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A client with type I diabetes mellitus has been prescribed a glucagon emergency kit for home use. When should the nurse instruct the client and family to administer glucagon?
- A. Prior to meals to prevent hyperglycemia.
- B. When symptoms of severe hypoglycemia are present.
- C. When the client is unable to eat during sick days.
- D. At the onset of symptoms of diabetic ketoacidosis.
Correct Answer: B
Rationale: This question is identical to Question 25. Glucagon is for severe hypoglycemia (B), not hyperglycemia (A), sick days (C), or ketoacidosis (D). Note: Duplicate question; consider removing.
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A client with psychosis is receiving an antipsychotic medication and is continually rubbing the back of the neck. What is the best nursing intervention?
- A. Obtain an extra pillow for the client to use at night.
- B. Give a PRN prescription for benztropine.
- C. Provide the client a heating pad to place on the neck.
- D. Obtain a prescription for physical therapy services.
Correct Answer: B
Rationale: Neck rubbing suggests extrapyramidal symptoms (e.g., dystonia) from antipsychotics. Benztropine (B), an anticholinergic, relieves these symptoms. Pillows (A), heating pads (C), and physical therapy (D) don’t address the cause.
The nurse is administering sodium polystyrene sulfonate to a client with acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?
- A. Serum potassium level of 3.8 mEq/L (3.8 mmol/L)
- B. Hemoglobin level of 13.5 g/dL (135 g/L).
- C. Serum glucose level of 120 mg/dL (6.7 mmol/L)
- D. Serum ammonia level of 30 Mcg/dL (17.62 Mermol/L)
Correct Answer: A
Rationale: Sodium polystyrene sulfonate treats hyperkalemia by exchanging sodium for potassium. A potassium level of 3.8 mEq/L (A) indicates effectiveness (normal range: 3.5-5.0 mEq/L). Hemoglobin (B), glucose (C), and ammonia (D) are unrelated to its action.
The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. What action should the nurse take?
- A. Instruct the client that it is necessary to take nothing but water with the medication.
- B. Withhold the medication until the client’s breakfast tray is available on the unit.
- C. Consult with a pharmacist about scheduling the dose one hour after the client eats.
- D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.
Correct Answer: A
Rationale: Risedronate, a bisphosphonate, must be taken with plain water on an empty stomach, 30 minutes before food or other beverages, to ensure optimal absorption. Milk (B) contains calcium, reducing absorption. Delaying until breakfast (C) violates timing requirements. Consulting a pharmacist (D) is unnecessary, as administration guidelines are clear.
A client with benign prostatic hyperplasia has been prescribed tamsulosin. What should the nurse do to monitor for an adverse reaction?
- A. Monitor the client’s blood pressure.
- B. Assess the client’s urine output.
- C. Perform a bladder scan.
- D. Obtain the client’s daily weights.
Correct Answer: A
Rationale: This question is identical to Question 29. Tamsulosin can cause hypotension (A), necessitating blood pressure monitoring. Urine output (B), bladder scans (C), and weights (D) don’t address adverse effects. Note: Duplicate question; consider removing.
A female patient with multiple sclerosis reports less fatigue and improved memory since she started using the herbal supplement, ginkgo biloba. What is the most important information for the nurse to include in the teaching plan for this patient?
- A. Nausea and diarrhea can occur when using this supplement.
- B. Ginkgo biloba use should be limited and not taken during pregnancy.
- C. Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo.
- D. Anxiety and headaches increase with the use of ginkgo biloba.
Correct Answer: C
Rationale: This question is identical to Question 39. Ginkgo biloba’s interaction with aspirin/NSAIDs (C) increases bleeding risk, a critical teaching point. Other side effects (A, D) and pregnancy limits (B) are less urgent. Note: Duplicate question; consider removing.