# A nurse is teaching a patient discharged on oral potassium chloride (extended-release tablet) 20 mEq twice daily for diuretic-induced hypokalemia. Which teaching points should be included? Select all that apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=374939&lang=en  
> language: en  
> subject: Pharmacological and Parenteral Therapies  
> category: PPT

## Question

A nurse is teaching a patient discharged on oral potassium chloride (extended-release tablet) 20 mEq twice daily for diuretic-induced hypokalemia. Which teaching points should be included? Select all that apply.

1

Take the tablets WITH FOOD or a full glass of water (8 oz, 240 mL) to reduce GI irritation and esophageal/gastric ulceration risk.

2

Do NOT crush, chew, or split the extended-release tablets — destroying the matrix releases all the potassium at once and causes severe GI injury.

3

Report symptoms of hyperkalemia — muscle weakness, palpitations, GI cramps, or paresthesias — to the provider immediately.

4

Avoid potassium-containing salt substitutes (such as Morton Lite Salt) and excessive potassium-rich foods because they can cause hyperkalemia when combined with KCl.

5

If you forget a dose, taking both doses at the next scheduled interval is acceptable because the extended-release formulation prevents a potassium spike.

## Explanation

Oral KCl teaching: take with food and full glass of water (GI protection), NEVER crush or split extended-release (causes esophageal/gastric ulcer), avoid K+ salt substitutes (hyperkalemia), report hyperkalemia symptoms. Choice 5 is dangerous — double-dosing potassium can cause life-threatening hyperkalemia; the rule is take a missed dose if remembered soon, or skip and take the next scheduled dose at usual time, but never double up.

## In-depth explanation

The "never crush" rule for KCl extended-release is among the most-tested NCLEX medication-administration points. Crushing destroys the extended-release matrix, dumping all the potassium at once and causing severe esophageal/gastric ulceration. Other never-crush drugs: nitroglycerin SR, aspirin EC, omeprazole DR, levodopa CR. Salt substitutes are a high-yield trap because patients/families often consider them "healthy".

## Clinical scenario

Patient on chronic **furosemide and oral KCl extended-release 20 mEq BID** for diuretic-induced hypokalemia. Discharge teaching needed.

## Key concepts

- **Extended-release KCl** — Slow-release oral potassium; never crush/chew/split; take with food and water for GI protection.
- **Potassium salt substitutes** — Products like Morton Lite Salt contain potassium chloride; combined with KCl supplement can cause hyperkalemia.
- **Missed dose rule** — Take when remembered if soon; skip if close to next dose; NEVER double up — applies to KCl, anticoagulants, antihypertensives.

## Related questions

- [A nurse is programming a high-alert IV medication on a smart infusion pump. Which actions …](https://mymerci.kr/pages/nclex_q.php?qn_id=372863&lang=en)
- [A patient has a serum potassium of 2.8 mEq/L and a new order for IV potassium chloride 40 …](https://mymerci.kr/pages/nclex_q.php?qn_id=373128&lang=en)
- [A patient on chronic phenytoin for seizure disorder reports new diplopia and unsteady gait…](https://mymerci.kr/pages/nclex_q.php?qn_id=373129&lang=en)
- [A patient on day 2 of total parenteral nutrition (TPN) has a capillary glucose of 248 mg/d…](https://mymerci.kr/pages/nclex_q.php?qn_id=373881&lang=en)
- [A nurse is teaching a patient newly started on metoprolol 25 mg twice daily for hypertensi…](https://mymerci.kr/pages/nclex_q.php?qn_id=374879&lang=en)
- [A patient post-radical cystectomy with ileal conduit urinary diversion is being taught uro…](https://mymerci.kr/pages/nclex_q.php?qn_id=374924&lang=en)
- [A 72-year-old on chronic warfarin for atrial fibrillation comes for routine follow-up. Aft…](https://mymerci.kr/pages/nclex_q.php?qn_id=374949&lang=en)
- [A nurse caring for a client 12 hours after a right lower lobectomy notes new crepitus exte…](https://mymerci.kr/pages/nclex_q.php?qn_id=374962&lang=en)

## Read in another language

- [en](https://mymerci.kr/pages/nclex_q.php?qn_id=374939&lang=en)
- [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=374939&lang=ko)
- [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=374939&lang=ja)
- [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=374939&lang=zh-tw)
- [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=374939&lang=vi)

---

More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en)

_For study reference only. Always follow current clinical guidelines and your institution’s protocols._