Nokea
The nurse is administering the long-acting insulin glargine (Lantus) to the client at 2200. The nurse asks the charge nurse to check the dosage. Which action should the charge nurse implement?
- A. Ask the nurse why the insulin is being given late.
- B. Check the MAR versus the dosage in the syringe.
- C. Instruct the nurse to complete a medication error form.
- D. Have the nurse notify the health-care provider.
Correct Answer: B
Rationale: Verifying MAR against syringe dosage ensures accuracy, per safety protocols. Timing questions, error forms, or HCP notification are unnecessary unless errors occur.
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A 66 year-old client is admitted for mitral valve replacement surgery. The client has a history of mitral valve regurgitation and mitral stenosis since her teenage years. During the admission assessment, the nurse should ask the client if as a child she had
- A. measles
- B. rheumatic fever
- C. hay fever
- D. encephalitis
Correct Answer: B
Rationale: rheumatic fever. Clients that present with mitral stenosis often have a history of rheumatic fever or bacterial endocarditis.
The client is diagnosed with tuberculosis and prescribed rifampin and isoniazid (INH), both antituberculosis medications. Which instruction is most important for the public health nurse to discuss with the client?
- A. The client will have to take the medications for nine (9) to 12 months.
- B. The client will have to stay in isolation as long as he or she is taking medications.
- C. Explain the client cannot eat any type of pork products while taking the medication.
- D. The urine may turn turquoise in color, but this is an expected occurrence and harmless.
Correct Answer: A
Rationale: TB treatment requires 9–12 months for cure, ensuring adherence is critical to prevent resistance, a public health priority. Isolation, pork, or urine color are incorrect or less urgent.
The client is receiving a continuous heparin drip, 20,000 units/500 mL D5W, at 23 mL/min. How many units of heparin is the client receiving an hour?
Correct Answer: 55200
Rationale: Concentration: 20,000 units / 500 mL = 40 units/mL. Rate: 23 mL/min x 60 min/hr = 1,380 mL/hr. Dose: 1,380 mL/hr x 40 units/mL = 55,200 units/hr.
The nurse in the physician's office is instructing an adult about taking penicillin V potassium (Pen-Vee-K) qid. When should the nurse tell him to take the medicine?
- A. With meals and at bedtime
- B. Once a day at 10:00 a.m.
- C. On an empty stomach at six-hour intervals
- D. With orange juice at four-hour intervals
Correct Answer: C
Rationale: Penicillin V potassium should be taken on an empty stomach at six-hour intervals to optimize absorption.
The client with arthritis is self-medicating with aspirin, a nonsteroidal anti-inflammatory medication. Which complication should the nurse discuss with the client?
- A. Tinnitus.
- B. Diarrhea.
- C. Tetany.
- D. Paresthesia.
Correct Answer: A
Rationale: High-dose aspirin can cause tinnitus, an early sign of salicylate toxicity, requiring education. Diarrhea, tetany, or paresthesia are less common.