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The nurse is talking with a client with alcohol use disorder who has a new prescription for disulfiram. Which of the following information should the nurse include?
- A. Most clients who take this medication do not need to attend therapy or support groups.
- B. Avoid drinking alcohol for 3 days after discontinuing this medication.
- C. Check for alcohol in household items you use regularly, such as mouthwash.
- D. You can expect to experience decreased cravings for alcohol.
Correct Answer: C
Rationale: Disulfiram causes severe adverse reactions when alcohol is consumed, even in small amounts found in products like mouthwash. Clients must avoid all alcohol-containing products to prevent a disulfiram-alcohol reaction, which can include nausea, vomiting, and flushing.
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A client with type 1 diabetes has a prescription for 30 units of insulin glargine at bedtime. Fingerstick blood glucose measurements are prescribed before meals and at bedtime with regular insulin based on a sliding scale. At 9 PM, the client's blood glucose measurement is 180 mg/dL (10.0 mmol/L). What action should the nurse take?
- A. Administer 30 units of glargine; give the client a snack, then administer 2 units of regular insulin
- B. Administer 30 units of glargine and 2 units of regular insulin in 2 different injections
- C. Mix 30 units of glargine with 2 units of regular insulin in the same syringe, drawing up the glargine first
- D. Mix 30 units of glargine with 2 units of regular insulin in the same syringe, drawing up the regular insulin first
Correct Answer: B
Rationale: The sliding scale indicates 2 units of regular insulin for a glucose of 180 mg/dL. Glargine, a long-acting insulin, should be given as prescribed (30 units). Glargine cannot be mixed with regular insulin in the same syringe due to differing pH levels, so separate injections are required.
The nurse is caring for a client with Cushing's syndrome. The nurse should carefully assess the client for signs of:
- A. Hypoglycemia
- B. Infection
- C. Hypovolemia
- D. Hyperinsulinemia
Correct Answer: B
Rationale: Cushing's syndrome causes immunosuppression, increasing infection risk . Hypoglycemia , hypovolemia , and hyperinsulinemia are not primary concerns.
The nurse is reinforcing education about lifestyle modifications for a client newly diagnosed with Meniere disease. Which statement by the client indicates a need for further teaching?
- A. I need to enroll in a smoking cessation program.
- B. I need to restrict the amount of potassium in my diet.
- C. I will lie down and avoid walking unassisted during acute attacks.
- D. I will limit the amount of caffeine and alcohol that I consume.
Correct Answer: B
Rationale: Restricting potassium isn't indicated for Ménière's disease; a low-sodium diet is typically recommended to reduce fluid retention. Smoking cessation, lying down during attacks, and limiting caffeine/alcohol are appropriate.
A client with a knee injury is scheduled for an MRI examination. The nurse explains the test to the client. Which finding in the client would make the client ineligible for this type of exam?
- A. Presence of a metal plate in the leg from an old fracture
- B. Presence of a ceramic artificial hip
- C. A history of asthma attacks
- D. Allergy to injected dye
Correct Answer: A
Rationale: A metal plate is a contraindication for MRI due to magnetic interference, making the client ineligible.
The nurse is caring for several hospitalized children with the following diagnoses. Which disorder is likely to result in metabolic acidosis?
- A. Severe diarrhea for 24 hours
- B. Nausea with anorexia
- C. Alternating constipation and diarrhea
- D. Vomiting for over 48 hours
Correct Answer: A
Rationale: Severe diarrhea is the only problem listed that can lead to metabolic acidosis if untreated.