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The nurse has an order to administer U-500 Humulin R insulin 10 units. How many units should the nurse draw up when administering this insulin?
- A. 50 units of Humulin R insulin in a 100-unit insulin syringe.
- B. 10 units of Humulin R insulin in a 500-unit insulin syringe.
- C. 10 units of Humulin R insulin in a 30-unit insulin syringe.
- D. 50 units of Humulin R insulin in a 50-unit insulin syringe.
- G. B
Correct Answer: U-500 is 5x concentrated; 10 units requires a U-500 syringe for accuracy. Other options misalign syringe type or dose.
Rationale: The correct answer is G. When administering U-500 Humulin R insulin, which is 5x concentrated, the nurse should use a U-500 insulin syringe for accuracy. Drawing up 10 units with a U-500 syringe ensures the correct dose is administered. Choice A and D suggest using different syringe types or incorrect doses, leading to potential dosing errors. Choice C mentions using a 30-unit syringe which is not appropriate for U-500 insulin. Choice B suggests using a 500-unit syringe which may lead to inaccuracies in dosing. Therefore, the correct choice is G as it aligns with the concentration of U-500 insulin and ensures accurate dosing.
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The risk for physical and psychological dependence is high from which class of medications, which is rarely used to treat insomnia or anxiety?
- A. Barbiturates.
- B. Nonsteroidal anti-inflammatory drugs (NSAIDs).
- C. Benzodiazepines.
- D. Selective serotonin reuptake inhibitors (SSRIs).
- G. A
Correct Answer: Barbiturates have high dependence risk and are rarely used for insomnia/anxiety due to safer alternatives like benzodiazepines. NSAIDs, benzodiazepines, and SSRIs don't fit this profile.
Rationale: The correct answer is A: Barbiturates. Barbiturates are known to have a high risk of physical and psychological dependence due to their sedative effects. They are rarely used to treat insomnia or anxiety nowadays because safer alternatives like benzodiazepines are available. Nonsteroidal anti-inflammatory drugs (NSAIDs) are primarily used for pain and inflammation, not for insomnia or anxiety. Benzodiazepines are commonly prescribed for these conditions but have a lower risk of dependence compared to barbiturates. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants and are not typically used for the treatment of insomnia or anxiety. Therefore, the correct answer is A because barbiturates have a high dependence risk and are not commonly used for these conditions.
After taking the medication guaifenesin (Mucinex), the client complains of coughing up phlegm. What is the best response by the nurse?
- A. This means there is probably more pathology present.
- B. This is indicative of an allergic reaction.
- C. This requires further investigation.
- D. This is a normal response to the medication.
- G. D
Correct Answer: Guaifenesin is an expectorant that loosens mucus, making coughing up phlegm a normal response. It's not indicative of more pathology, an allergic reaction, or a need for investigation unless symptoms worsen unusually.
Rationale: Step 1: Identify the medication's action - Guaifenesin is an expectorant that helps loosen and thin mucus in the airways.
Step 2: Understand the expected response - Coughing up phlegm after taking guaifenesin is a normal response due to the medication's action.
Step 3: Evaluate the other choices - A, B, and C are incorrect because coughing up phlegm is not indicative of more pathology, an allergic reaction, or a need for further investigation in this context.
Step 4: Choose the correct response - Option G correctly acknowledges that coughing up phlegm is a normal response to guaifenesin and does not suggest any unnecessary concerns or actions.
What would the nurse teach a client to avoid when taking barbiturates?
- A. Nicotine
- B. Alcohol
- C. Bananas
- D. Caffeine
- G. B
Correct Answer: Nicotine and caffeine don't critically interact. Alcohol, a CNS depressant, dangerously enhances barbiturate sedation. Bananas are unrelated.
Rationale: The correct answer is B: Alcohol. Barbiturates and alcohol are both central nervous system depressants, and when taken together, they can dangerously enhance sedation and respiratory depression. This can lead to overdose and even death. Nicotine (choice A) and caffeine (choice D) do not have critical interactions with barbiturates, so there is no specific teaching to avoid them. Bananas (choice C) are unrelated to barbiturate use and do not pose any risk. It is crucial for the nurse to educate the client on the dangers of combining barbiturates with alcohol to prevent adverse effects and ensure the client's safety.
How does drug therapy of tuberculosis differ from that of most other infections?
- A. Patients with tuberculosis have no symptoms.
- B. Antituberculosis drugs are used extensively for treating active disease, not prevention.
- C. Patients usually require therapy for a shorter period.
- D. Mycobacteria have a cell wall that is resistant to penetration by anti-infective drugs.
- G. D
Correct Answer: TB patients can have symptoms. Drugs treat both active disease and prevention (latent TB). TB therapy is longer (6-9 months+). Mycobacteria's resistant cell wall necessitates prolonged, combined drug therapy.
Rationale: The correct answer is G. The rationale is as follows:
1. TB patients can have symptoms: TB can present with symptoms such as cough, fever, weight loss, and night sweats.
2. Drugs treat both active disease and prevention: Antituberculosis drugs are used for both treating active TB disease and preventing latent TB from developing into active disease.
3. TB therapy is longer: TB therapy typically lasts 6-9 months or longer due to the slow-growing nature of Mycobacterium tuberculosis and the need to prevent drug resistance.
4. Mycobacteria's resistant cell wall: Mycobacteria have a unique cell wall that is resistant to penetration by many antibiotics, necessitating prolonged and combined drug therapy for effective treatment.
In summary, the other choices are incorrect because patients with TB can have symptoms, antituberculosis drugs are used for both treatment and prevention, therapy duration is usually longer, and the unique cell wall of Mycobacteria requires specific drug regimens.
Why are antianxiety medications used cautiously in older adults?
- A. The drug is not distributed as well due to poor circulation.
- B. The liver metabolizes the drug faster, making it ineffective.
- C. There is an inability to absorb the drugs due to decreased acid production.
- D. There is reduced elimination, leading to a buildup in the circulation.
- G. D
Correct Answer: Poor circulation affects distribution but isn't primary. Liver metabolism slows, not hastens. Acid production impacts some drugs, not anxiolytics. Reduced elimination increases buildup, risking side effects.
Rationale: The correct answer is D: There is reduced elimination, leading to a buildup in the circulation. In older adults, the kidneys tend to function less efficiently, resulting in reduced elimination of medications from the body. This decreased clearance can lead to a buildup of antianxiety medications in the bloodstream, potentially causing adverse effects or toxicity. This is why antianxiety medications should be used cautiously in older adults to prevent these risks.
Choices A, B, and C are incorrect because poor circulation, faster liver metabolism, and decreased acid production are not the primary reasons why antianxiety medications are used cautiously in older adults. These factors may influence drug absorption or metabolism, but the key concern with antianxiety medications in older adults is the reduced elimination leading to potential drug accumulation and its associated risks.