Nursing Elites

1. What is the approximate duration of action for intermediate-acting insulins like NPH?

• A. 6-8 hours.
• B. 10-14 hours.
• C. 16-20 hours.
• D. 24-28 hours.

Correct answer: C

Rationale: The correct answer is C: '16-20 hours.' Intermediate-acting insulins like NPH typically have a duration of action of approximately 16-20 hours. This prolonged action makes them effective in managing blood glucose levels over an extended period. Choices A, B, and D are incorrect because they do not align with the typical duration of action for intermediate-acting insulins. Choice A (6-8 hours) is too short, choice B (10-14 hours) is also shorter than the typical duration, and choice D (24-28 hours) is too long for intermediate-acting insulins like NPH.

2. A client with hypothyroidism is prescribed levothyroxine. The nurse should teach the client to take this medication:

• A. With meals
• B. Before bedtime
• C. On an empty stomach in the morning
• D. With a glass of milk

Correct answer: C

Rationale: Levothyroxine should be taken on an empty stomach in the morning to enhance absorption and efficacy. Taking it with meals (Choice A) may interfere with absorption due to food interactions. Taking it before bedtime (Choice B) can lead to difficulties with absorption and may disrupt the sleep cycle. Consuming levothyroxine with a glass of milk (Choice D) is not recommended as calcium in milk can interfere with its absorption. Therefore, the best practice is to take levothyroxine on an empty stomach in the morning to ensure optimal effectiveness.

3. Following a unilateral adrenalectomy, Nurse Betty would assess for hyperkalemia indicated by which of the following signs?

• A. Muscle weakness
• B. Tremors
• C. Diaphoresis
• D. Constipation

Correct answer: A

Rationale: Muscle weakness is a classic manifestation of hyperkalemia, an elevated level of potassium in the blood. After an adrenalectomy, where one adrenal gland is removed, there may be a risk of hyperkalemia due to altered hormone regulation. Tremors (Choice B) are not typically associated with hyperkalemia but may be seen in conditions like hypocalcemia. Diaphoresis (Choice C) and constipation (Choice D) are not specific indicators of hyperkalemia. Diaphoresis is excessive sweating and constipation is a common gastrointestinal issue, neither directly related to potassium imbalances.

4. The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH). Which of the following interventions should the nurse implement?

• A. Encourage increased fluid intake
• B. Administer vasopressin
• C. Monitor for signs of dehydration
• D. Restrict oral fluids

Correct answer: D

Rationale: The correct intervention for a client with syndrome of inappropriate antidiuretic hormone (SIADH) is to restrict oral fluids. SIADH leads to excessive release of antidiuretic hormone (ADH), causing the body to retain water and diluting the sodium levels in the blood (hyponatremia). Restricting oral fluids helps prevent further water retention and worsening hyponatremia. Encouraging increased fluid intake (choice A) would exacerbate the problem by further diluting sodium levels. Administering vasopressin (choice B) is not indicated in SIADH, as the condition is characterized by excess ADH secretion. Monitoring for signs of dehydration (choice C) is not the priority in SIADH since the issue is water retention rather than dehydration.

5. A client with type 2 diabetes mellitus is taking metformin. The nurse should monitor the client for which of the following potential side effects?

• A. Lactic acidosis
• B. Hypokalemia
• C. Hyperglycemia
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Lactic acidosis. Metformin, a common medication for type 2 diabetes mellitus, can lead to lactic acidosis, particularly in individuals with renal impairment or other predisposing factors. Monitoring for signs and symptoms of lactic acidosis, such as muscle pain, weakness, trouble breathing, dizziness, and slow or irregular heartbeat, is crucial when a client is taking metformin. Choice B, hypokalemia, is not a common side effect of metformin. Choice C, hyperglycemia, is contrary to the intended effect of metformin, which is to lower blood glucose levels. Choice D, weight gain, is not typically associated with metformin use; in fact, metformin may even contribute to weight loss in some individuals.

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