Nursing Elites

1. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

2. A healthcare professional is preparing to administer a transfusion of a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

• A. Ensure that the client has a patent IV line before obtaining the blood product from the refrigerator.
• B. Obtain help from another healthcare professional to confirm the correct client and blood product.
• C. Take a complete set of vital signs before beginning the transfusion and periodically during the transfusion.
• D. Stay with the client for the first 15 to 30 minutes of the transfusion.

Correct answer: B

Rationale: Obtaining help from another healthcare professional to confirm the correct client and blood product is crucial in preventing an acute hemolytic reaction during a blood transfusion. This reaction occurs due to ABO or Rh incompatibility. Verifying the correct client and blood product reduces the risk of administering the wrong blood type, which could lead to a life-threatening reaction. Checking for patency of the IV line (Choice A) is important but does not directly prevent an acute hemolytic reaction. Monitoring vital signs (Choice C) is essential for detecting transfusion reactions but does not prevent them. Staying with the client (Choice D) is important for early recognition of adverse reactions but does not address the root cause of preventing an acute hemolytic reaction.

3. A client has a new prescription for Morphine to manage post-operative pain. Which of the following assessments should the nurse perform first?

• A. Urine output
• B. Bowel sounds
• C. Pain level
• D. Respiratory rate

Correct answer: D

Rationale: The nurse should prioritize assessing the client's respiratory rate first when administering Morphine due to the risk of respiratory depression, which is a life-threatening adverse effect of this medication. Monitoring the respiratory rate is crucial to detect any signs of respiratory distress early and take prompt action to ensure the client's safety. Assessing urine output, bowel sounds, and pain level are also important but not as critical as monitoring respiratory rate when initiating Morphine therapy.

4. A client has been prescribed Aspirin for prevention of cardiovascular disease. Which of the following findings indicates the medication is effective?

• A. The client has a decrease in troponin levels.
• B. The client has a regular heart rhythm.
• C. The client experiences a decrease in episodes of angina.
• D. The client's blood pressure remains stable.

Correct answer: C

Rationale: The correct answer is C. A decrease in episodes of angina is an indicator of Aspirin's effectiveness in preventing cardiovascular events. Aspirin works by inhibiting platelet aggregation, thereby reducing the formation of blood clots that could lead to angina episodes or more severe cardiovascular complications. Choices A, B, and D are incorrect because troponin levels, heart rhythm, and blood pressure are not direct indicators of Aspirin's effectiveness in preventing cardiovascular events.

5. A client is starting therapy with docetaxel. Which of the following findings should the nurse instruct the client to report?

• A. Flushing
• B. Dyspnea
• C. Hyperglycemia
• D. Tinnitus

Correct answer: B

Rationale: The correct answer is B: Dyspnea. The nurse should instruct the client to report dyspnea because it can indicate pulmonary toxicity, a severe adverse effect of docetaxel. Dyspnea may suggest a potential serious condition that needs prompt evaluation and intervention to prevent complications. Flushing (choice A) is more commonly associated with other medications or conditions and is not a common side effect of docetaxel. Hyperglycemia (choice C) and tinnitus (choice D) are also not typically associated with docetaxel therapy and are not priority findings that the nurse should instruct the client to report.

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