Nokea
The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.
- A. The dose of insulin drawn up in the syringe
- B. The expiration date on the insulin vial
- C. The type of insulin to be administered
- D. The sliding scale insulin lispro prescription
- E. The insulin concentration
- F. The insulin vial for color and clarity
- G. The history and physical with the diabetes diagnosis listed
Correct Answer: A,B,C,D,E,F
Rationale: Dose, type, prescription, concentration, vial clarity, and expiration ensure safe insulin administration. B and G are standard nurse assessments, not requiring double-checking.
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A client who experiences migraine headaches reports having fewer headaches since using the herbal remedy feverfew. Which information is most important for the nurse to include in a teaching plan for this client?
- A. Increased anxiety and nervousness have been reported by those taking feverfew.
- B. Those with allergies to chamomile, ragweed, or yarrow should not take feverfew.
- C. Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew.
- D. Feverfew may interact with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs).
Correct Answer: B
Rationale: Feverfew can cause allergic reactions in individuals allergic to chamomile, ragweed, or yarrow, making this critical to prevent serious reactions. Anxiety, GI effects, or NSAID interactions are less urgent.
A female client who is starting a new prescription for doxycycline hyclate tells the nurse that she takes birth control pills. Which action should the nurse take?
- A. Instruct the client to take the two medications at least two hours apart.
- B. Advise the client that the birth control pills will be less effective while taking doxycycline hyclate.
- C. Notify the healthcare provider of the contraindication to tetracyclines.
- D. Encourage the client to stop taking birth control pills until she has finished taking all the doxycycline hyclate.
Correct Answer: B
Rationale: Doxycycline can reduce birth control pill effectiveness, requiring additional contraception. Timing separation, contraindication notification, or stopping birth control are incorrect actions.
A client receives a prescription for a secondary infusion of IV erythromycin 1 gram in 200 mL dextrose 5% in water (D5W) to be infused in 90 minutes. The nurse should program the infusion pump to deliver how many mL/hour? (Enter the numerical value only. If rounding is required, round to the nearest whole number.)
Correct Answer: 133
Rationale: Volume = 200 mL, Time = 90 minutes = 1.5 hours. Infusion rate = 200 mL / 1.5 hours = 133.33 mL/hr, rounded to 133 mL/hr.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
- A. Stores the medication at room temperature.
- B. Primes the inhaler with 7 pumps.
- C. Attaches spacer device to the inhaler.
- D. Rinses the mouth after each use.
Correct Answer: B
Rationale: Priming an ipratropium inhaler with 7 pumps is excessive; typically, 2–3 pumps are needed if unused for a period. Room temperature storage, spacer use, and mouth rinsing are correct practices.
Based on a client's serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?
- A. Give digoxin by another route to slow absorption.
- B. Begin cardioversion to stabilize heart rhythm.
- C. Administer potassium to stabilize the heart rate.
- D. Check acid-base and electrolyte values.
Correct Answer: D
Rationale: Checking acid-base and electrolyte values is critical to manage digoxin toxicity, as imbalances like hypokalemia exacerbate toxicity. Changing routes, cardioversion, or potassium administration are not immediate actions without further assessment.