Nokea
New medications are prescribed for the client taking lithium. Which medication, if prescribed, should the nurse question with the HCP?
- A. Isosorbide dinitrate by mouth tid
- B. Prednisone 20 mg by mouth daily
- C. Furosemide 80 mg by mouth daily
- D. Insulin aspart 2 units subcut with meals
Correct Answer: C
Rationale: Furosemide (Lasix) is a loop diuretic that promotes sodium loss and lithium retention, increasing serum lithium levels and risk of toxicity.
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The nurse is leading a group session for clients with panic disorder. Which statement made by the client indicates that further teaching is needed?
- A. I need to be able to identify triggers that escalate my anxiety to the point of panic.
- B. Diazepam is the long-term medication of choice because of its nonaddicting quality.
- C. Citalopram has been found to be helpful in the long-term treatment of panic disorder.
- D. I can use guided imagery and meditation to effectively reduce my anxiety symptoms.
Correct Answer: B
Rationale: Buspirone, not diazepam (Valium), is the long-term medication of choice for panic disorder due to its nonaddicting quality.
When administering intravenous electrolyte solution, the nurse should take which of the following precautions?
- A. Infuse hypertonic solutions rapidly.
- B. Mix no more than 80 mEq of potassium per liter of fluid.
- C. Prevent infiltration of calcium, which causes tissue necrosis and sloughing.
- D. As appropriate, reevaluate the client's digitalis dosage. He might need an increased dosage because IV calcium diminishes digitalis's action.
Correct Answer: C
Rationale: Preventing tissue infiltration is important to avoid tissue necrosis. Choice A is incorrect because hypertonic solutions should be infused cautiously and checked with the RN if there is a concern. Choice B is incorrect because potassium, mixed in the pharmacy per physician order, is mixed at a concentration no higher than 60 mEq/L.
The nurse completes teaching insulin administration to the parent of the toddler newly diagnosed with type 1 DM. The nurse concludes that the teaching was successful when the parent makes which statement?
- A. NPH insulin is only given at night immediately before the bedtime snack.
- B. I should use only the buttocks for the insulin injections until the child is older.
- C. Insulin lispro acts within 15 minutes and peaks 30 to 90 minutes after injection.
- D. Insulin detemir can be added to the insulin lispro pen to reduce the number of injections.
Correct Answer: C
Rationale: A: NPH (Humulin N) insulin can be given in the morning, but there is better glucose control if given at night. NPH peaks in 4 to 14 hours, so there is no need to make sure food is given immediately after administration. B: Insulin injections should always be rotated to prevent subcutaneous tissue damage from giving the injections in the same location. C: Lispro (Humalog) is rapid-acting insulin that peaks in 30 to 90 minutes and may last as long as 5 hours in the blood. This statement is correct, indicating teaching is effective. D: Detemir (Levemir) is long-acting and lispro (Humalog) is rapid-acting insulin. An insulin pen uses prefilled, multiple-use insulin cartridges; adding other types of insulins should not be attempted.
Which of the following is not considered one of the main mechanisms of Type II Diabetes treatment?
- A. Medications
- B. Nutrition
- C. Increased activity
- D. Continuous Insulin
Correct Answer: D
Rationale: Insulin is not required in continuous treatment for every Type II diabetic, as many can manage with lifestyle changes and oral medications.
The LPN is admitting a client to the unit and the client has rapidly blinking eyes, stuck out tongue, and a distorted posture. Which of these medications is the patient most likely taking?
- A. Clozapine
- B. Fluoxetine
- C. Ondansetron
- D. Haloperidol
Correct Answer: D
Rationale: Haloperidol is a first-generation antipsychotic that blocks dopamine receptors and is most likely to cause extrapyramidal symptoms (EPS), such as tardive dyskinesia. Symptoms of tardive dyskinesia include rapid blinking, mouth movements, sticking out of the tongue, rapid body movements, and a distorted posture.