 hours D. Obtain another INR analysis immediately.

Correct Answer is C

Explanation

A) Administer the scheduled dose: Administering the scheduled dose of warfarin when the INR is 5.0 is not appropriate because this INR level is significantly elevated, indicating a high risk of bleeding. Warfarin dosing should be adjusted based on INR levels to prevent complications such as excessive bleeding.
B) Discontinue the warfarin schedule: Completely discontinuing warfarin may not be necessary unless there are additional factors or signs of bleeding. It is essential to take appropriate action based on the INR level, but discontinuation should be guided by further evaluation and healthcare provider recommendations.
C) Withhold warfarin for 24 hours: Withholding the dose of warfarin is the correct action when faced with an elevated INR of 5.0. This intervention is crucial to prevent potential bleeding complications while waiting for further evaluation and guidance from the healthcare provider regarding additional management, such as administration of vitamin K or other reversal agents.

D) Obtain another INR analysis immediately: While obtaining another INR analysis can be helpful in monitoring trends, it is not the immediate priority if the INR is already 5.0. The primary action should be to withhold the dose and consult with the healthcare provider to determine the appropriate next steps for managing the elevated INR and ensuring patient safety.

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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 administering the angiotensin II receptor antagonist valsartan. Which physiological response causes its therapeutic effect?

Correct Answer is C

Explanation

The nurse is preparing to administer warfarin sodium 10 mg PO to a client whose international normalized ratio (INR) is 5.0. Which intervention should the nurse implement? Reference Range: International 1 normalized ratio (INR) [INR: 0.8 to 1.1]

Correct Answer is C

Explanation

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