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The nurse is teaching a client about storing their prescribed insulin. Which statement, if made by the client, would indicate a correct understanding of the teaching?
- A. Opened vials of insulin may be kept in the freezer.
- B. My opened vial of insulin is good for 45 days.
- C. If I travel, I can keep a vial of insulin in my car.
- D. Unopened vials of insulin should be stored in the refrigerator.
Correct Answer: D
Rationale: Unopened insulin vials should be refrigerated to maintain stability. Opened vials are good for about 28–30 days at room temperature, not 45 days. Freezing or storing in a car can degrade insulin.
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The nurse is teaching a client who is receiving newly oral prednisone. Which of the following Information should the nurse include concerning the possible side effects of this medication?
- A. Increased susceptibility to infection
- B. Weight gain
- C. Insomnia
- D. Blood glucose elevation
- E. Increased urine output
Correct Answer: A,B,C,D
Rationale: Prednisone, a corticosteroid, suppresses immunity (increasing infection risk), causes weight gain, insomnia, and elevates blood glucose. Increased urine output is not a common side effect; it’s more associated with diuretics.
The nurse is preparing to administer a regular insulin IV bolus to a client. The primary health care provider (PHCP) has prescribed an initial bolus dose of 0.1 unit/kg. The client weighs 242 lbs. How much regular insulin should the nurse administer to the client as an IV bolus?
Correct Answer: 11
Rationale: Convert 242 lbs to kg: 242 ÷ 2.2 = 110 kg. Calculate dose: 110 kg × 0.1 unit/kg = 11 units. Thus, 11 units of regular insulin should be administered.
The following scenario applies to the next 1 items
The home health nurse visits a client with chronic diabetes insipidus
Item 1 of 1
Nurses’ Note
1415 – Home health visit completed because the client was admitted to the hospital twice in the past six weeks for treatment nonadherence related to diabetes insipidus. Extensive teaching provided and reviewed education on prescribed desmopressin intranasal, maintenance of fluids, daily weight, intake and output, and when to seek emergency care.
Which client statements would indicate a correct understanding of the teaching?
- A. I should limit the amount of fluids that I drink after 5:00 PM.
- B. I will need to weigh myself at the same time every day.
- C. I should put both doses of the desmopressin in one nostril.
- D. I need to keep a log of my fluid intake and urine output.
- E. I may need an additional dose if I keep urinating a lot.
- F. If I develop confusion with this medication, I should call 911.
Correct Answer: B, D, F
Rationale: Daily weighing and logging intake/output monitor diabetes insipidus. Confusion may signal hyponatremia, needing emergency care. Fluid limits are incorrect, desmopressin dosing is per nostril, and extra doses require a provider's order.
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.
The nurse is caring for a client who recently had a dosage increase of prescribed levothyroxine. Which of the assessments following the increase is a priority?
- A. Weight
- B. Heart rate
- C. Activity status
- D. Oral temperature
Correct Answer: B
Rationale: Levothyroxine increases metabolism, and a dosage increase can cause hyperthyroidism symptoms, including tachycardia. Monitoring heart rate is a priority to detect adverse effects like arrhythmias. Weight, activity status, and temperature are relevant but less urgent.