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The LPN is taking care of a 176-pound client who has recently been diagnosed with diabetes. The primary healthcare provider has written an order for Lantus (insulin glargine injection) 100 units/mL, using weight-based dosing of 0.2 units/kg per day. The LPN should prepare ___ units for administration.
- A. 12
- B. 35
- C. 16
- D. 9
Correct Answer: C
Rationale: To find the answer, you must convert 176 pounds to kilograms. 2.2 pounds = 1 kg. You must divide 176 by 2.2, which equals 80 kg. The client is 80 kg, and they should receive 0.2 units for every kilogram they weigh, so 80 × 0.2 = 16 units.
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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.
The client's dose of mirtazapine was increased from 15 to 30 mg at bedtime two days ago. When the nurse is preparing to administer mirtazapine, the client reports having insomnia, irritability, and panic attacks. What should the nurse do next?
- A. Document the symptoms, hold the dose, and notify the HCP.
- B. Telephone the HCP to request a pm sedative to help the client sleep.
- C. Have the client participate in a card game with other clients on the unit.
- D. Reassure the client that these symptoms will subside after taking this dose.
Correct Answer: A
Rationale: Mirtazapine (Remeron) is an antidepressant. Adverse effects include insomnia, irritability, panic attacks, and suicidal ideation. A change in medication may be needed rather than a dosage increase.
The nurse is developing the plan of care for the 4-year-old client who is taking metronidazole for giardiasis. Which measures should be included in the plan of care? Select all that apply.
- A. Assess cardiac status.
- B. Assess for signs of infection.
- C. Reinforce strict hand washing.
- D. Give metronidazole with food.
- E. Monitor results of stool samples.
Correct Answer: B,C,E
Rationale: A: Metronidazole is not associated with any cardiac changes or adverse events. B: Giardiasis is an infectious diarrheal disease; the plan of care should include assessing for infection. Infection should subside when treated with metronidazole (Flagyl). C: Giardiasis is an infectious diarrheal disease; the plan of care should include reinforcing strict hand washing. D: Metronidazole should be given on an empty stomach. E: Giardiasis is an infectious diarrheal disease; the plan of care should include monitoring the results of stool samples.
Two hours after administering iron dextran, the nurse is drawing the client's blood sample for a laboratory test. Which intervention should the nurse implement when noting that the client's blood has a brownish hue?
- A. Document the serum color.
- B. Draw blood from another site.
- C. Immediately notify the HCP.
- D. Discard the sample of blood.
Correct Answer: A
Rationale: A: The nurse should document the finding of the blood's brownish hue; iron dextran (Dexferrum) may impart a brownish hue to blood drawn within four hours after administration. B: Drawing blood from another site is unnecessary because iron dextran imparts the brown-colored serum, and the color will be unchanged even if blood is drawn at another site. C: Notifying the HCP is unnecessary because the brown-colored serum is a normal finding after iron dextran administration. D: The blood sample should not be discarded because the brown-colored serum is a normal finding after iron dextran administration and will not affect laboratory analysis.
The nurse is preparing to care for the 14-month-old newly hospitalized toddler with bacterial gastroenteritis and severe dehydration. Which initial collaborative interventions should the nurse expect to implement? Select all that apply.
- A. IV antibiotic to treat infection
- B. Oral fluids for fluid rehydration
- C. IV fluid therapy for rehydration
- D. Analgesics for pain and discomfort
- E. An antidiarrheal to control diarrhea
- F. Antipyretic for elevated temperature
Correct Answer: A,C,F
Rationale: A: Antibiotics may be prescribed to treat bacterial gastroenteritis to ensure complete recovery. B: Oral fluid rehydration will be initiated later, but not initially, when the toddler presents with severe dehydration. C: The child who presents with severe dehydration needs IV therapy to stabilize the balance of fluids and electrolytes. D: The pain and discomfort the toddler will have are due to fever and cramping from the GI illness; thus, analgesics are usually not prescribed. E: An antidiarrheal medication is contraindicated. F: Fever is often a symptom of gastroenteritis. Ensuring that the fever is controlled will provide some comfort.