Nokea
The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consumed their breakfast at 7:30 AM. At what time is the client at an increased risk for a hypoglycemic reaction?
- A. 8:30 to 11:30 AM
- B. 3:30 to 7:30 PM
- C. 9:30 PM to midnight
- D. 1:00 to 5:00 AM
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
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During a home visit, a client with a history of angina reports frequent headaches. The client recently started a new prescription for diltiazem, a calcium channel blocker. What action should the nurse take?
- A. Explain the importance of obtaining a blood sample promptly to test for medication toxicity
- B. Consult with the healthcare provider regarding the necessity of an opioid analgesic for pain relief
- C. Recommend the client to discontinue the medication until contacting the healthcare provider
- D. Instruct the client on the use of acetaminophen every 4-6 hours as needed for headaches
Correct Answer: D
Rationale: The correct action for the nurse to take is to instruct the client to use acetaminophen for headaches. Acetaminophen is a suitable and safer option for managing headaches associated with calcium channel blockers like diltiazem. It is essential to avoid medications that can interact negatively with diltiazem, such as opioid analgesics, and to not discontinue the medication abruptly without consulting the healthcare provider. Monitoring for medication toxicity through blood samples is not typically indicated for managing headaches in this scenario.
A client with type 2 diabetes mellitus is prescribed semaglutide. The nurse should monitor for which potential adverse effect?
- A. Nausea
- B. Hypoglycemia
- C. Hyperglycemia
- D. Pancreatitis
Correct Answer: A
Rationale: The correct answer is A: Nausea. Semaglutide, a medication used to treat type 2 diabetes, is known to cause nausea as a potential adverse effect. It is important for the nurse to monitor the client for gastrointestinal symptoms, including nausea, after initiating treatment with semaglutide. While hypoglycemia and hyperglycemia are common concerns in diabetes management, they are not the primary adverse effects associated with semaglutide. Pancreatitis is a serious but rare adverse effect of GLP-1 receptor agonists like semaglutide, which should also be monitored for, but nausea is a more common and immediate concern.
The healthcare provider notes that a client has a new prescription for 20 mEq of potassium, IV site is inflamed but not tender, and has a blood flashback. What action should the healthcare provider take?
- A. Obtain a liter of normal saline with 20 mEq of KCl
- B. Contact the healthcare provider to clarify the prescription
- C. Withhold the prescription medication until a new IV is started
- D. Fax the prescription to the pharmacy for immediate dispensing
Correct Answer: B
Rationale: The healthcare provider should contact the prescriber to clarify the prescription because an inflamed IV site may indicate potential issues with administering the medication. It is important to ensure that the prescription is appropriate and safe for the client before proceeding with administration.
A client with rheumatoid arthritis is prescribed sulfasalazine. Which instruction should the nurse include in the client's teaching plan?
- A. Take this medication with meals.
- B. Avoid sunlight while taking this medication.
- C. Report any signs of infection to the healthcare provider.
- D. Take this medication on an empty stomach.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
After receiving the third dose of a new oral anticoagulant prescription, which action should the nurse implement? Select all that apply.
- A. Notify the healthcare provider of the finding
- B. Provide a PRN NSAID for gum discomfort
- C. Review the most recent coagulation lab values
- D. Complete a medication variance report
Correct Answer: C
Rationale: Reviewing the most recent coagulation lab values is crucial after receiving multiple doses of a new oral anticoagulant to ensure the patient is within the desired therapeutic range and to prevent adverse events related to over or under-anticoagulation. Notifying the healthcare provider of any concerning findings is important, but it may not be the immediate priority after receiving the third dose. Providing a PRN NSAID for gum discomfort is not typically indicated with oral anticoagulant therapy, as it may increase the risk of bleeding. Completing a medication variance report is more relevant in cases of medication errors or discrepancies, which may not apply in this scenario.