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The nurse monitors the client for a hypoglycemic reaction, knowing that NPH insulin peaks in approximately how many hours following administration?
- A. 1 hour
- B. 2 to 3 hours
- C. 4 to 12 hours
- D. 16 to 24 hours
Correct Answer: C
Rationale: NPH is an intermediate-acting insulin with a peak time in 4 to 12 hours. The remaining options describe periods of time that are either too short or too long.
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The nurse asks the client to sign a consent form before undergoing surgery. The client indicates that he was not told about the risks of the surgical procedure. Which of the following statements by the nurse is most appropriate?
- A. What are your concerns? I can answer any questions that you have.'
- B. You can go ahead and sign the form. I will be sure to tell the surgeon you have questions.'
- C. It is important that your questions are answered before you consent to the procedure. I will contact the surgeon.'
- D. I'm sure the risks are minimal, so you don't need to worry.'
Correct Answer: C
Rationale: Ensuring the client's questions about risks are answered before signing consent is critical for informed consent, requiring the nurse to contact the surgeon.
The physician is calling in an order for ampicillin for a neonate. The nurse should do which of the following? Select all that apply.
- A. Write down the order.
- B. Ask the physician to come to the hospital and write the order on the chart.
- C. Repeat the order to the physician over the telephone.
- D. Ask the physician to confirm that the order is correct.
- E. Ask the nursing supervisor to cosign the telephone order as transcribed by the nurse.
Correct Answer: A,C,D
Rationale: Writing the order, repeating it back, and confirming with the physician ensure accuracy and safety for a telephone order.
A client with a history of type 1 diabetes is admitted with diabetic ketoacidosis. The nurse should monitor the client for which of the following electrolyte imbalances? Select all that apply.
- A. Hypokalemia.
- B. Hypernatremia.
- C. Hypophosphatemia.
- D. Hypermagnesemia.
- E. Hypocalcemia.
Correct Answer: A, C
Rationale: Diabetic ketoacidosis can cause hypokalemia (insulin shifts potassium) and hypophosphatemia (osmotic diuresis).
An intravenous dose of lorazepam is prescribed for a client. Which data from the client's history would indicate the need to consult with the primary health care provider before administering the medication?
- A. Glaucoma
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Coronary artery disease
Correct Answer: A
Rationale: Lorazepam is a benzodiazepine and is contraindicated in clients who are comatose, with preexisting central nervous system (CNS) depression, with uncontrolled severe pain, and those with narrow-angle glaucoma. It is also contraindicated if hypersensitivity or cross-sensitivity with other benzodiazepines exists. It is also not prescribed for clients who are pregnant or breast-feeding.
A client with a history of depression is prescribed bupropion (Wellbutrin). The nurse should instruct the client to report which of the following side effects immediately?
- A. Mild headache.
- B. Seizures.
- C. Nausea.
- D. Fatigue.
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold, and seizures are a serious side effect requiring immediate reporting.