The healthcare professional must verify the client's identity before administration of medication. Which of the following is the safest way to identify the client?

Correct Answer: B

Rationale: Verifying the client's identity before administering medication is crucial to ensure patient safety. Checking the client's identification band is the safest and most reliable method to confirm the client's identity. Identification bands are specifically designed to prevent errors in patient identification and help healthcare professionals administer care to the correct individual.

Correct Answer: A

Rationale: The correct position for administering a cleansing enema is the Sims left lateral position. This position is preferred as it helps to facilitate the procedure by allowing gravity to assist in the flow of the enema solution. The individual lies on their left side with the right knee flexed towards the chest, which helps to promote retention of the enema solution and its distribution throughout the colon.

Correct Answer: C

Rationale: When addressing a client's difficulty swallowing capsules, the nurse must consider medication safety, absorption, and client comfort. The correct approach is to check the availability of a liquid preparation (Option C), as this is the safest and most effective alternative. Liquid medications are specifically formulated for easy swallowing and ensure accurate dosing without altering the drug's pharmacokinetics. Many medications come in liquid forms, suspensions, or orally disintegrating tablets, which are ideal for clients with dysphagia. This option avoids the risks associated with tampering with the capsule's integrity, such as altered absorption or irritation of the gastrointestinal tract. Option A, dissolving the capsule in water, is incorrect because not all capsules are designed to be dissolved. Some medications are encapsulated to protect them from stomach acid, control release rates, or prevent irritation of the esophageal or gastric lining. Dissolving them may lead to rapid absorption, reduced efficacy, or local irritation. For example, enteric-coated or extended-release capsules must remain intact to function as intended. Option B, breaking the capsule and mixing the contents with applesauce, is inappropriate unless specifically permitted by the pharmacist or drug manufacturer. Many capsules contain powders or granules that are bitter, unstable in food, or require precise dosing. Mixing with food can result in incomplete ingestion, altered absorption, or even toxicity if the drug is not meant to be taken this way. Additionally, some medications (e.g., cytotoxic drugs) pose a safety risk if handled outside their original form. Option D, crushing the capsule and placing it under the tongue, is dangerous and incorrect. Most medications are not formulated for sublingual administration, which bypasses the digestive system and liver metabolism, potentially leading to erratic absorption or adverse effects. Crushing can also compromise the drug's stability or cause mucosal irritation. Only drugs specifically designed for sublingual use (e.g., nitroglycerin) should be administered this way. In summary, the nurse must prioritize methods that preserve the medication's intended action while accommodating the client's needs. Liquid formulations are the gold standard for dysphagia management unless contraindicated, whereas modifying capsules without proper guidance risks therapeutic failure or harm. Always consult the pharmacist or prescribing information before altering medication administration routes.

Correct Answer: C

Rationale: Insulin is a peptide hormone that requires precise and controlled delivery to maintain blood glucose levels effectively. The **subcutaneous (C)** route is the standard for most insulin administration because the fatty tissue under the skin provides a slow, consistent absorption rate, which mimics the physiological release of insulin from the pancreas. This route ensures a predictable onset, peak, and duration of action, which is critical for managing diabetes. Subcutaneous injections are also practical for self-administration, with minimal risk of rapid fluctuations in blood sugar levels. **Intramuscular (A)** injections are inappropriate for routine insulin administration because muscles have a richer blood supply than subcutaneous tissue, leading to faster and less predictable absorption. This could result in hypoglycemia due to rapid insulin uptake. While intramuscular injections may be used in emergencies (e.g., diabetic ketoacidosis), they are not standard for daily management. **Intradermal (B)** injections are not used for insulin because the dermis lacks sufficient vascularization and fat to ensure consistent absorption. This route is typically reserved for diagnostic tests (e.g., tuberculosis skin tests) or vaccines, where small amounts of fluid are needed and slow absorption is acceptable. Insulin requires reliable absorption kinetics, which intradermal injections cannot provide. **Intravenous (D)** administration delivers insulin directly into the bloodstream, causing an immediate and sharp drop in blood glucose. This is only appropriate in critical care settings (e.g., severe hyperglycemia or diabetic ketoacidosis) where rapid action is necessary. However, for routine use, intravenous delivery is impractical, dangerous (risk of severe hypoglycemia), and requires continuous monitoring, making subcutaneous the definitive choice for daily insulin therapy. The subcutaneous route’s balance of safety, efficacy, and ease of use solidifies its role as the standard for insulin administration, while the other routes are either too erratic, impractical, or reserved for specialized scenarios.

Correct Answer: A

Rationale: The correct answer is A, "Three times a day orally," because the prescription "TID p.o." is a standard medical abbreviation that clearly defines the frequency and route of administration. "TID" stands for "ter in die," a Latin phrase meaning "three times a day," while "p.o." is the abbreviation for "per os," meaning "by mouth" or orally. This combination of terms explicitly instructs the healthcare provider to administer the medication three times daily via the oral route. There is no ambiguity in this interpretation, as these abbreviations are universally recognized in medical practice and documented in clinical guidelines. Choice B, "Three times a day after meals," is incorrect because it introduces an additional instruction not specified in the original order. While some medications are best taken after meals to reduce gastrointestinal irritation or enhance absorption, the prescription does not include this detail. Assuming administration timing without explicit instructions could lead to improper dosing intervals or unintended side effects. Unless the healthcare provider specifies "after meals" or "postprandial," the default interpretation should strictly follow the written order. Choice C, "Two times a day by mouth," is incorrect because it misinterprets the frequency of administration. "TID" explicitly means three times a day, not two. The abbreviation for twice daily is "BID" (bis in die). Misreading the frequency could result in subtherapeutic dosing, potentially reducing the medication's efficacy or leading to treatment failure. Additionally, while "p.o." is correctly interpreted as "by mouth," the incorrect frequency undermines the intended dosing schedule. Choice D, "Two times a day before meals," is incorrect for two reasons. First, as with choice C, it misinterprets "TID" as two doses instead of three. Second, it assumes administration "before meals," which is not indicated in the original order. Pre-meal dosing is typically specified when medications require an empty stomach for optimal absorption (e.g., some antibiotics or thyroid medications). Without such a directive, adding this condition could alter the drug's pharmacokinetics unnecessarily. In summary, the correct interpretation must adhere strictly to the abbreviations provided without making assumptions about timing relative to meals or altering the prescribed frequency. The use of standardized medical terminology ensures clarity and prevents medication errors, making "Three times a day orally" the only correct choice.