Nokea
A client with type 1 diabetes has a prescription for 20 units of NPH insulin daily at 7:30 AM and regular insulin before meals, based on a sliding scale. At 7:00 AM, the client's blood glucose level is 220 mg/dL (12.2 mmol/L), and the client's breakfast tray has arrived. What action should the nurse take?
- A. Administer 20 units of NPH insulin now and then 6 units of regular insulin after the morning meal
- B. Administer 26 units of insulin: 20 units of NPH insulin and 6 units of regular insulin in 2 separate injections
- C. Administer 26 units of insulin: 20 units of NPH mixed with 6 units of regular insulin in the same syringe, drawing up the NPH into the syringe first
- D. Administer 26 units of insulin: 20 units of NPH mixed with 6 units of regular insulin in the same syringe, drawing up the regular insulin first
Correct Answer: D
Rationale: Regular insulin is drawn up first to prevent NPH contamination, and both can be mixed in one syringe for a blood glucose of 220 mg/dL, assuming a sliding scale of 6 units. Administering after the meal or using separate injections is incorrect.
You may also like to solve these questions
A blood transfusion has just been started on an adult. Which assessment is most essential during the first hour?
- A. Temperature
- B. Blood pressure
- C. Respirations
- D. Pulse
Correct Answer: A
Rationale: Temperature monitoring detects febrile transfusion reactions, a common early complication, prioritizing patient safety.
The nurse is observing a client who sustained a left ankle sprain ascending the stairs using a modified 3-point gait. The nurse should intervene if the client is observed
- A. bearing weight on the right leg
- B. realigning the crutches between each step
- C. assuming the tripod position before ascending the stairs
- D. using the right crutch to support the weight while advancing the left leg onto the next step
Correct Answer: D
Rationale: In a modified 3-point gait, the injured leg (left) should not bear weight, and the right crutch with the left leg should not be used alone to advance. The other actions are consistent with proper crutch use.
An adult is to have a cardiac catheterization performed tomorrow. When preparing the client for the cardiac catheterization, it is essential for the nurse to do which of the following?
- A. Administer an enema two hours before the procedure
- B. Limit caffeine the day before the procedure
- C. Ask the client about allergies to shellfish
- D. Restrict fat intake the day before the procedure
Correct Answer: C
Rationale: Shellfish allergies may indicate iodine sensitivity, critical for contrast dye used in cardiac catheterization.
The nurse is assessing a comatose client receiving gastric tube feedings. Which of the following assessments requires an immediate response from the nurse?
- A. Decreased breath sounds in right lower lobe
- B. Aspiration of a residual of 100 cc of formula
- C. Decrease in bowel sounds
- D. Urine output of 250 cc in past 8 hours
Correct Answer: A
Rationale: Decreased breath sounds in right lower lobe. The most common problem associated with enteral feedings is atelectasis. Maintain client at 30 degrees of head elevation during feedings and monitor for signs of aspiration. Check for tube placement prior to each feeding or every 4 to 8 hours if the client is receiving continuous feeding.
What must the nurse emphasize when teaching a client with depression about a new prescription for nortriptyline (Pamelor)?
- A. Symptom relief occurs in a few days
- B. Alcohol use is to be avoided
- C. Medication must be stored in the refrigerator
- D. Episodes of diarrhea can be expected
Correct Answer: B
Rationale: Alcohol potentiates the action of tricyclic antidepressants.