Nokea
A nurse is providing teaching for a client who has a new prescription for Metformin. Which of the following adverse effects of Metformin should be correct the client to report to the provider?
- A. Somnolence
- B. Constipation
- C. Fluid retention
- D. Weight gain
Correct Answer: A
Rationale: Somnolence could indicate lactic acidosis, a rare but serious metformin side effect to report.
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A 52-year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c was 13.4%, despite her taking her medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?
- A. Insulin aspart
- B. Insulin glargine
- C. Insulin lispro
- D. NPH insulin
Correct Answer: B
Rationale: Insulin glargine is a long-acting, peakless insulin administered once daily, with a lower risk of hypoglycemia compared to other insulins.
Which of the following drugs interacts with nitroglycerine by inhibiting the metabolism of cGMP?
- A. Amyl nitrite
- B. Sildenafil
- C. Isosorbide mononitrate
- D. Nifedipine
Correct Answer: B
Rationale: Sildenafil, a PDE5 inhibitor, increases cGMP, enhancing nitroglycerin's hypotensive effect.
A client newly diagnosed with diabetes tells the nurse, 'I can't take any insulin made from pigs or cows.' Which of the following responses by the nurse is best?
- A. Most insulin comes from animal sources, but I'm sure alternative options are available.'
- B. Medications that are derived from animals are typically less expensive than synthetic medications, but synthetic insulin is commonly available.'
- C. Most insulin is synthetic now to help reduce the risk of disease transmission.'
- D. The animals aren't hurt in the production of medications, so you don't need to worry.'
Correct Answer: C
Rationale: Most insulin today is synthetic (e.g., recombinant DNA technology), reducing disease transmission risks and addressing patient concerns about animal sources effectively.
A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)
- A. 200
- B. 180
- C. 250
- D. 500
Correct Answer: A
Rationale: Calculation: (100 mL / 30 min) 60 min/hr = 200 mL/hr, matching the provided answer.
The choice of diuretic to use in treating hypertension is based on:
- A. Presence of diabetes with loop diuretics being used for these patients
- B. Level of kidney function with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid-40 mL/min range
- C. Ethnicity with aldosterone antagonists best for African Americans and older adults
- D. Presence of hyperlipidemia with higher doses needed for patients with LDL above 130 mg/dL
Correct Answer: B
Rationale: Thiazides are effective with GFR >40-50 mL/min; loops are used for lower GFR.