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A nurse is reinforcing teaching with a client who has diabetes mellitus and takes insulin glargine and insulin aspart. Which of the following actions indicates that the client understands the instructions?
- A. The client administers insulin glargine at the same time every day.
- B. The client mixes insulin aspart and insulin glargine in the same syringe.
- C. The client administers insulin aspart 30 min before breakfast.
- D. The client stores open vials of insulin glargine at room temperature for 60 days.
Correct Answer: A
Rationale: The correct answer is A. Administering insulin glargine at the same time every day helps maintain consistent blood sugar levels due to its long-acting nature. Mixing insulin aspart and glargine is incorrect as they have different onset and duration of action. Administering insulin aspart 30 min before breakfast may not align with the client's meal timing. Storing open vials of insulin glargine at room temperature for 60 days exceeds the recommended storage duration, risking potency and efficacy.
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A nurse is collecting data from a client who is taking lithium carbonate to treat bipolar disorder. For which of the following findings should the nurse monitor and report to the provider?
- A. Bruising
- B. Tremor
- C. Constipation
- D. Hypoglycemia
Correct Answer: B
Rationale: The correct answer is B: Tremor. Lithium carbonate is commonly associated with causing tremors as a side effect. The nurse should monitor and report any tremors in the client taking lithium as it could indicate lithium toxicity. Bruising (A), constipation (C), and hypoglycemia (D) are not typically associated with lithium carbonate use in treating bipolar disorder.
A nurse is caring for a client who has been taking epoetin alfa for 3 months. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication?
- A. Hgb
- B. Troponin
- C. Thyroxine (T4)
- D. Aspartate aminotransferase (AST)
Correct Answer: A
Rationale: The correct answer is A: Hgb. Epoetin alfa is a medication used to treat anemia by stimulating red blood cell production. Monitoring the client's hemoglobin (Hgb) levels is crucial to assess the effectiveness of the medication in increasing red blood cell count. Hemoglobin reflects the oxygen-carrying capacity of the blood and directly correlates with red blood cell levels. Troponin (B), Thyroxine (T4) (C), and Aspartate aminotransferase (AST) (D) are not relevant in monitoring the effectiveness of epoetin alfa therapy as they are related to cardiac function, thyroid function, and liver function, respectively.
A nurse is preparing to administer an influenza immunization IM to an infant. Which of the following actions should the nurse include in the plan of care?
- A. Use a ½-Inch needle.
- B. Use a 22-gauge needle.
- C. Use the flushing technique.
- D. Use the deltoid muscle for the injection site.
Correct Answer: A
Rationale: The correct answer is A: Use a ½-Inch needle. For infants, a ½-inch needle is recommended for intramuscular (IM) injections to ensure proper administration of the vaccine into the muscle. Using a shorter needle decreases the risk of reaching the bone or causing tissue damage.
B: Using a 22-gauge needle is not specific to infants and may not be the most appropriate size for their smaller muscles.
C: The flushing technique is not relevant to the administration of the vaccine.
D: The deltoid muscle is not typically used as the injection site for infants; the vastus lateralis muscle is more commonly used due to its larger muscle mass and ease of access.
In summary, using a ½-inch needle is the correct choice for an infant receiving an IM influenza immunization to ensure safe and effective administration.
Nurses Notes 0830: Walk-in clinic visit for adolescent client who is accompanied by their guardian. The guardian states, 'My child has a partner, and I want to be sure that they have some birth control before becoming sexually active': The client states, 'I want to be sure I don't get pregnant or get an STI.' 0915: Witnessed consent signed by client and guardian. Assisted provider with placement of intrauterine device (IUD). Client tolerated procedure well. Provider Prescriptions 0930: Human Papillomavirus (HPV) vaccine, administer first dose today IM
Which of the following client statements indicate that the nurse's reinforced teaching about the immunization was effective? Select all that apply.
- A. I need to have a blood test when I'm an adult to see if I'm still immune.
- B. This shot will keep me from getting herpes.
- C. Now I won't need to worry about having pap smears.
- D. I need to come back in 2 months for another shot.
- E. I will need a booster shot every 10 years.
- F. This shot can prevent me from getting some kinds of cancer.
- G. My partner should get this shot too.
Correct Answer: D, F, G
Rationale: The correct answers are D, F, and G. This indicates effective teaching because client D shows understanding of the need for a follow-up shot. Client F understands the preventive benefits against cancer. Client G recognizes the importance of their partner also getting the shot. Other choices are incorrect because client A confuses immunity with immunization timing, B and C show misunderstandings about the shot's purpose, and E is inaccurate about the frequency of booster shots.
A nurse is reviewing the allergies of a client who has rheumatoid arthritis prior to administering celecoxib to the client. The nurse should identify that which of the following allergies is a contraindication for receiving this medication?
- A. Sulfonamides
- B. Shellfish
- C. Fluoroquinolones
- D. Peanuts
Correct Answer: A
Rationale: The correct answer is A: Sulfonamides. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) and belongs to the class of sulfonamides. Patients allergic to sulfonamides are at risk of cross-reactivity with celecoxib, leading to severe allergic reactions. Shellfish (B), fluoroquinolones (C), and peanuts (D) are not related to the mechanism of action or composition of celecoxib, so they are not contraindications. It is important for the nurse to identify sulfonamide allergies to prevent adverse reactions in patients receiving celecoxib.