Nursing Elites

1. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?

• A. Withdraw ten units of regular insulin from a vial
• B. Withhold the dose until regular insulin is available
• C. Obtain a new vial of regular insulin and withhold
• D. Pull up 30 units from a vial but only administer 10 units

Correct answer: B

Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.

2. A client with diabetes mellitus type 2 is prescribed pioglitazone. The nurse should monitor for which potential adverse effect?

• A. Weight gain
• B. Liver toxicity
• C. Kidney stones
• D. Bone fractures

Correct answer: B

Rationale: The correct answer is B, liver toxicity. Pioglitazone is known to cause liver toxicity, so it is essential for the nurse to monitor the client's liver function while on this medication. Monitoring liver function tests can help detect any signs of liver damage early, allowing for timely intervention to prevent serious complications.

3. A client has sublingual nitroglycerine tablets prescribed to treat angina. The nurse realizes the client requires further education if the client makes which statements? (Select one that doesn't apply.)

• A. I will need to replace the nitroglycerine tablets every 3 to 5 months, not in a year.
• B. I should continue taking nitroglycerine tablets if I develop a headache.
• C. I understand nitroglycerine tablets do not cause addiction.
• D. If I feel dizzy when I take these, I should sit down or lie down until I feel better.

Correct answer: D

Rationale: The correct answer is D. Nitroglycerine sublingual tablets need to be replaced every 3 to 5 months, not every year, making statement A incorrect. While nitroglycerine can cause a headache, it is important to continue taking the prescribed nitroglycerine if the client has angina, making statement B accurate. Nitroglycerine tablets do not cause addiction, so statement C is correct. Dizziness and weakness are associated with the hypotensive effect of nitroglycerine; therefore, if the client feels dizzy when taking them, they should sit down or lie down until they feel better. Taking nitroglycerine tablets before an activity known to cause angina can help prevent angina attacks.

4. A client is prescribed phenytoin for the management of seizures. What instruction should the practical nurse provide to the client regarding this medication?

• A. Take the medication at the same time every day.
• B. Discontinue the medication if a rash develops.
• C. Avoid consuming dairy products.
• D. Monitor blood pressure regularly.

Correct answer: A

Rationale: The correct instruction the practical nurse should provide to the client regarding phenytoin is to take the medication at the same time every day. This consistency helps maintain a steady level of the medication in the bloodstream, which is crucial for effectively managing seizures. It is important for clients to adhere to their prescribed dosing schedule to optimize the therapeutic benefits of phenytoin. Choices B, C, and D are incorrect because discontinuing the medication without healthcare provider guidance can be dangerous, there is no specific interaction between phenytoin and dairy products, and monitoring blood pressure is not a primary concern with phenytoin therapy for seizures.

5. A practical nurse is reviewing the medication administration record for a client prescribed prednisone. What potential side effect should the nurse monitor for?

• A. Hypoglycemia
• B. Weight loss
• C. Hypertension
• D. Diarrhea

Correct answer: C

Rationale: Prednisone, a corticosteroid, can cause side effects such as hypertension, fluid retention, and weight gain. Hypertension is a common side effect of prednisone due to its impact on sodium and fluid retention in the body. Monitoring blood pressure is crucial to detect and manage hypertension in clients taking prednisone. Choices A, B, and D are incorrect. While prednisone can indirectly affect blood glucose levels, hypoglycemia is not a common side effect. Weight gain, not weight loss, is more prevalent with prednisone use. Diarrhea is not a typical side effect associated with prednisone.

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