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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 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 with a client who is to self-administer regular insulin and NPH insulin from the same syringe. Which of the following instructions should the nurse provide?
- A. Inject air into the regular insulin first.
- B. Shake the NPH insulin until it is well mixed.
- C. Draw up the NPH insulin into the syringe first.
- D. Discard regular insulin if it appears cloudy.
Correct Answer: A
Rationale: The correct answer is A: Inject air into the regular insulin first. This step is crucial when mixing regular and NPH insulin to prevent contamination. By injecting air into the regular insulin vial first, you prevent drawing NPH insulin back into the regular insulin vial. This maintains the integrity of each insulin type. Other choices are incorrect because shaking NPH insulin can cause foaming and interfere with accurate dosage measurement (choice B), drawing up NPH insulin first can lead to contamination of regular insulin (choice C), and discarding regular insulin if cloudy is not necessary as long as the expiration date has not passed (choice D).
A nurse is preparing to administer dextrose 5% in water IV to infuse at 100 mL/60 min. The drop factor on the manual IV tubing is 60 gtt/mL. The nurse should set the IV flow rate to deliver how many gtt/min. (Round to the nearest whole number.).
- A. 100 gtt/min.
Correct Answer: A
Rationale: The correct answer is A: 100 gtt/min. To calculate the IV flow rate, we first convert the prescribed volume (100 mL) and time (60 min) to drop factor per minute. 100 mL / 60 min = 1.67 mL/min. Then, we convert mL to drops using the drop factor (60 gtt/mL): 1.67 mL/min * 60 gtt/mL = 100.2 gtt/min. Rounding to the nearest whole number, the nurse should set the IV flow rate to 100 gtt/min.
Other choices (B-G) are incorrect as they are not calculated based on the given information and would lead to incorrect infusion rates.
A nurse is preparing to administer 400 mL of 0.9% sodium chloride IV over 8 hours. The drop factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.).
- A. 50 gtt/min.
Correct Answer: A
Rationale: To calculate the drip rate, we use the formula: Volume to be infused (mL) x Drop factor (gtt/mL) / Time (min). In this case, 400 mL x 60 gtt/mL / 480 minutes = 50 gtt/min (rounding to the nearest whole number). This ensures the correct rate of administration, preventing under or over-infusion. Other choices are incorrect because they do not accurately calculate the drip rate based on the given information.