A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?

Questions 68

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Pharmacology and the Nursing Process 9th Edition Test Bank Questions

Question 1 of 9

A client with diabetes mellitus must learn how to self-administer insulin. The physician has prescribed 10 U of U- 100 regular insulin and 35 U of 100-U isophane insulin suspension (NPH) to be taken before breakfast. When teaching the client how to select and rotate insulin injection sites, the nurse should provide which instruction?

Correct Answer: B

Rationale: The correct answer is B: “Rotate injection sites within the same anatomic region, not among different regions.” This instruction is important to prevent lipodystrophy and ensure consistent insulin absorption. Rotating sites within the same region helps maintain consistent insulin absorption rates and reduces the risk of developing scar tissue or fatty deposits. Injecting into healthy tissue with large blood vessels and nerves (choice A) can lead to inconsistent absorption. Administering insulin into areas of scar tissue or hypotrophy (choice C) can also disrupt absorption. Injecting into sites above muscles planned for exercise (choice D) can lead to unpredictable insulin absorption. Rotation within the same region optimizes insulin delivery and prevents complications.

Question 2 of 9

The nurse is observing a client receiving antiplatelet therapy for adverse reactions. Antiplatelet drugs most commonly produce which hypersensitivity reaction?

Correct Answer: C

Rationale: The correct answer is C: Bronchospasm. Antiplatelet drugs commonly cause hypersensitivity reactions like bronchospasm due to their effects on platelet function. They can trigger an allergic response leading to bronchoconstriction. Difficulty hearing (A) is not a common hypersensitivity reaction to antiplatelet therapy. Confusion (B) is more commonly associated with central nervous system effects rather than hypersensitivity reactions. Agranulocytosis (D) is a severe drop in white blood cells and is not typically a hypersensitivity reaction to antiplatelet drugs.

Question 3 of 9

Which of the ff actions should the nurse perform before a client with impaired physical mobility gets up?

Correct Answer: A

Rationale: The correct answer is A: Use parallel bars or a walker. Before a client with impaired physical mobility gets up, the nurse should provide assistive devices like parallel bars or a walker to ensure safe and supported ambulation. This helps prevent falls and promotes independence. Using incontinence pads (B) is not directly related to mobility. Applying an abdominal binder (C) is not necessary before the client gets up. Using a footboard (D) is more relevant for positioning in bed, not for assisting with ambulation.

Question 4 of 9

Correct method of mouth to mouth respiration is that the victim’s chin is held:

Correct Answer: D

Rationale: The correct answer is D (Downward) because it helps to maintain a clear airway for effective mouth-to-mouth respiration. By holding the victim's chin downward, you can ensure proper alignment of the airway, allowing the tongue to fall forward and prevent obstruction. Holding the chin forward (Choice A) may cause the airway to close, holding it backward (Choice B) may strain the neck, and holding it sideward (Choice C) may not provide optimal airway alignment. Holding the chin downward is the most effective and safe method for providing mouth-to-mouth respiration.

Question 5 of 9

Nursing measures in hemodynamic monitoring include assessing for localized ischemia owing to inadequate arterial flow. The nurse should:

Correct Answer: D

Rationale: The correct answer is D because assessing for localized ischemia involves evaluating multiple factors. A: Assessing color and temperature helps determine perfusion. B: Checking capillary refill assesses circulation. C: Evaluating pulse rate indicates cardiac output. Doing all of the above provides a comprehensive assessment of arterial flow and potential ischemia. Other choices are incorrect as they do not cover all aspects necessary for a thorough assessment.

Question 6 of 9

Which of the following immunoglobulins is first produced during an acute infection?

Correct Answer: C

Rationale: The correct answer is C: IgM. During an acute infection, the body's initial response is rapid and non-specific, leading to the production of IgM antibodies first. IgM is the first immunoglobulin class produced in response to a new antigen, providing immediate protection. IgG is produced later in the immune response and is responsible for long-term immunity. IgE is involved in allergic reactions and parasitic infections, not typically the first response to infection. IgD is primarily found on the surface of B cells and its function is not well understood in the context of acute infections.

Question 7 of 9

Which of the ff signs may be revealed by a visual examination in a client with tonsillar infection if group A streptococci is the cause?

Correct Answer: A

Rationale: The correct answer is A: White patches on the tonsils. Group A streptococci infection commonly presents with exudative tonsillitis, characterized by the presence of white patches or pus on the tonsils. This is due to the inflammatory response triggered by the bacteria. Hypertrophied tonsils (B), hemorrhage in the tonsils (C), and bleeding in the tonsils (D) are less likely to be visual signs of a streptococcal infection and are more indicative of other conditions or complications. Therefore, white patches on the tonsils are the most specific visual sign associated with group A streptococci tonsillar infection.

Question 8 of 9

The nurse is intervening for a family member with role strain. Which direct care nursing intervention is most appropriate?

Correct Answer: B

Rationale: The correct answer is B: Counseling about respite care options. This intervention is most appropriate as it addresses the issue of role strain by providing the family member with support and options for temporary relief from caregiving responsibilities. Respite care allows the family member to take a break and recharge, reducing stress and preventing burnout. A: Assisting with activities of daily living is important but may not directly address the underlying issue of role strain. C: Teaching range-of-motion exercises is beneficial for physical well-being but does not directly address the emotional and psychological impact of role strain. D: Consulting with a social worker may be helpful for additional support but may not provide immediate relief or practical solutions for the family member's role strain.

Question 9 of 9

The client with myasthenia gravis has become increasingly weaker. The physician prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or an increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Tensilon) is administered. Which of the following would indicate that the client is in cholinergic crisis?

Correct Answer: B

Rationale: The correct answer is B: An improvement of the weakness. Edrophonium is a short-acting cholinesterase inhibitor that helps differentiate between myasthenic and cholinergic crises in myasthenia gravis. In cholinergic crisis, there is an overdose of cholinesterase inhibitors leading to excessive acetylcholine at the neuromuscular junction, causing muscle weakness. Administering edrophonium will temporarily improve muscle weakness in cholinergic crisis due to the increased availability of acetylcholine. The other choices are incorrect because: A: No change suggests the client is not in cholinergic crisis. C: Complaints of muscle spasms are more indicative of myasthenic crisis. D: A temporary worsening of the condition is not expected in cholinergic crisis.

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