Nokea
An adult receives NPH insulin at 7:00 A.M. When is a hypoglycemic reaction most apt to develop?
- A. Mid morning
- B. Mid afternoon
- C. During the evening
- D. During the night
Correct Answer: B
Rationale: NPH insulin peaks 6-12 hours after administration (1:00 P.M.-7:00 P.M.), making mid-afternoon the likely time for hypoglycemia.
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The nurse is applying silver sulfadiazine (Silvadene) to a child with severe burns to arms and legs. Which side effect should the nurse be monitoring for?
- A. Skin discoloration
- B. Hardened eschar
- C. Increased neutrophils
- D. Urine sulfa crystals
Correct Answer: D
Rationale: Urine sulfa crystals. When applied to extensive areas, silver sulfadiazine may cause a transient neutropenia, as well as renal function changes with sulfa crystals production and kernicterus.
The client diagnosed with diabetes mellitus type 2 is scheduled for bowel resection in the morning. Which medication should the nurse question administering to the client?
- A. Ticlopidine (Ticlid), a platelet aggregate inhibitor.
- B. Ticarcillin (Timentin), an extended-spectrum antibiotic.
- C. Pioglitazone (Actos), a thiazolidinedione.
- D. Bisacodyl (Dulcolax), a cathartic laxative.
Correct Answer: A
Rationale: Ticlopidine increases bleeding risk, contraindicated pre-surgery. Antibiotics, antidiabetics, or laxatives are appropriate or less risky.
The elderly client is admitted to the emergency department from a long-term care facility. The client has multiple ecchymotic areas on the body. The client is receiving digoxin, a cardiac glycoside; Lasix, a loop diuretic; Coumadin, an anticoagulant; and Xanax, an antianxiety medication. Which order should the nurse request from the health-care provider?
- A. A STAT serum potassium level.
- B. An order to admit to the hospital for observation.
- C. An order to administer Valium intravenous push.
- D. A STAT international normalized ratio (INR).
Correct Answer: D
Rationale: Ecchymosis with Coumadin suggests bleeding risk; STAT INR assesses anticoagulation status, guiding reversal if needed. Potassium, admission, or Valium are less urgent.
A young woman delivered a 7-lb, 8-oz baby boy spontaneously. Ergotrate 0.4 mg q6h for five days is ordered. A half-hour after the nurse administers the first dose, she complains of abdominal cramping. The nurse's best response is based on which understanding?
- A. Cramping indicates a serious adverse reaction.
- B. Cramping can be reduced by abdominal breathing.
- C. The medication is having the desired effect.
- D. The dosage needs to be reduced.
Correct Answer: C
Rationale: Ergotrate causes uterine contractions, leading to cramping, which is the intended effect to prevent postpartum hemorrhage.
An adult client is being treated for genital herpes with acyclovir (Zovirax) tablets. Which statement she makes indicates that she understands her therapy?
- A. It is safe now to have sexual relations.
- B. I will stay home from work until the blisters are gone.
- C. This medicine will cure the herpes infection.
- D. If the blisters come back, I will start taking the pills immediately.
Correct Answer: D
Rationale: Acyclovir reduces symptoms and recurrence of herpes but does not cure it. Starting treatment at recurrence is appropriate.