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A client with a new diagnosis of type 1 diabetes mellitus is being taught by a nurse about insulin administration. Which of the following instructions should the nurse include?
- A. Store unopened vials of insulin in the refrigerator, not the freezer.
- B. Rotate injection sites within the same region to prevent tissue damage.
- C. Administer insulin at a 90-degree angle for subcutaneous injections.
- D. Avoid massaging the injection site after administering insulin.
Correct Answer: B
Rationale: The correct answer is to rotate injection sites within the same region to prevent tissue damage. By rotating sites, the client can prevent lipodystrophy, which is a condition characterized by the loss or change in body fat at the site of repeated injections. This practice also helps to ensure proper insulin absorption. Storing unopened vials of insulin in the refrigerator (Choice A) is correct, not in the freezer, as freezing can damage the insulin. Administering insulin at a 90-degree angle (Choice C) is more appropriate for subcutaneous injections, while a 45-degree angle is used for intramuscular injections. Massaging the injection site after administering insulin (Choice D) is not recommended as it can affect insulin absorption rates.
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A client is receiving furosemide for heart failure. Which of the following findings should the nurse report to the provider?
- A. Weight loss of 0.5 kg (1.1 lb) in 24 hours.
- B. Heart rate of 68/min.
- C. Potassium level of 3.8 mEq/L.
- D. Urine output of 60 mL/hr.
Correct Answer: B
Rationale: The correct answer is B. A heart rate of 68/min is lower than expected and should be reported as it may indicate digoxin toxicity. Choices A, C, and D are within normal limits for a client receiving furosemide for heart failure and do not require immediate reporting. Weight loss may be expected due to diuretic therapy, a potassium level of 3.8 mEq/L is within the normal range, and a urine output of 60 mL/hr indicates adequate renal perfusion.
A client has a new prescription for furosemide. Which of the following instructions should the nurse include?
- A. Take this medication with a full glass of water in the morning.
- B. Monitor your blood pressure daily while taking this medication.
- C. Take this medication at bedtime to prevent nocturia.
- D. Avoid taking this medication with food.
Correct Answer: A
Rationale: The correct answer is to instruct the client to take furosemide with a full glass of water in the morning. Furosemide is a diuretic that can cause increased urination, so it is best taken earlier in the day to avoid disrupting sleep with nocturia. Choice B is not the priority instruction for furosemide. Choice C is incorrect as taking furosemide at bedtime can lead to nocturia, which is undesirable. Choice D is incorrect because furosemide can be taken with or without food.
A healthcare professional is reviewing the medication history of a client who has a new prescription for warfarin. Which of the following medications should the healthcare professional identify as a contraindication for this client?
- A. Acetaminophen
- B. Ibuprofen
- C. Clopidogrel
- D. Metoprolol
Correct Answer: C
Rationale: The correct answer is C, Clopidogrel. Clopidogrel is an antiplatelet medication that increases the risk of bleeding when taken with warfarin. Acetaminophen (choice A) and metoprolol (choice D) do not have significant interactions with warfarin. Ibuprofen (choice B) is an NSAID that can also increase the risk of bleeding when taken with warfarin, but clopidogrel is a more significant contraindication due to its antiplatelet effects. Therefore, healthcare professionals should be cautious when combining warfarin with clopidogrel due to the increased risk of bleeding compared to other options.
A nurse is preparing to administer an IM injection to a client. Which of the following actions should the nurse take?
- A. Massage the injection site after administering the medication.
- B. Insert the needle at a 45° angle.
- C. Use a Z-track technique to administer the injection.
- D. Aspirate for blood before injecting the medication.
Correct Answer: C
Rationale: The correct answer is C: 'Use a Z-track technique to administer the injection.' When administering IM injections, using a Z-track technique helps prevent medication from leaking into subcutaneous tissues. This technique involves pulling the skin laterally, injecting the medication deeply into the muscle, and then releasing the skin. Choice A is incorrect because massaging the injection site after administering the medication can lead to increased blood flow and potential leakage of the medication. Choice B is incorrect as the needle should typically be inserted at a 90° angle for IM injections to ensure proper delivery into the muscle. Choice D is incorrect as aspirating for blood before injecting the medication is not routinely recommended for IM injections.
A healthcare provider is reviewing the medical records of a client with a prescription for combination oral contraceptives. Which of the following conditions is a contraindication?
- A. Hyperthyroidism
- B. Thrombophlebitis
- C. Diverticulosis
- D. Hypocalcemia
Correct Answer: B
Rationale: Thrombophlebitis is a contraindication to combination oral contraceptives due to the increased risk of thromboembolic events. Hyperthyroidism, diverticulosis, and hypocalcemia are not contraindications to combination oral contraceptives. Hyperthyroidism may affect thyroid hormone levels but does not directly contraindicate oral contraceptives. Diverticulosis is a condition related to the digestive system and does not impact the use of oral contraceptives. Hypocalcemia, a low calcium level in the blood, is not a contraindication for oral contraceptives.