Nokea
A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
- A. 2 to 4 hours after administration
- B. 4 to 12 hours after administration
- C. 16 to 18 hours after administration
- D. 18 to 24 hours after administration
Correct Answer: B
Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
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Prior to administering a prescribed drug, the nurse correctly identifies the client by which method?
- A. Checking a client's name on his or her wristband
- B. Checking a client's chart
- C. Asking the client if the are Mr. Jones
- D. Asking a client if he or she is the correct client
Correct Answer: A
Rationale: Client identifiers can include visual and verbal methods. Visual methods include use of a recent picture of the client or client wristband. Verbal methods include asking the client for his or her name and another unique identifier, such as his or her birth date. Never ask a client, 'Are you Mr. Jones?' because some clients may respond by answering 'yes' even though that is not their name due to confusion or difficulty hearing. Checking the client's chart would be inappropriate to use for identifying the client.
Select a suitable therapeutic indication for bethanechol:
- A. To decrease the heart rate
- B. To decrease the blood pressure
- C. For urinary retention
- D. Decrease intraocular pressure
Correct Answer: C
Rationale: Bethanechol, a muscarinic agonist, stimulates bladder contraction for urinary retention.
Idiosyncrasy is:
- A. A genetically determined abnormal reaction to drugs
- B. A characteristic toxic effect at therapeutic doses
- C. An altered physiological state produced by repeated drug use
- D. An immunologically mediated reaction
Correct Answer: A
Rationale: Idiosyncrasy is a genetically determined unusual response to a drug, e.g., G6PD deficiency with primaquine.
Characteristics of vitamin D and its metabolites include which of the following?
- A. Act to decrease serum levels of calcium
- B. Activation of vitamin D receptors in the major cells of
- C. Calcitriol is the major derivative responsible for increasing intestinal absorption of phosphate
- D. Metabolites of vitamin D increase renal excretion of calcium
Correct Answer: C
Rationale: Calcitriol increases intestinal absorption of calcium and phosphate.
The nurse is teaching a patient who has completed detoxification for alcohol abuse who will be discharged home with a prescription for disulfiram (Antabuse). Which statement by the patient indicates understanding of the teaching?
- A. Even topical products containing alcohol can have serious adverse effects while I am taking this drug
- B. If I experience drowsiness or skin rash, I should discontinue this drug immediately
- C. It is safe to take a product containing alcohol one week after the last dose of disulfiram
- D. This drug acts by blocking the pleasurable effects of alcohol
Correct Answer: A
Rationale: Disulfiram reacts with any alcohol, even topical; effects linger 2 weeks , and it causes aversion, not blocking pleasure . Disulfiram causes an unpleasant and potentially fatal reaction if alcohol is consumed while taking it and can even occur with topical products containing alcohol.