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A nurse is preparing to administer regular and NPH insulin to a client. Which of the following actions should the nurse take?
- A. Withdraw the NPH insulin last.
- B. Mix the medications in a 3-mL syringe.
- C. Administer the medications in two separate syringes.
- D. Inject air into the regular vial first.
Correct Answer: A
Rationale: The correct answer is A: Withdraw the NPH insulin last. This is because regular insulin is a clear solution and should be withdrawn first to prevent contamination with the cloudy NPH insulin. Mixing the medications in a 3-mL syringe (B) is not recommended as it may alter the effectiveness of the insulin. Administering the medications in two separate syringes (C) is important to avoid mixing them prior to administration. Injecting air into the regular vial first (D) is unnecessary and not a standard practice.
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A nurse is caring for a client who has chronic hypertension. The client's morning vital signs include BP 140/80 mm Hg, heart rate 54/min, and respiratory rate 18/min. Which of the following medications should the nurse plan to withhold?
- A. Hydrochlorothiazide
- B. Lisinopril
- C. Atenolol
- D. Aspirin
Correct Answer: C
Rationale: The correct answer is C: Atenolol. Atenolol is a beta-blocker that lowers heart rate and blood pressure. Given the client's low heart rate of 54/min, withholding atenolol is necessary to prevent further bradycardia. Hydrochlorothiazide (A) is a diuretic that helps lower blood pressure, and it can be continued. Lisinopril (B) is an ACE inhibitor used to manage hypertension, and it can be continued as well. Aspirin (D) is often prescribed for cardiovascular protection and can also be continued in this scenario.
A nurse is reviewing a list of current medications for a client who is starting therapy with furosemide. Which of the following medications should the nurse identify as being contraindicated?
- A. Levothyroxine
- B. Lithium carbonate
- C. Albuterol
- D. Cetirizine
Correct Answer: B
Rationale: The correct answer is B: Lithium carbonate. Furosemide can cause sodium depletion, leading to increased lithium levels and potential lithium toxicity. Levothyroxine (A) is not contraindicated with furosemide. Albuterol (C) may increase the risk of hypokalemia when used with furosemide but is not a contraindication. Cetirizine (D) does not have significant interactions with furosemide.
A nurse is reinforcing discharge teaching about sublingual nitroglycerin with a client who has angina. Which of the following statements indicates an understanding of the instructions?
- A. I understand that the medication can slow my heart rate.
- B. I am going to take the medication with food.
- C. I will take the medication every 10 minutes until the pain goes away.
- D. I should feel the effects of the medication within 5 minutes.
Correct Answer: D
Rationale: Correct Answer: D
Rationale: Nitroglycerin is a fast-acting medication used to relieve angina symptoms. Choosing option D shows understanding because nitroglycerin should provide relief within 5 minutes if the medication is effective. This rapid onset is crucial in managing acute angina attacks. Taking the medication every 10 minutes (C) could lead to overdose and severe side effects. Slow heart rate (A) is not a common side effect of nitroglycerin. Taking with food (B) may delay absorption and reduce effectiveness.
A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?
- A. Decreased triglycerides
- B. Decreased uric acid
- C. Increased albumin
- D. Increased potassium
Correct Answer: B
Rationale: The correct answer is B: Decreased uric acid. Allopurinol is used to treat high levels of uric acid in the blood, which can lead to conditions like gout. A decrease in uric acid levels indicates that the medication is effectively lowering the client's uric acid levels. Triglycerides (choice A) are not directly affected by allopurinol. Albumin (choice C) and potassium (choice D) levels are not typically influenced by allopurinol therapy.
A nurse is preparing to administer 17,000 units heparin subcutaneously. Available is heparin 20,000 units/mL. How many mL should the nurse administer? (Round the answer to the nearest hundredth. Use a leading zero if applicable. Do not use a trailing zero.)
- A. 0.85
Correct Answer: A
Rationale: To calculate the mL of heparin needed, use the formula: Amount needed (17,000 units) ÷ Concentration of heparin (20,000 units/mL) = mL to administer. 17,000 ÷ 20,000 = 0.85 mL (Round to the nearest hundredth). Therefore, the correct answer is A (0.85 mL). Other choices are incorrect as they do not result from the correct calculation.