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?

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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 physician orders furosemide (Lasix) 40 mg IV STAT for an acutely fluid-overloaded patient. Why was the IV route likely chosen?

Correct Answer: B

Rationale: The correct answer is B: IV is the route of choice for rapid administration. IV route allows for quick onset of action, crucial in acutely fluid-overloaded patients needing immediate diuresis. Option A is incorrect as furosemide can be given orally too. Option C is less relevant in this urgent situation where speed is key. Option D is also incorrect as the side effects are not determined by route of administration.

Question 3 of 9

Which of the following outcomes would indicate successful treatment of diabetes insipidus?

Correct Answer: A

Rationale: The correct answer is A: Fluid intake of less than 2,500mL. In diabetes insipidus, the body cannot properly regulate fluid balance, leading to excessive thirst and urination. Successful treatment aims to manage these symptoms by reducing fluid intake to prevent dehydration. Therefore, a decrease in fluid intake indicates successful treatment. Explanation for incorrect choices: B: Blood pressure of 90/50mmHg - Blood pressure is not directly related to the treatment of diabetes insipidus. C: Pulse rate of 126 beats/min - Pulse rate is not a specific indicator of successful treatment for diabetes insipidus. D: Urine output of more than 200mL/hour - In diabetes insipidus, excessive urine output is a symptom of the condition, so an increase in urine output does not indicate successful treatment.

Question 4 of 9

For the first 72 hours thyroidectomy surgery, the nurse would assess the client for Chvostek’s sign and Trousseau’s sign because they indicate which of the following?

Correct Answer: A

Rationale: The correct answer is A: Hypocalcemia. Chvostek's sign and Trousseau's sign are both indicators of hypocalcemia, which is a common complication following thyroidectomy surgery due to potential damage to the parathyroid glands. Chvostek's sign is elicited by tapping the facial nerve and observing facial muscle twitching, while Trousseau's sign involves carpal spasm induced by inflating a blood pressure cuff above systolic pressure. Both signs are sensitive indicators of hypocalcemia due to their association with neuromuscular irritability. Hypercalcemia (option C) and hyperkalemia (option D) are not typically associated with thyroidectomy surgery and would not present with these specific signs. Hypokalemia (option B) is not related to Chvostek's sign and Trousseau's sign.

Question 5 of 9

Which of the following tests would the nurse use as an initial screening test to determine hearing loss?

Correct Answer: D

Rationale: The correct answer is D: Whisper voice test. This test is used as an initial screening for hearing loss because it is simple, quick, and easily administered by a nurse. The nurse would whisper words or numbers at a specific distance from the patient to assess their ability to hear and repeat the whispered sounds accurately. This test provides a quick indication of potential hearing impairment. The other choices are incorrect: A: Romberg test assesses balance and not hearing. B: Caloric test evaluates the vestibular system, not hearing. C: Otoscopic examination is used to examine the ear canal and tympanic membrane, not to screen for hearing loss.

Question 6 of 9

Which action best demonstrates the nurse’s role in ensuring continuity of care during the evaluation phase?

Correct Answer: B

Rationale: The correct answer is B: Communicating the client’s progress to the interdisciplinary team. During the evaluation phase, the nurse plays a crucial role in ensuring continuity of care by effectively communicating the client’s progress to the interdisciplinary team. This action allows for collaborative decision-making based on the latest information, promotes coordination of care, and ensures that all team members are informed and involved in the client's care plan. Rewriting the care plan (A) is important but may not be the most immediate action during the evaluation phase. Reassessing the client (C) is valuable for gathering additional data but may not directly contribute to continuity of care during this phase. Providing emotional support (D) is essential but may not specifically address continuity of care during evaluation.

Question 7 of 9

A few minutes after beginning a blood transfusion, the nurse notes that the client has chills, dyspnea, and urticaria. The nurse reports this to the physician immediately because the client probably is experiencing which problem?

Correct Answer: A

Rationale: The correct answer is A: A hemolytic reaction to mismatched blood. Chills, dyspnea, and urticaria are indicative of a hemolytic transfusion reaction, which occurs when the recipient's immune system attacks the donor's red blood cells. This can lead to various symptoms, including fever, chills, difficulty breathing, and hives. This type of reaction is most commonly seen with mismatched blood types. Option B (A hemolytic reaction to Rh-incompatible blood) is incorrect because Rh incompatibility typically leads to hemolytic disease of the newborn, not an immediate transfusion reaction. Option C (A hemolytic allergic reaction caused by bacterial contamination of donor blood) is incorrect as bacterial contamination would present with symptoms such as fever and sepsis, not chills, dyspnea, and urticaria. Option D (None of the above) is incorrect as the symptoms presented align with a hemolytic transfusion reaction.

Question 8 of 9

The most effective pharmacologic agent for the treatment of Parkinson’s disease is:

Correct Answer: A

Rationale: The correct answer is A: Levodopa. Levodopa is the most effective pharmacologic agent for Parkinson's disease as it is converted to dopamine in the brain, replenishing dopamine levels which are depleted in Parkinson's. Selegiline and Symmetrel provide symptomatic relief but are not as effective as Levodopa. Permax is not commonly used due to its association with serious side effects like heart valve damage.

Question 9 of 9

Which nursing intervention is most appropriate for a client with multiple myeloma?

Correct Answer: D

Rationale: The correct answer is D: Preventing bone injury. In multiple myeloma, abnormal plasma cells can weaken bones, leading to fractures. Preventing bone injury involves educating the client on fall prevention, avoiding heavy lifting, and ensuring a safe environment. Monitoring respiratory status (A) is not the priority in multiple myeloma. Restricting fluid intake (B) is not directly related to managing multiple myeloma. Balancing rest and activity (C) is important for overall well-being but does not directly address the specific needs of a client with multiple myeloma.

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