Nokea
Jim is having a hip replacement surgery and would like to self-donate blood for the surgery. In addition to being prescribed epogen alpha he should also be prescribed:
- A. Folic acid to prevent megaloblastic anemia
- B. Iron, to start when the epogen starts
- C. An antihypertensive to counter the adverse effects of epogen
- D. Vitamin B12 to prevent pernicious anemia
Correct Answer: B
Rationale: Iron supports erythropoiesis with epoetin alfa; antihypertensives manage side effects, not prophylaxis.
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A nurse is providing teaching to a client who has a prescription for Pramlintide for type 1 Diabetes Mellitus. Which of the following should the nurse include in the teaching?(Select one that does not apply.)
- A. Take oral medications 1 hr before injection.
- B. Use upper arms as preferred injection sites.
- C. Mix pramlintide with breakfast dose of insulin.
- D. Inject pramlintide just before a meal.
Correct Answer: D
Rationale: Injecting before meals and discarding after 28 days are key for pramlintide; it's not mixed with insulin.
A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge?
- A. Keep insulin vials refrigerated at all times.
- B. Rotate the insulin injections systematically.
- C. Increase the amount of insulin before unusual exercise.
- D. Monitor the urine acetone level to determine the insulin dosage.
Correct Answer: B
Rationale: Insulin dosages should not be adjusted or increased before unusual exercise. If acetone is found in the urine, it may possibly indicate the need for additional insulin. To minimize the discomfort associated with insulin injections, the insulin should be administered at room temperature. Injection sites should be systematically rotated from one area to another. The client should be instructed to give injections in one area, about 1 inch apart, until the whole area has been used and then to change to another site. This prevents dramatic changes in daily insulin absorption.
Which of the following would be the best source of drug information for a nurse?
- A. Drug Facts and Comparisons book
- B. A nurse's drug guide
- C. A drug package insert
- D. The Physician's Drug Reference (PDR)
Correct Answer: B
Rationale: The most user-friendly drug source for a nurse is a nurse's drug guidebook. A guide provides nursing implications and patient teaching points that are most useful to nurses. The Drug Facts and Comparisons book provides a wide range of drug information but is hard to manipulate and is very expensive. A package insert contains all of the chemical and drug company research information about a drug, however, the information can be difficult to understand and the print is very small. The PDR is heavily cross-referenced and difficult to use.
A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?
- A. Calcium 9.2 mg/dL
- B. Calcium 10.3 mg/dL
- C. Potassium 3.4 mEq/L
- D. Potassium 4.8 mEq/
Correct Answer: C
Rationale: Hypokalemia (3.4 mEq/L, C) increases digoxin toxicity risk by enhancing its effects.
A nurse in the operating room is caring for a client who received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and his body temperature begins to rise. The nurse should anticipate a prescription for which of the following medications?
- A. Neostigmine
- B. Naloxone
- C. Dantrolene
- D. Vecuronium
Correct Answer: C
Rationale: Dantrolene treats malignant hyperthermia, characterized by rigidity and hyperthermia.