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A nurse is preparing to administer regular insulin 4 units and NPH insulin 10 units subcutaneously to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take first?
- A. Inject 10 units of air into the NPH insulin vial.
- B. Draw up 10 units from the NPH insulin vial.
- C. Inject 4 units of air into the regular insulin vial.
- D. Draw up 4 units from the regular insulin vial.
Correct Answer: C
Rationale: The correct answer is C: Inject 4 units of air into the regular insulin vial. This action is done to prevent negative pressure in the vial, making it easier to withdraw the correct dose of insulin. By injecting air first, the nurse ensures that the exact amount of insulin can be withdrawn accurately without causing any damage to the vial or affecting the dose.
Choice A is incorrect as injecting air into the NPH insulin vial is not necessary before drawing up the insulin. Choice B is incorrect as drawing up the NPH insulin before preparing the regular insulin would be out of sequence. Choice D is incorrect as drawing up the regular insulin before injecting air into the vial could lead to difficulty in withdrawing the correct dose.
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A nurse is reinforcing teaching with a client who has pancreatitis and a new prescription for pancrelipase. Which of the following statements by the client indicates an understanding of the teaching?
- A. I will take this medication whole.
- B. I can expect this medication to cure the pancreatitis.
- C. I should discontinue the medication if I develop fatty stools.
- D. I will take this medication at bedtime.
Correct Answer: A
Rationale: The correct answer is A: "I will take this medication whole." This is correct because pancrelipase should be taken whole to ensure the proper release of enzymes in the small intestine for digestion. Option B is incorrect because pancrelipase does not cure pancreatitis but helps with digestion. Option C is incorrect because fatty stools are expected side effects of pancrelipase and not a reason to discontinue the medication. Option D is incorrect because pancrelipase should be taken with meals or snacks, not specifically at bedtime.
A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?
- A. Hepatic enzymes process medications more rapidly.
- B. Gastric emptying rate increases.
- C. Brain receptors become less sensitive to medications.
- D. Renal excretion time slows for medication.
Correct Answer: D
Rationale: The correct answer is D: Renal excretion time slows for medication. As individuals age, there is a decline in renal function, leading to a decrease in glomerular filtration rate and renal blood flow. This results in a slower excretion of medications from the body, leading to potential accumulation and increased risk of toxicity. Choices A, B, and C are incorrect as hepatic enzymes may actually decrease in function with age, gastric emptying rate tends to slow down, and brain receptors can become more sensitive rather than less sensitive to medications in older adults.
A nurse is collecting data from a client who is taking sumatriptan. Which of the following reports indicates a therapeutic response to the medication?
- A. Increased bone mass
- B. Relief of chest pain
- C. Improved mood
- D. Absence of headache
Correct Answer: D
Rationale: The correct answer is D: Absence of headache. Sumatriptan is a medication used to treat migraines by constricting blood vessels in the brain. A therapeutic response to sumatriptan would be the absence of a headache, as the medication is intended to relieve migraine symptoms. Increased bone mass (A), relief of chest pain (B), and improved mood (C) are not expected therapeutic responses to sumatriptan. These symptoms are not typically associated with the mechanism of action or indications for sumatriptan use. Therefore, the absence of a headache is the most appropriate indicator of a therapeutic response to sumatriptan in this scenario.
A nurse is collecting data from a client who takes furosemide daily for heart failure. Which of the following laboratory values should the nurse review before administering the medication?
- A. Erythrocyte sedimentation rate
- B. Thyroxine
- C. Serum potassium
- D. Serum aspartate aminotransferase
Correct Answer: C
Rationale: The correct answer is C: Serum potassium. Furosemide is a loop diuretic that can cause potassium depletion, leading to hypokalemia. Monitoring serum potassium levels is crucial to prevent complications such as cardiac arrhythmias. Erythrocyte sedimentation rate (A) is not relevant for assessing furosemide therapy. Thyroxine (B) is a thyroid hormone and not directly affected by furosemide. Serum aspartate aminotransferase (D) is a liver enzyme and not specifically impacted by furosemide administration.
A nurse is assisting in the care of a client who is to receive a transfusion of packed RBCs. Which of the following actions should the nurse take?
- A. Ensure that the unit of packed RBCs is transfused within 6 hr.
- B. Obtain 0.9% sodium chloride solution for IV infusion.
- C. Use filterless IV tubing for the transfusion.
- D. Remain at the client's bedside for the first 5 min of the transfusion.
Correct Answer: B
Rationale: The correct answer is B because 0.9% sodium chloride solution is the appropriate IV solution to use when administering packed RBCs to prevent hemolysis. The sodium chloride solution is isotonic, which helps maintain the integrity of the RBCs during transfusion. Other choices are incorrect because: A: There is no specific time limit within which packed RBCs must be transfused. C: Using filterless IV tubing can increase the risk of air embolism and contamination. D: Remaining at the client's bedside for only 5 minutes is inadequate for monitoring potential adverse reactions during the transfusion.