The nurse is caring for a client who has a finger stick blood glucose level of 130 mg/dL (7.21 mmol/L) Prior to administering the scheduled dose of acarbose, the nurse is informed that morning meal trays will be 30 minutes late. Which action should the nurse take?

Reference Range:

Glucose [74 to 106 mg/dl. (4.1 to 5.9 mmol/L)]

Administer the medication

Notify the healthcare provider.

Hold the medication until the meal trays arrive.

Obtain another finger tick blood glucose level.

Answer and Explanation

The Correct Answer is C

A. Administer the medication: Acarbose is an alpha-glucosidase inhibitor that should be taken with the first bite of a meal to effectively manage postprandial blood glucose levels. Administering it before the meal is inappropriate as it can lead to inadequate glucose control.
B. Notify the healthcare provider: While notifying the healthcare provider might be necessary if there are significant issues, it is not the immediate action needed in this situation. The priority is to manage the timing of the medication relative to the meal.
C. Hold the medication until the meal trays arrive: Acarbose should be taken with food to work effectively in controlling blood glucose levels after meals. If the meal is delayed, the medication should be held until the meal is ready to ensure proper administration.
D. Obtain another finger stick blood glucose level: Rechecking the blood glucose level does not address the issue of the timing of the acarbose administration. The focus should be on ensuring the medication is taken with the meal.

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Correct Answer is A

Explanation

A. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin: It is appropriate to administer a PRN dose of sublingual nitroglycerin for immediate relief of acute angina while leaving the transdermal patch in place. The sublingual nitroglycerin acts quickly to relieve chest pain, while the transdermal patch provides a longer, more sustained effect.
B. Reassure the client that the patch will begin to take effect within a few minutes: The transdermal patch generally takes 30 to 60 minutes to reach therapeutic levels, which is not suitable for immediate relief of acute chest pain. Therefore, reassurance alone may not address the current symptoms effectively.
C. Withhold further doses of nitroglycerin until contacting the healthcare provider: Withholding further doses of nitroglycerin without assessing the situation can delay appropriate relief of chest pain. Immediate intervention is necessary, and it is appropriate to use sublingual nitroglycerin as needed.

D. Obtain another transdermal patch and position it on the patient's left upper chest: Applying an additional transdermal patch is not necessary and could lead to excessive nitroglycerin exposure. The current patch should be left in place, and sublingual nitroglycerin can be used for acute symptoms.

A. Mix the capsule granules with water. B. Request the pharmacist to provide tablets. C. Open the capsule to crush the granules. D. Sprinkle the granules in applesauce.

Correct Answer is A

Explanation

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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Naxlex Comprehensive Predictor Exams

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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