Nokea
The client with type 2 diabetes mellitus is prescribed glyburide (Micronase), a sulfonylurea. Which statement indicates the client understands the medication teaching?
- A. I should carry some hard candy when I go walking.
- B. I must take my insulin injection every morning.
- C. There are no side effects I need to worry about.
- D. This medication will make my muscles absorb insulin.
Correct Answer: A
Rationale: Glyburide can cause hypoglycemia; carrying candy prepares for low blood sugar during activity. Insulin, no side effects, or muscle absorption are incorrect.
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The nurse is hanging 1,000 mL of IV fluids to run for eight (8) hours. The intravenous tubing is a microdrip. How many gtt/min should the IV rate be set?
Correct Answer: 15
Rationale: Microdrip is 60 gtt/mL. Rate: (1,000 mL / 8 hr) x (60 gtt/mL / 60 min) = 125 mL/hr x 1 gtt/min = 15.625 gtt/min, rounded to 15 gtt/min.
The nurse is administering an antacid to a client with gastroesophageal reflux disease. Which statement best describes the scientific rationale for administering this medication?
- A. This medication will suppress gastric acid secretion.
- B. This medication will decrease the gastric pH.
- C. This medication will coat the stomach lining.
- D. This medication interferes with prostaglandin production.
Correct Answer: C
Rationale: Antacids neutralize acid and coat the stomach, relieving GERD symptoms. Acid suppression, pH decrease, or prostaglandins are unrelated.
The client diagnosed with coronary artery disease is prescribed an HMG-CoA reductase inhibitor to help reduce the cholesterol level. Which assessment data should be reported to the health-care provider?
- A. Complaints of flatulence.
- B. Weight loss of two (2) pounds.
- C. Complaints of muscle pain.
- D. No bowel movement for two (2) days.
Correct Answer: C
Rationale: Muscle pain with statins may indicate myopathy or rhabdomyolysis, requiring urgent HCP reporting. Flatulence, weight loss, or constipation are less serious.
The elderly client is in a long-term care facility. If the client does not have a daily bowel movement in the morning, he requests a cathartic, bisacodyl (Dulcolax). Which action is most important for the nurse to take?
- A. Ensure the client gets a cathartic daily.
- B. Discuss the complications of a daily cathartic.
- C. Encourage the client to increase fiber in the diet.
- D. Refuse to administer the medication to the client.
Correct Answer: B
Rationale: Daily cathartics risk dependence and electrolyte imbalance; discussing complications educates and promotes safer alternatives like fiber.
A client confides in the RN that a friend has told her the medication she takes for depression, Wellbutrin, was taken off the market because it caused seizures. What is an appropriate response by the nurse?
- A. Ask your friend about the source of this information.'
- B. Omit the next doses until you talk with the doctor.'
- C. There were problems, but the recommended dose is changed.'
- D. Your health care provider knows the best drug for your condition.'
Correct Answer: C
Rationale: Wellbutrin was introduced in the U.S. in 1985 and then withdrawn because of the occurrence of seizures in some patients taking the drug. The drug was reintroduced in 1989 with specific recommendations regarding dose ranges to limit the occurrence of seizures. The risk of seizure appears to be strongly associated with dose.