Nokea
The decision may be made to switch from twice daily neutral protamine Hagedorn (NPH) insulin to insulin glargine to improve glycemia control throughout the day. If this is done:
- A. The initial dose of glargine is reduced by 20% to avoid hypoglycemia
- B. The initial dose of glargine is 2 to 10 units per day
- C. Patients who have been on high doses of NPH will need tests for insulin antibodies
- D. Obese patients may require more than 100 units per day
Correct Answer: A
Rationale: Switching to glargine reduces the dose by 20% to prevent hypoglycemia due to its steady action vs. NPH peaks.
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A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action?
- A. Notify the registered nurse.
- B. Administer pain medication to reduce the discomfort.
- C. Apply ice and maintain the infusion rate, as prescribed.
- D. Elevate the extremity of the IV site, and slow the infusion.
Correct Answer: A
Rationale: When antineoplastic medications (Chemotherapeutic Agents) are administered via IV, great care must be taken to prevent the medication from escaping into the tissues surrounding the injection site, because pain, tissue damage, and necrosis can result. The nurse monitors for signs of extravasation, such as redness or swelling at the insertion site and a decreased infusion rate. If extravasation occurs, the registered nurse needs to be notified; he or she will then contact the health care provider.
Drugs mostly cross biological membranes by
- A. Passive diffusion
- B. Active diffusion
- C. Active transport
- D. Carrier mediated transport
Correct Answer: A
Rationale: Most drugs cross membranes via passive diffusion based on concentration gradients.
A nurse is completing a nursing history for a client who takes Simvastatin. The nurse should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?
- A. History of severe constipation
- B. History of hypertension
- C. Active hepatitis C
- D. Type 2 diabetes mellitus
Correct Answer: C
Rationale: Active hepatitis C contraindicates ezetimibe due to increased liver risk with statins.
Azathioprine is useful in the following diseases EXCEPT:
- A. Rheumatoid arthritis
- B. Psoriatic arthritis
- C. Reactive arthritis
- D. osteoarthritis
Correct Answer: D
Rationale: Azathioprine is not typically used for osteoarthritis, a degenerative condition.
The following drug when used for prolonged period in the maintenance treatment of tonic-clonic seizures can lead to increased metabolism of warfarin like drugs:
- A. Phenobarbitone
- B. Meprobamate
- C. Chlordiazepoxide
- D. Triazolam
Correct Answer: A
Rationale: Phenobarbitone induces CYP450, increasing warfarin metabolism.