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A nurse administers subcutaneous NPH insulin at 0700 to a child who has diabetes. At which of the following times should the nurse observe for hypoglycemia caused by the onset of the medication?
- A. 715
- B. 800
- C. 900
- D. 1000
Correct Answer: D
Rationale: The correct answer is D: 1000. NPH insulin typically starts working within 1 to 2 hours after administration, peaks in 4 to 12 hours, and lasts up to 24 hours. Since the nurse administered the insulin at 0700, the onset of hypoglycemia should be observed around 0900 to 1100. Choice A (715) is too soon for onset. Choice B (800) falls within the expected onset time, but it may be too early for hypoglycemia. Choice C (900) is also within the expected onset time frame, but waiting until 1000 (Choice D) allows for a more accurate observation of hypoglycemia as the peak effect of NPH insulin is approaching.
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A nurse is caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?
- A. Decreased temperature.
- B. Hypotension.
- C. Tachycardia.
- D. Constipation.
Correct Answer: C
Rationale: The correct answer is C: Tachycardia. Levothyroxine is a medication used to treat hypothyroidism by increasing thyroid hormone levels. If the client's dose is too high, it can lead to hyperthyroidism symptoms, such as tachycardia (fast heart rate), due to an excess of thyroid hormone. Decreased temperature (A) is a sign of hypothyroidism, not hyperthyroidism. Hypotension (B) is more likely to occur with hypothyroidism, as thyroid hormone helps regulate blood pressure. Constipation (D) is a symptom of hypothyroidism, not hyperthyroidism.
A nurse is reinforcing teaching with a client who is to start subcutaneous heparin. Which of the following information should the nurse include in the teaching?
- A. Use a soft-bristled toothbrush.
- B. Inject the medication deep into the thigh muscle.
- C. Expect stools to become black and tarry.
- D. Easy bruising indicates the medication is effective.
Correct Answer: A
Rationale: The correct answer is A: Use a soft-bristled toothbrush. When starting subcutaneous heparin, it is important to minimize the risk of bleeding. Using a soft-bristled toothbrush helps prevent gum bleeding. Choice B is incorrect because heparin is typically injected into the subcutaneous tissue, not deep into the muscle. Choice C is incorrect because black, tarry stools are a sign of gastrointestinal bleeding, not a side effect of heparin. Choice D is incorrect because easy bruising is not an indication of heparin's effectiveness, but rather a side effect indicating a need to adjust the dosage.
A nurse in the emergency department is assisting with the care of a client who has a deep laceration on her left lower forearm and is bleeding heavily from the wound. Which of the following actions should the nurse take first?
- A. Apply a tourniquet just above the wound.
- B. Place the client in a modified Trendelenburg position.
- C. Apply pressure directly to the wound.
- D. Settle the client in a reclining position.
Correct Answer: C
Rationale: The correct action is to apply pressure directly to the wound first. This is crucial to control the bleeding and prevent further blood loss. Applying pressure helps to promote clotting and reduce the risk of hypovolemic shock. It is the immediate and most effective intervention to manage the situation.
Choice A (Apply a tourniquet just above the wound) is incorrect because tourniquets should be used as a last resort due to the risk of tissue damage and potential complications.
Choice B (Place the client in a modified Trendelenburg position) is incorrect as this position is not recommended for patients with bleeding as it can increase intracranial pressure and worsen the situation.
Choice D (Settle the client in a reclining position) is incorrect because the priority is to control the bleeding first before adjusting the client's position.
The physician orders vancomycin hydrochloride 2 g/day by mouth in 4 divided doses. The pharmacy fills the client's prescription with 500 mg vancomycin hydrochloride capsules. The nurse should instruct the client to take______capsule(s) per dose.
Correct Answer: A
Rationale: Correct Answer: A
Rationale: To calculate how many capsules to take per dose, divide the total daily dose (2 g) by the strength of each capsule (500 mg).
1. Convert 2 g to mg: 2 g = 2000 mg
2. Divide 2000 mg by 500 mg per capsule: 2000 mg / 500 mg = 4 capsules per day
3. Since the prescription is to be taken in 4 divided doses, the client should take 1 capsule per dose.
Summary:
B: Incorrect - Not the correct calculation based on the dose and capsule strength.
C: Incorrect - Not the correct calculation based on the dose and capsule strength.
D: Incorrect - Not the correct calculation based on the dose and capsule strength.
E: Incorrect - Not the correct calculation based on the dose and capsule strength.
F: Incorrect - Not the correct calculation based on the dose and capsule strength.
G: Incorrect - Not the correct calculation
A nurse is preparing to administer dexamethasone 3 mg PO. Available are dexamethasone 1.5 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.).
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: The correct answer is B: 2 tablets. To achieve a total of 3 mg of dexamethasone, the nurse will need to administer 2 tablets of 1.5 mg each. This is calculated by dividing the total dose needed (3 mg) by the strength of each tablet (1.5 mg). Dividing 3 mg by 1.5 mg gives us 2 tablets. Therefore, the nurse should administer 2 tablets to achieve the desired dose of 3 mg.
Choice A (1 tablet) is incorrect because 1 tablet would only provide 1.5 mg of dexamethasone, which is less than the required dose of 3 mg. Choices C (3 tablets) and D (4 tablets) are incorrect as they would result in an overdose, exceeding the required dose of 3 mg.