Nokea
The nurse instructs the client in mixing and administering regular and NPH insulin. Which of the following statements indicates that the client needs additional instruction?
- A. I draw up the regular insulin first
- B. I shake the bottle of NPH insulin before drawing it up
- C. I store the insulin in a cool place
- D. I insert the needle at a 90-degree angle
Correct Answer: B
Rationale: Shaking NPH insulin can damage it; it should be gently rolled. Drawing up regular insulin first, cool storage, and a 90-degree injection angle are correct practices.
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The nurse is developing an education plan for clients with hypertension. Which of the following long-term goals is most appropriate for the nurse to emphasize?
- A. Develop a plan to limit stress.
- B. Participate in a weight reduction program.
- C. Commit to regular exercise.
- D. Monitor blood pressure regularly.
Correct Answer: D
Rationale: Regular blood pressure monitoring empowers clients to track their hypertension and adjust lifestyle or medication as needed.
A pregnant woman at 22 weeks' gestation is diagnosed with gonorrhea. The physician orders doxycycline (Vibramycin). The nurse should first:
- A. Inform the client about the effects of the drug.
- B. Make sure the record notes that the baby must receive eyedrops when born.
- C. Have the physician add a single dose of ceftriaxone (Rocephin).
- D. Discuss with the physician the need to change the order.
Correct Answer: D
Rationale: Doxycycline is contraindicated in pregnancy due to risks to the fetus. The nurse should discuss changing the order to a safer alternative, such as ceftriaxone, which is recommended for gonorrhea in pregnancy.
A young adult has been bitten by a human and the skin on the forearm is broken. The client's last tetanus shot was about 8 years ago. The nurse should prepare the client to receive:
- A. An injection of tetanus toxoid.
- B. An application of a corticosteroid cream.
- C. Closure of the wound with sutures.
- D. Testing for tuberculosis.
Correct Answer: A
Rationale: A human bite with broken skin and a tetanus shot over 5 years ago warrants tetanus toxoid to prevent tetanus infection. The other options are not indicated for this scenario.
A worried mother confides in the nurse that she wants to change physicians because her infant is not getting better. The best response by the nurse is which of the following?
- A. This doctor has been on our staff for 20 years.'
- B. I know you are worried, but the doctor has an excellent reputation.'
- C. You always have an option to change. Tell me about your concerns.'
- D. I take my own children to this doctor.'
Correct Answer: C
Rationale: Acknowledging the mother's concerns and offering to discuss them respects her autonomy and opens a dialogue to address specific issues, potentially resolving misunderstandings or facilitating a change if needed.
A client with a history of depression is prescribed fluoxetine (Prozac). The nurse should instruct the client to report which of the following side effects?
- A. Insomnia.
- B. Bradycardia.
- C. Hypotension.
- D. Weight gain.
Correct Answer: A
Rationale: Fluoxetine commonly causes insomnia, which should be reported to manage treatment.