The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Document the client’s refusal of the medication at this time.

Explain the need to take the medication at least 1 hour before meals.

Allow the client to take the medication up to 1 hour after breakfast.

Instruct the client to take it when the meal tray is delivered.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Documenting the client’s refusal of the medication at this time is not the best response. While it is important to document any refusal of medication, the nurse should first educate the client on the proper administration of sucralfate. Sucralfate works by forming a protective barrier over ulcers, and it is most effective when taken on an empty stomach, at least 1 hour before meals.

Choice B reason:

Explaining the need to take the medication at least 1 hour before meals is the correct response. Sucralfate should be taken on an empty stomach to ensure it can effectively coat the stomach lining and protect it from acid. Taking it before meals maximizes its efficacy in treating and preventing ulcers.

Choice C reason:

Allowing the client to take the medication up to 1 hour after breakfast is not appropriate. Sucralfate needs to be taken on an empty stomach to form a protective barrier over the ulcer. Taking it after a meal would reduce its effectiveness, as the presence of food can interfere with its action.

Choice D reason:

Instructing the client to take it when the meal tray is delivered is incorrect. Sucralfate should be taken on an empty stomach, at least 1 hour before meals, to ensure it can properly coat the stomach lining and provide the necessary protection against stomach acid

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Correct Answer is C

Explanation

Choice A reason:

Teaching the client about foods high in calcium is important, but it is not the most immediate action required. A serum calcium level of 5.5 mg/dL is significantly below the normal range (8.5-10.2 mg/dL) and indicates severe hypocalcemia. While dietary education is beneficial for long-term management, the nurse must first address the acute issue by notifying the healthcare provider.

Choice B reason:

Beginning to taper the drug dose per protocol is not appropriate without consulting the healthcare provider. Methylprednisolone, a corticosteroid, can cause decreased calcium absorption and increased calcium excretion. However, any changes to the medication regimen should be directed by the healthcare provider, especially in the context of severe hypocalcemia.

Choice C reason:

Notifying the healthcare provider of the finding is the most critical action. Severe hypocalcemia can lead to serious complications such as cardiac arrhythmias, muscle spasms, and seizures. Immediate medical intervention is necessary to correct the calcium imbalance and prevent potential life-threatening conditions.

Choice D reason:

Administering the medication with a glass of milk is not sufficient to address the severe hypocalcemia. While milk contains calcium, the amount is not enough to correct a serum calcium level as low as 5.5 mg/dL. The nurse must prioritize notifying the healthcare provider to ensure appropriate treatment is initiated.

Word count: 500 words.

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

Correct Answer is C

Explanation

Choice A reason:

Placing the new patch on the client’s shoulder and leaving both patches in place for 12 hours is not recommended. Fentanyl patches are designed to be used one at a time, and overlapping patches can lead to an overdose due to excessive absorption of the medication1. The standard practice is to remove the old patch before applying a new one.

Choice B reason:

Removing the patch and consulting with the healthcare provider about the client’s pain resolution is a cautious approach. However, it is not necessary to consult the healthcare provider if the client denies pain and the patch is due for replacement. The nurse should follow the standard protocol for patch replacement.

Choice C reason:

Applying the new patch in a different location after removing the original patch is the correct action. This ensures that the medication is delivered effectively while preventing skin irritation and potential overdose. The new patch should be placed on a different area of intact skin to allow the previous site to recover.

Choice D reason:

Administering an oral analgesic and evaluating its effectiveness before applying the new patch is not appropriate in this scenario. The client is already receiving pain management through the transdermal patch, and additional oral analgesics are not necessary unless there is breakthrough pain. The focus should be on proper patch replacement

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The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Prior to administering an oral dose of methylprednisolone, the nurse determines the client’s serum total calcium level is 5.5 mg/dL (1.375 mmol/L). What action is most important for the nurse to take?

Correct Answer is C

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 C

Explanation

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