Nokea
Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:
- A. 1 hour after each meal
- B. Once daily, at the same time each day
- C. 15 minutes before breakfast, lunch, and dinner
- D. Before each meal, based on the blood glucose level
Correct Answer: B
Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.
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A client is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?
- A. The development of complaints of insomnia
- B. The development of audible expiratory wheezes
- C. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
- D. A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication
Correct Answer: B
Rationale: The development of audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm, associated with propranolol. Beta-blockers can trigger bronchospasm, especially in clients with chronic obstructive pulmonary disease or asthma. This complication can lead to significant respiratory distress and should be addressed promptly to prevent further complications.
When administering etanercept (Enbrel) to a client with rheumatoid arthritis for 3 weeks, what is the most important assessment for the nurse to perform?
- A. Assessing the injection site for itching and edema
- B. Monitoring white blood cell counts and platelet counts
- C. Evaluating for fatigue and joint pain in the client
- D. Checking for a metallic taste in the mouth and loss of appetite
Correct Answer: B
Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.
When monitoring a client for acute toxicity associated with bethanechol chloride (Urecholine), what sign should the nurse check for to indicate toxicity?
- A. Dry skin
- B. Dry mouth
- C. Bradycardia
- D. Signs of dehydration
Correct Answer: C
Rationale: The correct answer is C: Bradycardia. Toxicity from bethanechol chloride (Urecholine) can lead to excessive muscarinic stimulation, resulting in manifestations like salivation, sweating, involuntary urination and defecation, bradycardia, and severe hypotension. When facing toxicity, treatment involves supportive measures and administering atropine sulfate subcutaneously or intravenously.
The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
- A. Constipation
- B. Abdominal pain
- C. An episode of diarrhea
- D. Hematest-positive nasogastric tube drainage
Correct Answer: C
Rationale: Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.
A client with hypertension is prescribed clonidine (Catapres) transdermal patch. Which statement by the client indicates an understanding of the medication?
- A. I should change the patch daily.
- B. I should remove the old patch before applying a new one.
- C. I should avoid alcohol consumption while using this patch.
- D. I should apply the patch to different sites each time.
Correct Answer: B
Rationale: The correct answer is B. The client should remove the old clonidine (Catapres) patch before applying a new one to prevent overdose. The patch is typically changed every 7 days. Avoiding alcohol consumption is important as it can potentiate the sedative effects of clonidine. It is recommended to rotate application sites to prevent skin irritation and ensure optimal drug absorption.