Nokea
The nurse has attended a continuing education conference regarding medication administration and meal times. Which statement, if made by the nurse, would indicate correct understanding?
- A. Proton pump inhibitors (PPls) should be given as the client eats their breakfast.
- B. Glucocorticoids should be given on an empty stomach to prevent gastrointestinal irritation.
- C. Rapid-acting insulins should be administered approximately 5-10 minutes before meals
- D. Levodopa-Carbidopa should be administered with a high-protein snack to enhance its absorption.
Correct Answer: C
Rationale: Rapid-acting insulins are administered 5-10 minutes before meals to match glucose spikes.
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The nurse is caring for a client who is receiving the prescribed hydromorphone. Which of the following side effects should the nurse look for in the client? Select all that apply.
- A. Urinary incontinence
- B. Pupil dilation
- C. Diarrhea
- D. Altered level of consciousness (LOC)
- E. Constipation
Correct Answer: D,E
Rationale: Hydromorphone, an opioid, can cause altered level of consciousness and constipation. Urinary incontinence, pupil dilation, and diarrhea are not typical side effects.
The nurse is providing discharge teaching for a client post-inguinal herniorrhaphy. Which statement by the client indicates a need for further teaching?
- A. I'll avoid heavy lifting for about 6 weeks.
- B. I can take a shower tomorrow.
- C. I'll call the doctor if I have a fever.
- D. I can resume sexual activity next week.
Correct Answer: D
Rationale: Resuming sexual activity within a week post-inguinal herniorrhaphy may strain the surgical site, indicating a need for further teaching to delay such activities for 4–6 weeks. The other statements align with appropriate postoperative care. CN: Health promotion and maintenance; CL: Evaluate
The nurse is planning a community health class for older adults. Which topic should the nurse prioritize?
- A. discussing and preventing polypharmacy
- B. strategies to stay physically active
- C. staying socially engaged in the community
- D. recommended immunizations
Correct Answer: A
Rationale: Polypharmacy is a critical issue in older adults, increasing the risk of adverse drug events.
The client with type 1 diabetes mellitus is taught to take NPH insulin at 5 p.m. each day. The client should be instructed that the greatest risk of hypoglycemia will occur at about what time?
- A. 11 a.m., shortly before lunch.
- B. 1 p.m., shortly after lunch.
- C. 6 p.m., shortly after dinner.
- D. 1 a.m., while sleeping.
Correct Answer: D
Rationale: NPH insulin peaks 4–12 hours after administration (around 9 p.m. to 5 a.m.), with the greatest hypoglycemia risk overnight, such as at 1 a.m.
A client is to receive glargine (Lantus) insulin in addition to a dose of aspart (NovoLog). When the nurse checks the blood glucose level at the bedside, it is greater than 200 mg/dL. How should the nurse administer the insulins?
- A. Put air into the glargine insulin vial, and then air into the aspart insulin vial, and draw up the correct dose of aspart insulin first.
- B. Roll the glargine insulin vial, then roll the aspart insulin vial. Draw up the longer-acting glargine insulin first.
- C. Shake both vials of insulin before drawing up each dose in separate insulin syringes.
- D. Add a little air to the glargine insulin vial and draw up the correct dose in an insulin syringe; then, with a different insulin syringe, put air into the aspart vial and draw up the correct dose.
Correct Answer: D
Rationale: Glargine and aspart insulins cannot be mixed. They should be drawn up in separate syringes to maintain their distinct actions (long-acting vs. rapid-acting). Shaking or rolling is inappropriate for glargine, which is clear.