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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Hypoglycemic mechanism of biguanides is:
- A. Enhance closure of ATP sensitive K+ channels
- B. Inhibits gluconeogenesis in the liver
- C. Enhance glucose absorption from gastro-intestinal tract
- D. Decrease glycolysis in the peripheral tissue
Correct Answer: B
Rationale: Biguanides like metformin inhibit hepatic gluconeogenesis, reducing blood glucose production.
A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis?
- A. Factor
- B. Darkness
- C. Erythema
- D. Coolness
Correct Answer: C
Rationale: Erythema and pain are classic signs of phlebitis, inflammation of the vein.
A patient receiving gentamicin should be monitored for which potential adverse effect?
- A. Nephrotoxicity
- B. Hepatotoxicity
- C. Ototoxicity
- D. Both A and C
Correct Answer: D
Rationale: Gentamicin, an aminoglycoside, commonly causes nephrotoxicity and ototoxicity , requiring monitoring of renal function and hearing.
The nurse administers amoxicillin 500 mg. The half-life of this drug is approximately 1 hour. At what point would the drug level in the body be 62.5 mg if the drug was not administered again?
- A. 1 hours after the original dose
- B. 2 hours after the original dose
- C. 3 hours after the original dose
- D. 4 hours after the original dose
Correct Answer: C
Rationale: The half-life of a drug is the time it takes for the amount of drug in the body to decrease to one-half of the peak level it previously achieved. At a dose of 500 mg the drug level would be 250 mg in 1 hour, 125 mg in 2 hours, 62.5 mg in 3 hours, and 31.25 mg in 4 hours so the correct answer is 3 hours.
The nurse is helping a client review a prescription from the health care provider. When examining the prescription, which of the following would the nurse expect to find documented?
- A. Name of the drug
- B. Dosage of the drug
- C. Route of drug administration
- D. All the above
Correct Answer: D
Rationale: The prescription must contain the client's name, the name of the drug, the dosage, the method and times of administration, and the signature of the licensed health care provider prescribing the drug.