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A nurse is teaching a client who has a new prescription for Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?
- A. Remove the patch each evening.
- B. Cut each patch in half if angina attacks are under control.
- C. Take off the nitroglycerin patch for 30 min if a headache occurs.
- D. Apply a new patch every 48 hr
Correct Answer: A
Rationale: Removing the patch nightly prevents tolerance to nitroglycerin.
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A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:
- A. 2 to 4 hours after administration
- B. 4 to 12 hours after administration
- C. 16 to 18 hours after administration
- D. 18 to 24 hours after administration
Correct Answer: B
Rationale: Humulin NPH is an intermediate-acting insulin. The onset of action is 1.5 hours, it peaks in 4 to 12 hours, and its duration of action is 24 hours. Hypoglycemic reactions most likely occur during peak time.
The following drugs can be used for treatment of diabetes except one:
- A. Insulines
- B. Biguanides
- C. alfa glucosidase inhibitors
- D. Glucagon
Correct Answer: D
Rationale: Glucagon increases blood glucose levels by promoting glycogenolysis and gluconeogenesis, making it unsuitable for diabetes treatment, unlike the others which lower glucose.
Attenuated vaccines are also known as:
- A. Killed vaccines
- B. Booster vaccines
- C. Inactivated vaccines
- D. Live vaccines
Correct Answer: D
Rationale: Attenuated vaccines are live, weakened forms, unlike killed/inactivated or booster-specific vaccines.
Vera, age 70, has isolated systolic hypertension. Calcium channel blocker dosages for her should be:
- A. Started at about half the usual dosage
- B. Not increased over the usual dosage for an adult
- C. Given once daily because of memory issues in the older adult
- D. Withheld if she experiences gastroesophageal reflux
Correct Answer: A
Rationale: Elderly patients start at half dose due to reduced metabolism and clearance.
A patient may develop neutropenia from using topical Silvadene for burns. Neutropenia is a(n):
- A. Cytotoxic hypersensitivity reaction
- B. Immune complex hypersensitivity
- C. Immediate hypersensitivity reaction
- D. Delayed hypersensitivity reaction
Correct Answer: A
Rationale: Neutropenia from Silvadene (silver sulfadiazine) is a Type II cytotoxic reaction , targeting blood cells, not immune complex , immediate , or delayed .