Nursing Elites

1. A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the onset of action of the insulin at which of the following times?

• A. 0745
• B. 0700
• C. 0645
• D. 0457

Correct answer: A

Rationale: Insulin glulisine has a rapid onset of action, typically around 15 minutes. Therefore, the nurse should expect the onset around 0745. Choice A is correct as it aligns with the expected onset time. Choices B, C, and D are incorrect as they do not match the typical onset time of insulin glulisine.

2. A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number)

• A. 5 mL
• B. 6 mL
• C. 4 mL
• D. 7 mL

Correct answer: A

Rationale: To calculate the amount of amoxicillin in mL needed per dose, we can use the formula: 50 mg/mL = 250 mg / X mL. Cross multiply to solve for X: 50X = 250. Divide both sides by 50 to find X, which equals 5 mL per dose. Therefore, the nurse should administer 5 mL of amoxicillin per dose. Choice B, 6 mL, is incorrect as it does not match the calculated result. Choice C, 4 mL, is incorrect as it is too low based on the calculation. Choice D, 7 mL, is incorrect as it is too high based on the calculation.

3. A client with a seizure disorder has a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply)

• A. PTT
• B. Aspartate aminotransferase (AST)
• C. Alanine aminotransferase (ALT)
• D. All of the Above

Correct answer: D

Rationale: The correct answer is D, 'All of the Above.' Valproic acid can impact liver function and coagulation. Monitoring the Prothrombin Time (PTT), Aspartate Aminotransferase (AST), and Alanine Aminotransferase (ALT) is crucial. PTT is monitored to assess coagulation status, while AST and ALT are liver enzymes that indicate liver function. Monitoring these values helps detect any potential adverse effects of valproic acid on the liver and blood clotting. Choices A, B, and C are incorrect because each of these laboratory values plays a critical role in evaluating the client's response to valproic acid therapy and detecting associated complications.

4. A nurse is preparing to administer heparin 8,000 units subcutaneously every eight hours. The amount available is heparin injection 10,000 units/mL. How many milliliters should the nurse administer per dose? (Round the answer to the nearest tenth)

• A. 0.8 mL
• B. 0.9 mL
• C. 10.0 mL
• D. 98.0 mL

Correct answer: A

Rationale: To determine the volume of heparin to administer per dose, divide the prescribed dose (8,000 units) by the concentration of heparin available (10,000 units/mL). 8000 units / 10000 units/mL = 0.8 mL. Therefore, the nurse should administer 0.8 mL per dose. Choice B, 0.9 mL, is incorrect as the correct calculation results in 0.8 mL. Choices C and D are significantly higher and incorrect, indicating an inaccurate calculation.

5. When administering subcutaneous epinephrine for a client experiencing anaphylaxis, what adverse effect should the nurse monitor for?

• A. Hypotension
• B. Hyperthermia
• C. Hypoglycemia
• D. Tachycardia

Correct answer: D

Rationale: The correct adverse effect to monitor for when administering subcutaneous epinephrine for anaphylaxis is tachycardia. Epinephrine stimulates adrenergic receptors, leading to an increased heart rate (tachycardia). Hypotension (Choice A) is less likely due to the vasoconstrictive effects of epinephrine. Hyperthermia (Choice B) and hypoglycemia (Choice C) are not commonly associated with epinephrine administration for anaphylaxis.

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