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 in an acute mental health facility is caring for a client who is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority?
- A. Administer the clonidine on the prescribed schedule.
- B. Provide ice chips at the client's bedside.
- C. Educate the client on the effects of clonidine.
- D. Obtain baseline vital signs
Correct Answer: D
Rationale: Baseline vital signs are the priority to assess withdrawal severity and monitor clonidine's effects.
Robert, age 51 years, has been told by his primary care provider (PCP) to take an aspirin a day. Why would this be recommended?
- A. He has arthritis and this will help with the inflammation and pain
- B. Aspirin has anti-platelet activity and prevents clots that cause heart attacks
- C. Aspirin acidifies the urine and he needs this for prostate health
- D. He has a history of GI bleed, and one aspirin a day is a safe dosage
Correct Answer: B
Rationale: Aspirin's antiplatelet effect reduces cardiovascular risk, a common recommendation for men over 50; arthritis or prostate aren't primary reasons.
Food in the gastrointestinal tract affects drug absorption by:
- A. Altering the pH of the colon, which decreases absorption
- B. Competing with the drug for plasma proteins
- C. Altering gastric emptying time
- D. Altering the pH of urine
Correct Answer: C
Rationale: Food alters gastric emptying time, which can delay or enhance drug absorption depending on the drug's properties.
Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
- A. Decreased therapeutic levels of quinidine
- B. Increased therapeutic levels of quinidine
- C. Decreased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
- D. Increased levels of a coadministered drug, such as digoxin, that requires P-glycoprotein for absorption and elimination
Correct Answer: D
Rationale: Quinidine inhibits P-glycoprotein, increasing levels of drugs like digoxin by reducing efflux, not affecting quinidine itself or lowering digoxin .
A patient needs to receive 500 mL of IV fluid over 4 hours. The drop factor of the IV tubing is 15 gtt/mL. What is the flow rate in drops per minute?
- A. 31 gtt/min
- B. 42 gtt/min
- C. 62 gtt/min
- D. 75 gtt/min
Correct Answer: A
Rationale: Flow rate = (500 mL 15 gtt/mL) ÷ (4 60) = 7,500 ÷ 240 = 31.25 gtt/min, rounded to 31 gtt/min.