Nokea
A 33-year-old man with a history of asthma comes into the emergency department after getting stung by a bee. The treating physician wants to give epinephrine subcutaneously. Which of the following contraindications to this medication is noted?
- A. Diabetes mellitus
- B. Narrow-angle glaucoma
- C. Pulmonary failure
- D. Thyroid disease
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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A nurse is providing teaching to a client who has a new prescription for Metoprolol. Which of the following statements should the nurse include?
- A. This medication may make you feel dizzy at first.
- B. You should avoid foods that are high in fat.
- C. Take the medication in the morning.
- D. You may experience a rapid heart rate while taking this medication.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client in a critical care unit is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?
- A. Prone
- B. On the nonoperative side
- C. Sims'
- D. Semi-Fowler's
Correct Answer: D
Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.
A client with type 2 diabetes is prescribed insulin glargine (Lantus). Which statement by the client indicates a need for further teaching?
- A. I should inject this insulin at the same time each day.'
- B. I can mix this insulin with regular insulin if needed.'
- C. This insulin helps control my blood sugar overnight.'
- D. I should not see a peak in action with this insulin.'
Correct Answer: B
Rationale: Insulin glargine, a long-acting basal insulin, provides steady glucose control without a peak. Mixing it with regular insulin is incorrect'glargine's pH precipitates if combined, altering its action, indicating a teaching need. Same-time injection ensures consistency. Overnight control and no peak align with its 24-hour, flat profile. The misconception about mixing risks erratic glucose levels, critical in type 2 diabetes where stability is key. Further teaching must clarify glargine's unique formulation, preventing administration errors that could lead to hypo- or hyperglycemia, making B the statement requiring correction.
A client with deep vein thrombosis has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which of the following statements should the nurse make?
- A. Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.
- B. I will call the provider to get a prescription for discontinuing the IV heparin today.
- C. Both heparin and warfarin work together to dissolve the clots.
- D. The IV heparin increases the effects of the warfarin and decreases the length of your hospital stay.
Correct Answer: A
Rationale: The correct answer is A because warfarin takes several days to reach a therapeutic level and exert its full anticoagulant effect. During this time, the IV heparin is continued to prevent clotting until the warfarin is effective. Both medications are used together temporarily for this reason. Discontinuing heparin prematurely can increase the risk of clot formation. Therefore, the nurse should explain to the client that the IV heparin will be continued until the warfarin reaches a therapeutic level.
A healthcare professional is preparing to administer IV Furosemide to a client with heart failure. Which of the following actions should the healthcare professional take?
- A. Administer the medication undiluted.
- B. Dilute the medication with normal saline.
- C. Administer the medication through a central line.
- D. Administer the medication slowly over 2 minutes.
Correct Answer: D
Rationale: Furosemide, when administered intravenously, should be given slowly over 2 minutes to reduce the risk of ototoxicity, a known adverse effect of rapid infusion. This method allows for better monitoring of the client's response and decreases the likelihood of adverse reactions associated with a faster administration rate.