Nokea
The nurse is reviewing newly prescribed medications for assigned clients. Which of the following prescribed medications should the nurse question?
- A. Furosemide for a client with hyperparathyroidism
- B. Methimazole for a client with hyperthyroidism
- C. Hydrocortisone for a client with diabetes insipidus
- D. Prazosin for a client with pheochromocytoma
Correct Answer: C
Rationale: Hydrocortisone is inappropriate for diabetes insipidus, which requires desmopressin to manage water reabsorption. Furosemide may be used in hyperparathyroidism, methimazole treats hyperthyroidism, and prazosin manages hypertension in pheochromocytoma.
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The nurse has instructed a client scheduled for an injection of dulaglutide for diabetes mellitus (type two). Which of the following statements by the client would require follow-up?
- A. I should tell my doctor if I experience abdominal pain and vomiting.
- B. I should take this medication within one hour of eating a meal.
- C. If this medication works, I should notice a reduction in my hemoglobin A1C (HbA1c).
- D. I will receive this medication once a week.
Correct Answer: B
Rationale: Dulaglutide, a GLP-1 agonist, is taken weekly regardless of meals, not within one hour of eating. Abdominal pain/vomiting should be reported, HbA1c reduction is expected, and weekly dosing is correct.
The nurse administers a combination of regular insulin and NPH insulin subcutaneously to a client at 0800. At which time should the nurse initially assess the client for hypoglycemia based on the peaks of the medications?
- A. 830
- B. 1000
- C. 1200
- D. 1400
Correct Answer: B
Rationale: Regular insulin peaks at 2-4 hours (1000-1200), and NPH peaks at 4-12 hours. Initial hypoglycemia risk is highest around 1000 due to regular insulin's peak effect.
This nurse is caring for a client who is receiving prescribed sitagliptin. The nurse understands that this medication is intended to treat which condition?
- A. Hyperlipidemia
- B. Diabetes mellitus
- C. Hypothyroidism
- D. Hypertension
Correct Answer: B
Rationale: Sitagliptin, a DPP-4 inhibitor, treats type 2 diabetes mellitus by enhancing incretin effects to lower blood glucose. It does not treat hyperlipidemia, hypothyroidism, or hypertension.
The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an infusion of regular insulin. Which of the following clinical data should be reported to the primary healthcare provider (PHCP) immediately?
- A. Glucose 297 mg/dL, 16.52 mmol/L (70-110 mg/dL, 4.0-11.0 mmol/L)
- B. Potassium 3.2 mEq/L, 3.2 mmol/L (3.5-5 mEq/L, 3.5-5.1 mmol/L)
- C. BUN 24 mg/dL, 8.568 mmol/L (10-20 mg/dL, 2.5 to 6.4 mmol/L)
- D. Hemoglobin A1C 8.9% ( < 7%, 4.8%-6.0%)
Correct Answer: B
Rationale: In DKA, insulin shifts potassium into cells, risking hypokalemia. A level of 3.2 mEq/L is critical and needs immediate reporting to prevent arrhythmias. Glucose, BUN, and HbA1C are monitored but less urgent.
The nurse is caring for a client who is receiving newly prescribed prednisone. Which of the following medications should the client avoid while receiving this medication?
- A. valsartan
- B. naproxen
- C. omeprazole
- D. acetaminophen
Correct Answer: B
Rationale: Naproxen, an NSAID, should be avoided with prednisone due to increased risk of gastrointestinal bleeding and ulceration. Valsartan, omeprazole, and acetaminophen are generally safe with prednisone, though monitoring is needed.