Laboratory reference ranges
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L)
The nurse is assisting with the care of four clients with diabetes mellitus. Which of the following prescriptions should the nurse clarify with the health care provider?
- A. 10 units regular insulin IV push for serum glucose level >250 mg/dL (13.9 mmol/L)
- B. 14 units glargine insulin subcutaneous injection every night at 2000
- C. 18 units aspart insulin subcutaneous injection 15 minutes before breakfast
- D. 20 units NPH insulin IV push administered every morning at 700
Correct Answer: D
Rationale: NPH insulin is not administered IV, as it is a suspension and can cause embolism or erratic absorption. This prescription requires clarification.
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A 35 year-old client with sickle cell crisis is talking on the telephone but stops as the nurse enters the room to request something for pain. The nurse should
- A. Administer a placebo
- B. Encourage increased fluid intake
- C. Administer the prescribed analgesia
- D. Recommend relaxation exercises for pain control
Correct Answer: C
Rationale: Administer the prescribed analgesia. Pain relief is a priority in sickle cell crisis, and prescribed analgesics are appropriate.
The nurse hears another staff member talking in a crowded elevator about a client on the unit. The client is identified by name and details of illness. What action should the practical nurse take at this time?
- A. Report the behavior to the head nurse
- B. Report the behavior if it happens again
- C. Interrupt the conversation in the elevator
- D. Speak to the staff member when he/she gets off the elevator
Correct Answer: D
Rationale: Speaking to the staff member privately after the elevator ride addresses the HIPAA violation discreetly, promoting education and correction without immediate escalation.
A woman is scheduled for an electromyography procedure (EMG) in the outpatient department. What should the nurse say to the woman?
- A. Do not eat or drink anything after midnight the night before the procedure.'
- B. Are you allergic to shellfish or iodine?'
- C. Do not eat or drink anything that contains caffeine for two to three days before the procedure.'
- D. There is no special preparation for this procedure.'
Correct Answer: D
Rationale: EMG requires no special preparation, as it involves muscle and nerve testing without fasting, allergies, or caffeine restrictions.
The nurse is teaching a group of adults about modifiable cardiac risk factors. Which of the following should the nurse focus on first?
- A. Weight reduction
- B. Stress management
- C. Physical exercise
- D. Smoking cessation
Correct Answer: D
Rationale: Smoking cessation. Stopping smoking is the priority for clients at risk for cardiac disease, because of its effects of reducing oxygenation and constricting blood vessels.
A client complaining of severe shortness of breath is diagnosed with congestive heart failure. The nurse observes a falling pulse oximetry. The client's color changes to gray and she expectorates large amounts of pink frothy sputum. The first action of the nurse would be which of the following?
- A. Call the health care provider
- B. Check vital signs
- C. Position in high Fowler's
- D. Administer oxygen
Correct Answer: D
Rationale: Administer oxygen. In a medical emergency, airway and breathing are prioritized. Oxygen administration addresses the immediate respiratory distress.
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