Nokea
The nurse is teaching a client with a new diagnosis of type 1 diabetes mellitus about insulin administration. Which of the following instructions is most important?
- A. Rotate injection sites.
- B. Store insulin in the freezer.
- C. Administer insulin at bedtime only.
- D. Use the same syringe for multiple doses.
Correct Answer: A
Rationale: Rotating injection sites prevents lipodystrophy and ensures consistent insulin absorption.
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A client is scheduled to have surgery. The nurse should place priority on determining whether the surgeon wants which medications held in the preoperative period to assure client safety?
- A. Warfarin
- B. Furosemide
- C. Famotidine
- D. Multivitamin with minerals
Correct Answer: A
Rationale: The nurse is careful to question the surgeon about whether warfarin should be administered in the preoperative period. This medication is often withheld for a period of time preoperatively to minimize the risk of hemorrhage during surgery. The other medications may also be withheld if specifically prescribed, but usually they are discontinued as part of an NPO (nothing by mouth) after midnight prescription.
A client with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium (Atrovent). The nurse should instruct the client to:
- A. Rinse the mouth after inhalation.
- B. Take the medication with meals.
- C. Avoid using the inhaler during an acute attack.
- D. Stop the medication if dizziness occurs.
Correct Answer: A
Rationale: Rinsing the mouth after ipratropium inhalation prevents oral irritation or infection.
Before discharge from the hospital after a myocardial infarction, a client is taught to exercise by gradually increasing the distance walked. Which vital sign should the nurse teach the client to monitor to determine whether to increase or decrease the exercise level?
- A. Pulse rate.
- B. Blood pressure.
- C. Body temperature.
- D. Respiratory rate.
Correct Answer: A
Rationale: Monitoring pulse rate helps determine if the exercise level is appropriate, as an excessively high rate indicates overexertion.
A client with severe major depression states, 'My heart has stopped and my blood is black ash.' The nurse interprets this statement to be evidence of which of the following?
- A. Hallucination.
- B. Illusion.
- C. Delusion.
- D. Paranoia.
Correct Answer: C
Rationale: The client's statement reflects a false, fixed belief that is not based in reality, which is characteristic of a delusion. Hallucinations involve sensory perceptions, illusions are misinterpretations of stimuli, and paranoia involves suspicion, none of which fit this scenario.
The nurse is working on discharge plans with a client who is diagnosed with intermittent explosive disorder, characterized by sudden angry outbursts. The nurse determines that the client is ready for discharge when he makes which of the following comments?
- A. I'm just not going to let myself get angry anymore.'
- B. Spilling doesn't help, but I like being with my buddies at the bar.'
- C. I'll be taking valproic acid (Depakote) and propranolol (Inderal) to help stay in control.'
- D. It would help if my mom would stop getting on my case all the time.'
Correct Answer: C
Rationale: Understanding the role of medications (valproic acid and propranolol) in controlling outbursts indicates readiness for discharge in managing intermittent explosive disorder.