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A nurse is mixing regular insulin and NPH insulin in the same syringe prior to administering it to a client who has diabetes mellitus. Which of the following actions should the nurse take first?
- A. Withdraw the regular insulin from the vial
- B. Withdraw the NPH insulin from the vial
- C. Inject air into the NPH vial
- D. Inject air into the regular insulin vial
Correct Answer: C
Rationale: The correct answer is C: Inject air into the NPH vial. This step is crucial to prevent creating a vacuum in the vial when withdrawing the NPH insulin, ensuring accurate dosage measurement. Injecting air into the NPH vial equalizes pressure, making it easier to withdraw the correct amount of insulin without causing air bubbles.
Choice A is incorrect as withdrawing regular insulin first may lead to air being drawn into the syringe when withdrawing NPH insulin. Choice B is incorrect because withdrawing NPH insulin first without equalizing pressure may cause difficulty in drawing the correct amount of insulin. Choice D is incorrect as injecting air into the regular insulin vial before withdrawing NPH insulin is unnecessary and may introduce air bubbles into the syringe.
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A nurse is teaching a guardian of a school-age child who has a new prescription for a fluticasone metered-dose inhaler. Which of the following information should the nurse include in the teaching? (SATA)
- A. Soak the inhaler in water after use.
- B. Have your child take one inhalation as needed for shortness of breath.
- C. Shake the device prior to administration.
- D. A spacer will make it easier to use the device.
Correct Answer: C,D,E
Rationale: Correct Answer: C, D, E
Rationale:
C: Shake the device prior to administration - Shaking the inhaler ensures proper mixing of the medication for effective delivery to the lungs.
D: A spacer will make it easier to use the device - A spacer helps improve medication delivery by ensuring more of the medication reaches the lungs rather than the mouth or throat.
E: - Additional information may include the importance of proper inhaler technique, how to clean the device, how to monitor for side effects, and when to seek medical help.
Incorrect Choices:
A: Soak the inhaler in water after use - Soaking the inhaler in water can damage the device and affect the medication's effectiveness.
B: Have your child take one inhalation as needed for shortness of breath - The prescription likely specifies a specific dosing regimen that should be followed, rather than using the inhaler as needed.
A nurse is preparing to administer Igrasm 5mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day?
Correct Answer: 325 mcg
Rationale: The correct answer is 325 mcg. First, convert the client's weight from lb to kg: 143 lb ÷ 2.2 = 65 kg. Next, calculate the daily dose: 5 mcg/kg/day x 65 kg = 325 mcg/day. Therefore, the nurse should administer 325 mcg per day.
Other choices are incorrect because they do not follow the correct conversion of weight to kg and do not calculate the dose accurately based on the weight and prescribed dosage.
A nurse is caring for a client who has a prescription for amoxicillin. Which of the following findings indicates the client is experiencing an allergic reaction?
- A. Nausea
- B. Cardiac dysrhythmia
- C. Laryngeal edema
- D. Insomnia
Correct Answer: C
Rationale: The correct answer is C: Laryngeal edema. Laryngeal edema is a severe allergic reaction symptom that can lead to airway obstruction and respiratory distress. This is a life-threatening condition that requires immediate intervention. Nausea (A) and insomnia (D) are common side effects of amoxicillin but not indicative of an allergic reaction. Cardiac dysrhythmia (B) is not a typical allergic reaction symptom to amoxicillin.
A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?
- A. Oxygen saturation 96%
- B. PaCO2 30 mm Hg
- C. Increase in BP
- D. Decrease in protein
Correct Answer: C
Rationale: The correct answer is C: Increase in BP. Albumin is a colloid solution that helps increase blood volume and subsequently improves blood pressure in shock patients. Increasing blood volume leads to an increase in blood pressure. Option A is incorrect because oxygen saturation is not directly affected by albumin infusion. Option B is incorrect because a low PaCO2 level is not a direct effect of albumin infusion. Option D is incorrect because albumin is a protein and its infusion would not lead to a decrease in protein levels.
A nurse is caring for a client who is to receive potassium replacement. The provider's prescription reads, 'Potassium chloride 30 mEq in 0.9% sodium chloride 100 mL IV over 30 min.' Which of the following reasons should the nurse clarify this prescription with the provider?
- A. Potassium chloride should be diluted in dextrose 5% in water.
- B. The potassium infusion rate is too rapid.
- C. Another formulation of potassium should be given IV.
- D. The client should be treated by giving potassium by IV bolus.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Potassium chloride infusion rate should not exceed 10 mEq/hr to prevent hyperkalemia and cardiac arrhythmias.
2. In this case, 30 mEq in 100 mL over 30 min exceeds the safe rate.
3. Clarification is needed to adjust the infusion rate to avoid potential harm.
4. Other choices are incorrect as dextrose dilution, different formulations, and IV bolus are not the primary concerns.