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A client recently diagnosed with insulin-dependent diabetes mellitus (IDDM). As part of the treatment plan, the client receives Humulin N 32 units and Humulin R 8 units each morning.
Which of the following actions, if performed by the client while preparing the morning insulin injection, would require an intervention by the nurse?
- A. After the client draws up 8 units of Humulin R, she adds Humulin N to the syringe for a total of 40 units.
- B. The client draws up 32 units of the clear insulin followed by 8 units of cloudy insulin for a total of 40 units.
- C. Initially, the client injects air into the Humulin N vial without drawing up any insulin.
- D. The client injects air into each bottle of insulin equal to the amount of insulin to be withdrawn.
Correct Answer: B
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) clear insulin always drawn up first (2) correct-Humulin R is clear and drawn up first, only 8 units are ordered, Humulin N is cloudy (3) allows you to withdraw medication later (4) allows you to withdraw medication later
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The nurse is caring for a client who has a cervical radioactive implant. Which action is not appropriate for the nurse when caring for this client?
- A. Post a radioactive symbol on the client's chart and on the door to the room.
- B. Put on gloves to remove any radioactive implant that may have come out.
- C. Wash hands with soap and water after caring for the client.
- D. Limit the amount of time with the client.
Correct Answer: B
Rationale: Removing a radioactive implant requires specialized handling, not just gloves, to avoid exposure, making this action inappropriate.
The nurse is teaching a group of college students about breast self-examination. A woman asks for the best time to perform the monthly exam. What is the best reply by the nurse?
- A. The first of every month, because it is easiest to remember'
- B. Right after the period, when your breasts are less tender'
- C. Do the exam at the same time every month'
- D. Ovulation, or mid-cycle is the best time to detect changes'
Correct Answer: B
Rationale: The best time for a breast self-exam (BSE) is a week after a menstrual cycle, when the breasts are no longer swollen and tender due to hormone elevation.
The physician prescribes sulfisoxazole (Gantrisin) 2 g PO qid for a client. Which of the following instructions is MOST important for the nurse to include when teaching the client about this medication?
- A. Drink plenty of fluids.
- B. Wear sunscreen when outdoors.
- C. Eliminate dairy products from your diet.
- D. Take this medication with meals.
Correct Answer: A
Rationale: Sulfisoxazole can cause crystalluria; adequate fluid intake prevents kidney stones. Options B, C, and D are less critical or incorrect.
The nurse is caring for a client receiving intravenous nitroglycerin for acute angina. What is the most important assessment during treatment?
- A. Heart rate
- B. Neurologic status
- C. Urine output
- D. Blood pressure
Correct Answer: D
Rationale: The vasodilatation that occurs as a result of this medication can cause profound hypotension. The client's blood pressure must be evaluated every 15 minutes until stable and then every 30 minutes to every hour.
The nurse is to perform a routine blood glucose check on a diabetic client before administering insulin. Which action is correct?
- A. Puncture the end of the thumb in the middle of the fleshy part.
- B. Puncture the end of the finger on the side.
- C. Draw blood from the antecubital vein in the arm.
- D. Puncture the finger and collect the blood in a vial.
Correct Answer: B
Rationale: Puncturing the finger's side avoids nerve-rich areas, ensuring accurate and less painful glucose testing.