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A nurse administers subcutaneous NPH insulin at 0700 to a child who has diabetes. At which of the following times should the nurse observe for hypoglycemia caused by the onset of the medication?
- A. 715
- B. 800
- C. 900
- D. 1000
Correct Answer: D
Rationale: The correct answer is D: 1000. NPH insulin typically starts working within 1 to 2 hours after administration, peaks in 4 to 12 hours, and lasts up to 24 hours. Since the nurse administered the insulin at 0700, the onset of hypoglycemia should be observed around 0900 to 1100. Choice A (715) is too soon for onset. Choice B (800) falls within the expected onset time, but it may be too early for hypoglycemia. Choice C (900) is also within the expected onset time frame, but waiting until 1000 (Choice D) allows for a more accurate observation of hypoglycemia as the peak effect of NPH insulin is approaching.
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A nurse in a provider's office is collecting data from a client who has hypothyroidism. Which of the following should the nurse expect?
- A. Bradycardia.
- B. Moist skin.
- C. Blurred vision.
- D. Insomnia.
Correct Answer: A
Rationale: The correct answer is A: Bradycardia. In hypothyroidism, there is a decrease in thyroid hormone production, leading to a slowed metabolism. This results in bradycardia, or a slow heart rate, as the thyroid hormone plays a role in regulating heart function. Moist skin (B), blurred vision (C), and insomnia (D) are not typically associated with hypothyroidism; instead, dry skin, vision changes, and fatigue are more common symptoms.
A nurse is reinforcing discharge instructions for a client who has asthma and is about to start taking theophylline. The nurse should instruct the client to monitor which of the following findings is an adverse effect of the medication.
- A. Drowsiness.
- B. Constipation.
- C. Tachycardia.
- D. None of the above.
Correct Answer: C
Rationale: The correct answer is C: Tachycardia. Theophylline, a bronchodilator used in asthma, can cause tachycardia as an adverse effect due to its stimulant effect on the heart. Tachycardia is characterized by a fast heart rate, which can be concerning and may indicate an overdose or toxicity of the medication. Monitoring for tachycardia is crucial to ensure the client's safety and well-being.
Incorrect answers:
A: Drowsiness - Theophylline is a stimulant and is more likely to cause insomnia or restlessness rather than drowsiness.
B: Constipation - Constipation is not a common adverse effect of theophylline.
D: None of the above - This is incorrect as tachycardia can be an adverse effect of theophylline.
A nurse is teaching the parents of a child who has diabetes mellitus about the manifestations of hypoglycemia. Which of the following manifestations should the nurse include in the teaching?
- A. Dry mucous membranes.
- B. Polyuria.
- C. Poria.
- D. Bradycardia.
Correct Answer: D
Rationale: The correct answer is D: Bradycardia. Hypoglycemia can lead to decreased heart rate due to inadequate glucose supply to the heart. This can result in bradycardia. Dry mucous membranes (A) are more indicative of dehydration. Polyuria (B) is excessive urination, which is not a common manifestation of hypoglycemia. "Poria" (C) is not a recognized medical term. Therefore, the correct manifestation to include in teaching about hypoglycemia in a child with diabetes mellitus is bradycardia.
A nurse is preparing to administer lorazepam 2 mg PO. Available in lorazepam 1 mg tablets. How many tablets should the nurse administer?
- A. 1
- B. 2
- C. 3
- D. 4
Correct Answer: B
Rationale: The correct answer is B: 2 tablets. The nurse needs to administer 2 mg of lorazepam, and each tablet is 1 mg. Therefore, to achieve the total dose of 2 mg, the nurse should administer 2 tablets. Administering 1 tablet (choice A) would only provide 1 mg, which is insufficient. Choices C and D would exceed the required dose of 2 mg, leading to potential overdose and adverse effects.
A nurse is reinforcing teaching for a client who has angina pectoris and a new prescription to apply a nitroglycerin transdermal patch daily. Which of the following instructions should the nurse give the client?
- A. Remove the used patch with medication areas to the inside and discard it in a closed receptacle.
- B. Keep the current nitroglycerin patch in place for 24 hours per day.
- C. Cleanse the excess hair from the skin before applying a nitroglycerin patch.
- D. Apply a second patch in place if angina pain occurs.
Correct Answer: A
Rationale: The correct answer is A: Remove the used patch with medication areas to the inside and discard it in a closed receptacle. This instruction is crucial as it ensures proper disposal to prevent accidental exposure to others. Removing the patch with the medication area inside reduces the risk of skin irritation. Keeping the patch in a closed receptacle prevents animals or children from coming into contact with the medication.
Choice B is incorrect because the patch should be applied for a specific duration, typically around 12-14 hours, not 24 hours. Choice C is unnecessary as excess hair does not affect the patch's efficacy. Choice D is dangerous as applying a second patch without medical guidance can lead to overdose.