Nokea
The nurse is assisting a client with their newly prescribed insulin pump. The nurse understands which insulin is commonly loaded into the pump?
- A. Rapid acting
- B. Ultra long-acting insulin
- C. Intermediate acting
- D. Long acting
Correct Answer: A
Rationale: Rapid-acting insulin, such as lispro or aspart, is used in insulin pumps to mimic physiological insulin delivery for basal and bolus dosing. Long-acting or intermediate-acting insulins are not suitable for pumps.
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The nurse has administered five units of regular insulin and ten units of NPH insulin. After administering both prescribed insulins, the nurse should assess the client for hypoglycemia
- A. thirty minutes after administration.
- B. two to four hours after administration.
- C. four to six hours after administration.
- D. ten to twelve hours after administration.
Correct Answer: B
Rationale: Regular insulin peaks in 2–4 hours, posing the highest hypoglycemia risk during this time. NPH insulin peaks later (4–12 hours). Assessing 2–4 hours after administration aligns with regular insulin’s peak effect.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following laboratory tests require careful monitoring?
- A. Potassium
- B. Sodium
- C. Glucose
- D. Magnesium
Correct Answer: B
Rationale: SIADH causes water retention, diluting sodium and risking hyponatremia. Close sodium monitoring prevents neurological complications like seizures or coma.
The nurse is conducting health screenings for hypothyroidism at the community health fair. Which client is at the highest risk for this condition? A client who is
- A. underweight, anxious, has a rapid pulse, and reports persistent diarrhea.
- B. overweight, reports perspiration while playing sports, and reports feeling cold all the time.
- C. obese, has high blood pressure, and has frequent reports of thirst.
- D. obese, has periorbital edema, and reports a decrease in motivation.
Correct Answer: D
Rationale: Hypothyroidism causes weight gain, edema, and fatigue or decreased motivation. Underweight, rapid pulse, and diarrhea suggest hyperthyroidism; thirst and hypertension are less specific.
The nurse is caring for a client diagnosed with a myxedema coma. The nurse should anticipate a prescription for which of the following medications?
- A. Levothyroxine
- B. Methimazole
- C. Tolvaptan
- D. Hydrochlorothiazide
- E. Hydrocortisone
Correct Answer: A,E
Rationale: Myxedema coma, a severe hypothyroidism emergency, requires levothyroxine to restore thyroid hormone levels and hydrocortisone to address potential adrenal insufficiency. Methimazole treats hyperthyroidism, and tolvaptan and hydrochlorothiazide manage fluid balance, not hypothyroidism.
The nurse is preparing to administer metformin to a client with diabetes mellitus (type two). Which of the following laboratory test results should the nurse monitor during the therapy?
- A. white blood cell (WBC) count
- B. vitamin B12 level
- C. serum uric acid level
- D. thyroid-stimulating hormone (TSH) level
Correct Answer: B
Rationale: Metformin can cause vitamin B12 deficiency over time, requiring monitoring. WBC, uric acid, and TSH are not primarily affected by metformin.