Nokea
A nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which of the following actions, if performed by the client, indicates the need for further teaching?
- A. Withdraws the NPH insulin first
- B. Withdraws the regular insulin first
- C. Injects air into NPH insulin vial first
- D. Injects an amount of air equal to the desired dose of insulin into the vial
Correct Answer: A
Rationale: When preparing a mixture of regular insulin with another insulin preparation, the regular insulin is drawn into the syringe first. This sequence will avoid contaminating the vial of regular insulin with insulin of another type. Options 2, 3, and 4 identify the correct actions for preparing NPH and regular insulin.
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The American Dietetic Association recommends pregnant women take a supplement including:
- A. 1,000 IU daily of vitamin D
- B. 2.4 mcg/day of vitamin B12
- C. 600 mcg/day of folic acid
- D. 8 mg/day of iron
Correct Answer: C
Rationale: 600 mcg/day of folic acid is recommended during pregnancy to prevent neural tube defects.
Monitoring for a patient being prescribed iron for iron deficiency anemia includes:
- A. Reticulocyte count 1 week after therapy is started
- B. Complete blood count every 2 weeks throughout therapy
- C. Hemoglobin level at 1 week of therapy
- D. INR weekly throughout therapy
Correct Answer: A
Rationale: Reticulocyte count at 1 week assesses iron therapy response; CBC or hemoglobin checks are later, and INR is irrelevant.
A patient with asthma has been using a nicotine transdermal 24-hour patch for 3 weeks to quit smoking. The patient reports having difficulty sleeping. What action will the nurse take?
- A. Ask the provider for a prescription for Nicotrol NS
- B. Recommend removing the patch at bedtime
- C. Suggest using an 18-hour patch instead
- D. Tell the patient to stop the patch and join a support group
Correct Answer: C
Rationale: An 18-hour patch reduces sleep disruption while aiding cessation; Nicotrol is risky with asthma. The patient should try an 18-hour patch to help with sleep.
Mutations in receptor tyrosine kinases would most likely be associated with :
- A. Neurologic diseases
- B. Endocrine diseases
- C. Cancers
- D. Metabolic abnormalities
Correct Answer: C
Rationale: Receptor tyrosine kinases are often linked to uncontrolled cell growth when mutated, commonly associated with cancers.
Hannah will be traveling to Mexico with her church group over spring break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes following normal food and water precautions as well as taking:
- A. Loperamide four times a day throughout the trip
- B. Bismuth subsalicylate with each meal and at bedtime
- C. A prescription for diphenoxylate with atropine to use if she gets diarrhea
- D. None of the above
Correct Answer: B
Rationale: Bismuth subsalicylate prevents traveler's diarrhea when taken prophylactically; loperamide or diphenoxylate are for treatment, not prevention.