Nokea
A client who takes metformin for diabetes mellitus type 2 is taking nothing by mouth (NPO) for surgery. What pre-op prescription should the practical nurse (PN) anticipate for this client's glucose management?
- A. NPO except for metformin and regular snacks
- B. NPO except for oral antidiabetic agent
- C. Novolin-N insulin subcutaneously twice daily
- D. Regular insulin subcutaneously per sliding scale
Correct Answer: D
Rationale: When a client taking metformin for diabetes mellitus type 2 is NPO for surgery, it is essential to manage their glucose levels effectively. In this scenario, the best approach is to prescribe regular insulin subcutaneously according to a sliding scale based on the client's blood glucose levels. This method allows for precise adjustment of insulin doses to maintain blood glucose within the target range while the client is unable to take oral medications.
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A client with a history of hypertension is prescribed hydrochlorothiazide. The practical nurse should monitor the client for which potential adverse effect?
- A. Hyperkalemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hyponatremia
Correct Answer: B
Rationale: Hydrochlorothiazide is a diuretic that can lead to potassium loss, resulting in hypokalemia. Monitoring for hypokalemia is essential because it can cause various complications such as cardiac dysrhythmias. Therefore, the practical nurse should closely watch for signs and symptoms of low potassium levels in clients taking hydrochlorothiazide.
A client receiving enalapril reports a persistent dry cough. The nurse should explain that this side effect is related to which medication action?
- A. It reduces the production of angiotensin II.
- B. It increases the production of angiotensin II.
- C. It causes increased production of bradykinin.
- D. It increases the production of aldosterone.
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?
- A. Withdraw ten units of regular insulin from the 70/30 vial
- B. Withhold the dose until regular insulin is available
- C. Obtain a new vial of regular insulin and withhold
- D. Pull up 30 units from the 70/30 vial but only administer 10 units
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with type 2 diabetes mellitus is prescribed dulaglutide. The nurse should monitor for which potential adverse effect?
- A. Nausea
- B. Hypoglycemia
- C. Hyperglycemia
- D. Pancreatitis
Correct Answer: A
Rationale: The correct answer is 'Nausea.' Dulaglutide, a medication commonly used in the management of type 2 diabetes, can lead to gastrointestinal side effects such as nausea. While hypoglycemia and hyperglycemia are potential concerns in diabetes management, they are not typically associated with dulaglutide use. Pancreatitis is a serious adverse effect of some diabetes medications, but it is not a common side effect of dulaglutide.
A client with severe rheumatoid arthritis is prescribed infliximab. The nurse should monitor for which potential adverse effect?
- A. Increased risk of infection
- B. Bone marrow suppression
- C. Hair loss
- D. Pancreatitis
Correct Answer: A
Rationale: The correct answer is A: Increased risk of infection. Infliximab is known to increase the risk of infection due to its immunosuppressive effects. It is crucial for the nurse to monitor for signs of infection in the client receiving infliximab to promptly address any potential complications and ensure the client's safety and well-being.