The nurse should give a client half a glass of water after taking a buccal medication.
True.
False.
It depends on the client's preference.
It depends on the medication type.
The Correct Answer is B
Choice A rationale
Giving water after a buccal medication would cause the medication to be swallowed. Buccal medications are designed for absorption through the rich vascularization of the buccal mucosa, allowing direct entry into the systemic circulation and bypassing first-pass hepatic metabolism. Swallowing defeats this purpose.
Choice B rationale
Buccal medications are intended to dissolve slowly in the buccal pouch (between the cheek and gums) and be absorbed directly into the bloodstream through the mucous membranes. Consuming water would wash the medication away, leading to premature swallowing and subsequent degradation by gastric enzymes or first-pass metabolism in the liver, thus reducing its therapeutic effect.
Choice C rationale
The client's preference for water does not supersede the pharmacokinetic principles governing buccal medication administration. The route of administration is chosen specifically for its absorption profile, and introducing water compromises the intended local absorption mechanism, regardless of patient comfort.
Choice D rationale
The type of medication is precisely why water should be avoided. Buccal medications, by their very design, rely on sustained contact with the oral mucosa for systemic absorption. Regardless of the specific drug, water interferes with this fundamental mechanism, rendering the buccal route ineffective.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Inflammation of the gallbladder, or cholecystitis, typically causes pain in the right upper quadrant of the abdomen, often radiating to the right shoulder or back. While percussion can elicit tenderness, the primary location of pain is not the costovertebral angle, which is anatomically associated with the kidneys.
Choice B rationale
Sharp pain along the costovertebral angles (CVA) during percussion is a classic clinical sign known as CVA tenderness. This finding is highly indicative of inflammation or infection of the kidneys, such as pyelonephritis. The kidneys are retroperitoneal organs located just below the twelfth rib, making them directly accessible to percussion at this anatomical landmark.
Choice C rationale
Enlargement of the liver, or hepatomegaly, is typically assessed by palpation and percussion of the right upper quadrant, below the costal margin. While it can cause discomfort, liver enlargement does not primarily manifest as pain at the costovertebral angles upon percussion.
Choice D rationale
Pancreatitis, inflammation of the pancreas, usually causes severe epigastric pain that often radiates to the back. While it is a retroperitoneal organ, its anatomical location and the nature of the pain differ significantly from the localized tenderness elicited at the costovertebral angles during percussion.
Correct Answer is D
Explanation
Choice A rationale
Reading newsprint at 20 inches assesses near vision, but it is not the standard clinical method for comprehensive visual acuity assessment. While it can provide some insight into the patient's functional near vision, a more precise and standardized tool like a Jaeger card or specific near vision charts are preferred for accurate diagnostic evaluation.
Choice B rationale
The Jaeger card is specifically designed to assess near visual acuity, typically held at 14 inches (35 cm) from the eye. While useful for evaluating reading vision, it does not provide information about distance visual acuity, which is a primary component of a comprehensive eye examination and is assessed using a Snellen chart.
Choice C rationale
The confrontation test assesses peripheral vision, not central visual acuity. It involves the examiner bringing fingers or objects into the patient's field of vision from various directions. While an important part of a complete eye examination to detect visual field defects, it does not quantify the sharpness of central vision.
Choice D rationale
The Snellen chart is the gold standard for assessing distance visual acuity. Positioning it 20 feet away standardizes the testing distance, allowing for accurate measurement of visual acuity as a fraction (e.g., 20/20). This provides a reliable and reproducible measure of central vision, critical for diagnosing and monitoring visual impairments.
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