Nursing Elites

1. Which of the following types of insulin is classified as 'long-acting'?

• A. Lispro (Humalog)
• B. NPH (Humulin N)
• C. Regular insulin (Humulin R)
• D. Glargine (Lantus)

Correct answer: D

Rationale: The correct answer is Glargine (Lantus). Glargine is classified as a long-acting insulin due to its slow, steady release over an extended period, making it suitable for basal insulin requirements. It has a duration of action that can last up to 24 hours, helping to maintain stable blood sugar levels throughout the day. Lispro (Humalog) is a rapid-acting insulin, NPH (Humulin N) is an intermediate-acting insulin, and Regular insulin (Humulin R) is a short-acting insulin, so they are not classified as long-acting insulins.

2. A client is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should be administered to suppress normal flora in the GI tract?

• A. Kanamycin
• B. Gentamicin
• C. Neomycin
• D. Tobramycin

Correct answer: C

Rationale: The correct answer is C: Neomycin. Neomycin, an aminoglycoside antibiotic, is administered orally before GI surgery to eliminate the normal flora in the large intestine. This helps reduce the risk of postoperative infections by decreasing the bacterial load in the gut. Choices A, B, and D (Kanamycin, Gentamicin, Tobramycin) are not typically used to suppress normal flora in the GI tract before colorectal surgery.

3. What is one therapeutic use for nitroglycerin?

• A. Relief or prevention of anginal attacks
• B. Diuresis and mobilization of excess fluid
• C. Decreasing nausea and vomiting
• D. Relief of anxiety

Correct answer: A

Rationale: Nitroglycerin is primarily used for the relief or prevention of anginal attacks. It works by dilating blood vessels, increasing blood flow and oxygen to the heart muscle, thereby relieving chest pain caused by angina. The medication is not indicated for diuresis, antiemetic effects, or anxiety relief. Therefore, choices B, C, and D are incorrect as they do not reflect the therapeutic use of nitroglycerin.

4. A client has a new prescription for a Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

• A. Remove the patch each evening.
• B. Do not cut the patch in half even if angina attacks are under control.
• C. Remove the nitroglycerin patch for 30 minutes if a headache occurs.
• D. Apply a new patch every 48 hours.

Correct answer: A

Rationale: The correct instruction for a client using a Nitroglycerin transdermal patch is to remove the patch each evening to prevent tolerance. This allows for a nitrate-free period of 10 to 12 hours during each 24-hour period, reducing the risk of developing tolerance to the medication. Choice B is incorrect because cutting the patch could alter the dose delivery and is not recommended. Choice C is incorrect as removing the patch for 30 minutes when a headache occurs may not be effective in managing symptoms. Choice D is incorrect as Nitroglycerin patches are usually applied once daily, not every 48 hours.

5. A healthcare provider is caring for a group of clients who are not protected against Varicella. The healthcare provider should prepare to administer the Varicella vaccine at this time to which of the following clients?

• A. 24-year-old woman in the third trimester of pregnancy
• B. 12-year-old child who has a severe allergy to neomycin
• C. 2-month-old infant who has no health problems
• D. 32-year-old man who has essential hypertension

Correct answer: D

Rationale: The correct answer is the 32-year-old man who has essential hypertension. Individuals who did not receive two doses of the varicella vaccine earlier in life should be immunized. Essential hypertension is not a contraindication for this vaccine, making it safe to administer to this client. Choice A is incorrect because administering the Varicella vaccine is contraindicated during pregnancy due to the risk of transmission to the fetus. Choice B is incorrect because a severe allergy to neomycin is a contraindication to the Varicella vaccine, which contains a trace amount of neomycin. Choice C is incorrect because the Varicella vaccine is not recommended for infants under 12 months of age.

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