Nursing Elites

1. Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

• A. Decreased urinary output
• B. Decreased blood pressure
• C. Decreased peripheral edema
• D. Decreased blood glucose level

Correct answer: A

Rationale: Desmopressin promotes renal conservation of water by increasing the permeability of kidney collecting ducts to water, resulting in decreased urinary output. Therefore, the therapeutic response expected after administering desmopressin for diabetes insipidus is a reduction in urinary output.

2. A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:

• A. 2 to 4 hours after administration
• B. 4 to 12 hours after administration
• C. 16 to 18 hours after administration
• D. 18 to 24 hours after administration

Correct answer: B

Rationale: Humulin NPH is an intermediate-acting insulin with a peak action time of 4 to 12 hours after administration. During this period, the risk of hypoglycemic reactions is highest. It is important for the client to be aware of this timing to prevent, recognize, and manage hypoglycemia effectively.

3. A client is taking phenytoin (Dilantin) for seizure control, and a sample for a serum drug level is drawn. Which of the following indicates a therapeutic serum drug range?

• A. 5 to 10 mcg/mL
• B. 10 to 20 mcg/mL
• C. 20 to 30 mcg/mL
• D. 30 to 40 mcg/mL

Correct answer: B

Rationale: The correct therapeutic serum drug level range for phenytoin (Dilantin) is 10 to 20 mcg/mL. This range is considered optimal for seizure control while minimizing the risk of toxicity. Monitoring drug levels helps ensure that the client is within the therapeutic range for effective treatment.

4. The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?

• A. Alopecia
• B. Chest pain
• C. Pulmonary fibrosis
• D. Orthostatic hypotension

Correct answer: D

Rationale: The correct answer is 'D: Orthostatic hypotension.' Etoposide is associated with orthostatic hypotension, a sudden drop in blood pressure that can occur when transitioning from lying down to standing up. It is important for the nurse to monitor the client's blood pressure during the infusion to detect and manage this potential side effect.

5. A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for:

• A. Pupillary changes
• B. Scattered lung wheezes
• C. Sudden increase in pain
• D. Sudden episodes of diarrhea

Correct answer: C

Rationale: Naloxone hydrochloride is an antidote to opioids and may be administered to postoperative clients to address respiratory depression. This medication can also reverse the effects of analgesics, potentially leading to a sudden increase in pain. Therefore, the nurse must assess the client for any unexpected rise in pain levels after naloxone administration. Choices A, B, and D are incorrect because pupillary changes, scattered lung wheezes, and sudden episodes of diarrhea are not typically associated with naloxone administration for respiratory depression.

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