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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How do you determine if the medication is effective for a client with anemia secondary to chronic kidney disease (CKD)?
- A. Food diary shows increased consumption of iron-rich foods
- B. Reports of increased energy levels and decreased fatigue
- C. Hemoglobin level increased to 12 grams/dL
- D. Takes concurrent iron therapy without adverse effects
Correct Answer: C
Rationale: To assess the effectiveness of the medication for anemia in a client with CKD, monitoring hemoglobin levels is crucial. Hemoglobin levels serve as a direct indicator of the response to treatment and improvement in the condition. An increase in hemoglobin level to 12 grams/dL suggests that the medication is effectively addressing the anemia associated with CKD.
A 67-year-old client is discharged from the hospital with a prescription for digoxin 0.25 mg daily. Which instruction by the practical nurse (PN) is correct?
- A. Take the medication in the morning before getting out of bed.
- B. Do not take the medication if the heartbeat is irregular or slow.
- C. Expect some vision changes due to the medication.
- D. Increase intake of foods rich in potassium.
Correct Answer: B
Rationale: The correct instruction for a client taking digoxin is not to take the medication if the heartbeat is irregular or slow. Digoxin can affect the heart rhythm, so it is crucial to monitor the pulse rate. In case of irregular or slow heartbeats, the medication should be withheld, and the healthcare provider should be consulted. This step is necessary to prevent potential complications associated with digoxin therapy.
A client with a diagnosis of bipolar disorder is prescribed topiramate. The nurse should monitor for which potential adverse effect?
- A. Cognitive impairment
- B. Weight gain
- C. Liver toxicity
- D. Weight gain
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with diabetes mellitus type 2 is prescribed dapagliflozin. The nurse should monitor for which potential adverse effect?
- A. Genital infections
- B. Hypoglycemia
- C. Hyperglycemia
- D. Nausea
Correct Answer: A
Rationale: Dapagliflozin, a medication used in diabetes mellitus type 2, is associated with an increased risk of genital infections. This risk is due to its mechanism of action that involves promoting the excretion of glucose through the urine, creating a favorable environment for microbial growth in the genital area. Therefore, monitoring for genital infections is essential when a client is prescribed dapagliflozin.
A client has been diagnosed with open-angle glaucoma. The health care provider prescribes pilocarpine 1% eye drops. The nurse explains that which action of this drug makes it a useful treatment for the client's condition?
- A. The ciliary muscle contracts increasing the outflow of aqueous humor in the eye.
- B. Ciliary muscles are paralyzed to decrease accommodation.
- C. Bilateral mydriasis with cycloplegia is accomplished.
- D. The production of aqueous humor in the eyes is decreased.
Correct Answer: A
Rationale: Pilocarpine, a cholinergic agent, stimulates the ciliary muscle to contract, which opens the trabecular meshwork and facilitates the outflow of aqueous humor, reducing intraocular pressure. This mechanism helps in managing open-angle glaucoma by improving drainage and lowering pressure within the eye.