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It is 1800, and the client has a scheduled dose of insulin glargine due. The client has a regular diet tray ordered with 60 carbohydrates. The tray has not yet arrived in the room. For each nursing action below, click to specify if the action is indicated, contraindicated or nonessential.Each row must have one option selected.
- A. Give insulin lispro 4 units: Contraindicated
- B. Verify that the client can count carbohydrates: Nonessential
- C. Mix the insulin lispro and insulin glargine in one syringe: Contraindicated
- D. Give insulin glargine 12 units: Indicated
Correct Answer:
Rationale: A: Lispro is contraindicated without meal intake to avoid hypoglycemia. B: Carb counting is nonessential for scheduled glargine. C: Mixing lispro and glargine is contraindicated. D: Glargine is indicated as scheduled.
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A client is scheduled for a spiral computed tomography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client's history requires follow-up by the nurse?
- A. Metal hip prosthesis was placed twenty years ago.
- B. Takes metformin hydrochloride for type 2 diabetes mellitus.
- C. Report of client's sobriety for the last five years.
- D. CT scan that was performed six months earlier.
Correct Answer: B
Rationale: Metformin use requires follow-up due to the risk of lactic acidosis with contrast agents affecting renal function. Metal prostheses, sobriety, and prior CT scans are less relevant to contrast administration safety.
The nurse is administering sucralfate to a client with stomatitis secondary to chemotherapy. The client wants to take the medication after breakfast. How should the nurse respond?
- A. Explain the need to take the medication at least 1 hour before meals.
- B. Allow the client to take the medication up to 1 hour after breakfast.
- C. Document the client's refusal of the medication at this time.
- D. Instruct the client to take it when the meal tray is delivered.
Correct Answer: A
Rationale: Sucralfate must be taken on an empty stomach, at least 1 hour before meals, to effectively coat the mucosa. Post-meal administration, refusal documentation, or meal-time dosing are incorrect.
Which laboratory value should the nurse review prior to administering the initial dose of a statin medication?
- A. Serum liver enzymes.
- B. Complete blood count.
- C. Serum electrolytes.
- D. Capillary blood glucose.
Correct Answer: A
Rationale: Statins can affect liver function, so reviewing serum liver enzymes is critical to monitor for hepatic adverse effects before initiation. CBC, electrolytes, and glucose are less directly related.
A client is receiving tamsulosin, an alpha-adrenergic blocking agent, for the management of urinary retention due to benign prostatic hyperplasia (BPH). Which instruction is most important for the nurse to provide?
- A. Reduce daily fluid intake.
- B. Stand and sit up slowly.
- C. Take the medication early in the day.
- D. Use a twice-a-week dosing schedule.
Correct Answer: B
Rationale: Tamsulosin may cause orthostatic hypotension, so standing and sitting slowly prevents dizziness or falls. Fluid reduction, early dosing, or twice-weekly schedules are incorrect for tamsulosin.
The healthcare provider prescribes enoxaparin sodium 80 mg SUBQ twice daily. The nurse is preparing a preloaded 1 mL syringe labeled, 'Enoxaparin sodium injection, USP 60 mg/0.6 mL.' How many mL should the nurse administer? (Enter numeric value only. If rounding is required, round to the nearest tenth.)
Correct Answer: 0.8
Rationale: Desired dose = 80 mg, Concentration = 60 mg/0.6 mL = 100 mg/mL. Volume = 80 mg / 100 mg/mL = 0.8 mL.