Mr. Johnson received his first dose of Lente insulin at 7:30 A.M. When should he be observed for signs of hypoglycemia?

Correct Answer: B

Rationale: Rationale: The correct answer is B) 4-6 P.M. because Lente insulin typically peaks around 4-12 hours after administration. Since Mr. Johnson received his dose at 7:30 A.M., the time frame of 4-6 P.M. aligns with when he is most likely to experience hypoglycemia due to the peak action of the insulin. Monitoring during this window allows for timely intervention if his blood sugar drops too low. Option A) 10-11 A.M. is too soon after the dose for hypoglycemia to typically occur as Lente insulin does not peak this early. Option C) between 2 A.M. and breakfast is incorrect as it does not coincide with the expected peak action time of Lente insulin. Option D) immediately after the injection is also incorrect as hypoglycemia is not an immediate risk with Lente insulin but rather occurs later due to its slower onset and longer duration of action. Educationally, understanding the timing of insulin action is crucial for healthcare providers to ensure patient safety and effective management of diabetes. By knowing when to expect peak effects and potential side effects like hypoglycemia, healthcare professionals can provide appropriate care and support to patients like Mr. Johnson.

Correct Answer: B

Rationale: The correct answer is B) Levothyroxine taken orally daily. This medication is the standard treatment for hypothyroidism as it replaces the deficient thyroid hormone in the body. Levothyroxine helps to regulate metabolism, energy levels, and overall body functions in individuals with an underactive thyroid gland. Option A) Testosterone gel applied daily is incorrect as it is used to treat low testosterone levels, not hypothyroidism. Option C) Rapid-acting insulin injections taken with food are for managing diabetes, not hypothyroidism. Option D) Propranolol taken daily until symptoms resolve is a beta-blocker used to manage symptoms like rapid heart rate and tremors in hyperthyroidism, not for treating hypothyroidism. In an educational context, it is crucial for healthcare providers to have a solid understanding of the appropriate medications for different endocrine disorders. Patient education is essential in ensuring medication adherence and optimal treatment outcomes. Understanding the rationale behind specific medication choices empowers healthcare providers to provide accurate information to patients like Anthony, thereby enhancing patient understanding and compliance with their treatment plans.

Correct Answer: C

Rationale: Rationale: The correct answer is C) Insulin. Insulin is indeed the hormone released by beta islet cells in the pancreas. It plays a crucial role in regulating blood glucose levels by promoting the uptake of glucose into cells for energy production or storage. Option A) Progesterone is a female sex hormone produced mainly in the ovaries and plays a role in the menstrual cycle and pregnancy. It is not produced by the pancreas. Option B) Glucagon is another hormone produced in the pancreas by alpha islet cells. Unlike insulin, glucagon acts to increase blood glucose levels by stimulating the liver to release stored glucose into the bloodstream. Option D) Parathormone, also known as parathyroid hormone, is released by the parathyroid glands and regulates calcium levels in the blood, not glucose levels. In an educational context, understanding the hormones of the endocrine system is vital for healthcare professionals like nurses to effectively manage conditions like diabetes. Knowing which hormone is responsible for lowering blood glucose levels (insulin) and which one raises it (glucagon) is essential for providing proper care to patients with diabetes. This knowledge helps in medication administration, patient education, and overall disease management.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Check the apical pulse, blood pressure, and temperature every 4 hours. This task can be delegated to an experienced certified nursing assistant (CNA) because it involves routine monitoring of vital signs, which is within the scope of practice for a CNA and does not require advanced medical knowledge. Option A instructing the patient to report symptoms is important but should be done by a licensed healthcare provider who can interpret these symptoms in the context of the patient's condition. Option C involves drawing blood for hormone levels, which requires specific training and should be done by a phlebotomist or a nurse. Option D explaining medication side effects should be done by a nurse or provider who can provide comprehensive information and answer questions. Educationally, it's important to understand delegation in healthcare settings. Delegating tasks appropriately ensures that each team member works within their scope of practice, optimizing efficiency and patient care. It's crucial to recognize the competencies of different healthcare professionals and assign tasks accordingly to promote safe and effective patient management.

Correct Answer: B

Rationale: Assigning the 58-year-old diabetic with peripheral neuropathy and cellulitis of the left ankle (Option B) to the new nurse is the most appropriate choice. This patient's condition is stable and requires routine wound care and monitoring. It provides an opportunity for the new nurse to practice essential nursing skills like wound dressing changes, assessing neurovascular status, and administering medications for pain and infection. Option A should be avoided as the patient is showing signs of a medical emergency, hyperglycemia with mental status changes and rapid, deep breathing, requiring immediate intervention beyond the scope of a new nurse. Option C involves a patient who has just undergone major surgery and needs close monitoring, making it unsuitable for a new nurse. Option D presents a patient with diabetic ketoacidosis requiring intensive management and swift decision-making skills, which may overwhelm a new nurse. This scenario teaches the importance of appropriate patient assignment based on acuity and complexity, ensuring new nurses can build their confidence and competence gradually while providing safe and effective care. It emphasizes the significance of matching patient needs with the skill level and experience of the nurse for optimal patient outcomes.