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Questions 164

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Extract:

Exhibit 1
Medication administration record

Allergies: No known drug allergies

Medication Time
Insulin NPH: 75 units subcutaneously, twice daily 0800, 2000
Insulin lispro: sliding scale dosing, before meals and at bedtime 0800, 1130, 1730, 2100

Exhibit 2
Laboratory results and reference ranges

Sodium
136-145 mEq/L
(136-145 mmol/L) 141 mEq/L
(141 mmol/L)
Potassium
3.5-5.0 mEq/L
(3.5-5.0 mmol/L) 3.0 mEq/L
(3.0 mmol/L)
Glucose (fasting)
70-110 mg/dL
(3.9-6.1 mmol/L) 328 mg/dL
(18.2 mmol/L)





Question 1 of 5

The nurse is preparing to administer medications scheduled for 0800 to a client with type 1 diabetes mellitus. After reviewing the client's morning laboratory test results, which of the following actions would be a priority for the nurse to take?

Correct Answer: B

Rationale: Abnormal lab results (e.g., severe hypo/hyperglycemia) require provider notification to adjust treatment. Administering insulin, checking ketones, or rechecking glucose are secondary without specific lab values.

Extract:


Question 2 of 5

The primary nursing diagnosis for a client with congestive heart failure with pulmonary edema is

Correct Answer: C

Rationale: Cardiac output altered: decreased. Increasing cardiac output is the primary goal of therapy, improving comfort and respiratory status.

Question 3 of 5

A registered nurse (RN) is assigned to work at the Poison Control Center telephone hotline. In which of these cases of childhood poisoning would the nurse suggest that parents have the child drink orange juice?

Correct Answer: A

Rationale: An 18 month-old who ate an undetermined amount of crystal drain cleaner. Orange juice is acidic and will help neutralize the alkaline drain cleaner.

Question 4 of 5

The home health hospice nurse visits a client who is newly prescribed extended-release oxycodone 40 mg orally, scheduled every 12 hours to treat severe chronic cancer pain. Which information is most important to reinforce to the client’s caregiver?

Correct Answer: A

Rationale: Around-the-clock dosing maintains pain control in cancer, preventing peaks and troughs. Combining with immediate-release opioids is common, dosage changes require provider orders, and tapering is less critical in terminal care.

Question 5 of 5

An adult is receiving cancer chemotherapy. Metoclopramide (Reglan) is also prescribed. The client asks why she is getting Reglan. How should the nurse respond?

Correct Answer: B

Rationale: Metoclopramide is an antiemetic, prescribed to prevent nausea and vomiting, common chemotherapy side effects, improving patient comfort.

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