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A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration?
- A. 30 minutes to 3 hours.
- B. 2 to 6 hours.
- C. 4 to 5 hours.
- D. 6 to 10 hours.
Correct Answer: D
Rationale: The correct answer is D: 6 to 10 hours. NPH insulin typically peaks around 6-10 hours after administration. This delayed peak is important to prevent hypoglycemia between meals. It is an intermediate-acting insulin, so it takes longer to reach its peak effect compared to short-acting insulins. Option A (30 minutes to 3 hours) is too short for NPH insulin to peak. Option B (2 to 6 hours) is closer but does not fully capture the peak timeframe. Option C (4 to 5 hours) is not accurate as NPH insulin peaks later. Therefore, option D is the most appropriate choice based on the pharmacokinetics of NPH insulin.
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A nurse is reviewing laboratory data from a client who has a pulmonary embolism and is receiving IV heparin. Which of the following findings should the nurse report to the provider?
- A. Patient's platelets 100,000.
- B. Prothrombin time (PT) 12 seconds.
- C. Thrombin time (TT) 55 seconds.
- D. Hematocrit 35%.
Correct Answer: A
Rationale: The correct answer is A: Patient's platelets 100,000. In a client receiving IV heparin for a pulmonary embolism, a platelet count of 100,000 indicates potential heparin-induced thrombocytopenia, a serious adverse effect that can lead to thrombosis. Thrombocytopenia increases the risk of bleeding. This finding needs immediate attention from the provider to prevent complications. The other choices are incorrect because B (PT) and C (TT) are not directly related to heparin therapy monitoring, and D (Hematocrit) does not indicate a potential adverse effect of heparin therapy like thrombocytopenia does.
A nurse is preparing to administer levothyroxine 100mcg po to a client who has hypothyroidism. Available levothyroxine is 50 mcg tablets. How many tablets should the nurse administer? (Round off to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
- A. 1 tablet.
- B. 2 tablets.
- C. 3 tablets.
- D. 4 tablets.
Correct Answer: B
Rationale: To determine the number of tablets to administer, divide the prescribed dose by the available dose per tablet. In this case, 100mcg ÷ 50mcg = 2 tablets. The correct answer is B because administering 2 tablets of 50mcg each will provide the total prescribed dose of 100mcg. Choice A is incorrect as it would only provide 50mcg, while choices C and D would exceed the prescribed dose. Choices E, F, and G are not applicable.
A nurse Rover medical-surgical unit is caring for a client who asks to review his medical record. Which of the following responses should the nurse make?
- A. You will have to submit a written request for access to your record.
- B. We will provide you a copy of your records when we are preparing you for discharge.
- C. Sorry, but you do not have the time to read your chart.
- D. I can set up a time for you to meet with your provider to go over your medical record.
Correct Answer: D
Rationale: The correct answer is D. The nurse should set up a time for the client to meet with their provider to go over their medical record. This response respects the client's right to access their medical information in a timely and organized manner, ensuring they can fully understand their health status and treatment plan. Option A delays the process with unnecessary paperwork. Option B limits access to records only at discharge. Option C dismisses the client's request. Options E, F, and G are irrelevant.
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 caring for a client who is taking levothyroxine for hypothyroidism. Which of the following indicates the client's dose is too high?
- A. Decreased temperature.
- B. Hypotension.
- C. Tachycardia.
- D. Constipation.
Correct Answer: C
Rationale: The correct answer is C: Tachycardia. Levothyroxine is a medication used to treat hypothyroidism by increasing thyroid hormone levels. If the client's dose is too high, it can lead to hyperthyroidism symptoms, such as tachycardia (fast heart rate), due to an excess of thyroid hormone. Decreased temperature (A) is a sign of hypothyroidism, not hyperthyroidism. Hypotension (B) is more likely to occur with hypothyroidism, as thyroid hormone helps regulate blood pressure. Constipation (D) is a symptom of hypothyroidism, not hyperthyroidism.