The home care nurse cares for a client diagnosed with type 1 diabetes. The client receives insulin therapy in a 4-dose protocol. The client injects rapid-acting insulin subcutaneously at 11:45. The nurse knows the peak action of rapid acting insulin occurs at which time?
1245 to 1345 (one hour after)
The nurse on the medical unit expects which medication to be administered to the client newly diagnosed with type 2 diabetes mellitus who is experiencing hyperglycemia?
Glipizide
The home care nurse visits a client and learns the health care provider has prescribed methotrexate. The nurse knows that methotrexate is used to treat which conditions?
cancer, arthritis, and psoriasis
The nurse cares for a client receiving intermittent infusion of ceftriaxone IV. Prior to administering the next dose, the health care provider orders 10 units heparin IV. The nurse understands the heparin is ordered for which reason?
Maintain the patency of the IV
heparin
an anticoagulant used to prevent or treat thromboemvolic disorders; low dose of heparin (heparin flush) used to keep IV patent; solution is dilute and will not cause systemic anticoagulation effects
The client has filled a prescription for dorzolamide for newly diagnosed glaucoma. The nurse knows the client needs additional education if the client makes which statement?
Although I had a reaction to sulfa medications, I don’t need to worry about eye drops.
The nurse assesses a client taking the contraceptive norgestrel. It is most important for the nurse to follow up on which client statement?
“My ankles and feet are swelling.”
The nurse observes another nurse administer a parenteral injection. The nurse pulls the client’s skin to one side and holds the skin, inserts the needle at a 90 degree angle, injects the medication, withdraws the needle, and releases the skin. The nurse is using which technique to administer the medication?
Z-track injection (prevents medication from leaking into subcutaneous tissue; after drawing up medication, replace first needle with another needle; iron dextran injected using Z-track method
The nurse cares for a client receiving carbamazepine. The nurse uunderstands that carbamazepine is administered for which disorders?
Diabetic neuropathy and trigeminal neuralgia
Carbamazepine
can lessen the pain of both diabetic neuropathy and trigeminal neuralgia. It is important to monitor intake and output, supervise ambulation, monitor CBC, take with meals, and wear protective clothing due to photosensitivity.
The nurse cares for an elderly client taking finasteride. The nurse instructs the client about possible adverse effects. The nurse knows the most likely adverse effect of finasteride includes which finding?
Decreased libido and impotence.
Finasteride
decreases the male hormone testosterone, so it sometimes does lessen the libido; impotence is also a possible adverse effect; acts to decrease size of prostate and decreases urinary symptoms
The nurse identifies which of the following medications is prescribed for patients diagnosed with hyperthyroidism
Levothyroxine sodium (Synthroid)
levothyroxine sodium
thyroid agent, most frequently used hormone replacement therapy in hypothyroidism; taken on a lifelong basis; hormone levels are monitored periodically to ensure correct dosage; side effects include nervousness, tremors, insomnia, tachycardia, dysrhythmias; excess doses produce symptoms of hyperthyroidism; monitor pulse and blood pressure; instruct patient to report chest pain, palpitations, sweating, or shortness of breath to physician
The healthcare provider orders gabapentin for a client reporting neuralgia. The client tells the nurse the client has difficulty swallowing pills. Which response is best?
“Open the capsule and sprinkle it in juice or on applesauce.”
The nurse understands that the similarities between a schedule I drug and a schedule V drug include which of the following?
Both schedule I drugs and schedule V drugs have some abuse potential.
The nurse plans to administer both regular and intermediate-acting insulin to a client diagnosed with type 1 diabetes. Which actions by the nurse reflect correct understanding of the proper administration procedure?
The nurse draws up the regular insulin first, then the intermediate-acting insulin.
An older client has been taking sustained-release nitroglycerin for several years. The client heard an advertisement for sildenafil and asks the nurse if there should be any concerns about taking both in the same day. Which response is best?
“Taking both together can result in hypotension, which could be fatal.”
The client has just been diagnosed with rheumatoid arthritis and the healthcare provider ordered prednisone. Which most important point does the nurse include when teaching the client about this medication?
The dose of prednisone must be increased and decreased gradually. (to minimize the reaction of the body to the sudden gain or loss of exogenous steroids)
The emergency department nurse is notified that a client is being brought in with a probable acetaminophen overdose. Which medication does the nurse prepare to administer?
Acetylcysteine
HCP prescribes promethazine for the client. The nurse knows that promethazine is prescribed for which situations?
Going on a cross-ocean cruise, having an elective operation, enhancing pain medication after surgery.
The nurse instructs a client receiving probenecid. Which statement most important?
“Drink at least eight glasses of water each day.”
probenecid
anti-gout medication that increases the excretion of uric acid
The nurse indicates a client diagnosed with bipolar disorder receiving lithium 300mg three times a day. The nurse determines that teaching is effective if the client makes which statement?
“I will eat a moderate amount of sodium”
The clinic nurse receives a phone call from a young adult whose sexual partner is being treated for trichomoniasis with metronidazole.
Prescribe metronidazole for the young adult
Phentermine is most prescribed for which clients?
obese
Which medication is used for the treatment of parkinson’s?
Trihexyphenidyl
Lamaze. Which response is best?
Depending on the medication and the trimester of pregnancy, appropriate choices can be made.
Carbonyl iron
Sit upright for 15 to 30 minutes after taking the medication. (Upright posture reduces likelihood of esophageal corrosion)
Minocycline
Client’s tongue
The nurse cares for the client receiving colestipol. The nurse encourages the client to ingest an adequate amount of which vitamins?
Vitamin A, D, and K
Pulmonary edema. Most important?
A toilet (with the oral form, diuresis is expected to start in an hour and peak over the next 2 hours; if IV, the onset is in 5 minutes and the peak is in half an hour, client needs easy access to a toilet, urinal
Atrial fibrillation receiving lisinopril. Which statement indicates need for further teaching?
“I have switched to a salt substitute instead of iodized salt.” (they should avoid both high-sodium and high-potassium foods; should use seasonings other than salt or salt substitute)
how many mL should the nurse administer for each dose?
4 mL
A client diagnosed with acute gout has been taking daily ibuprofen as prescribed for 4 weeks. The client tells the nurse that a ringing sound has developed in the ears. Which is the best interpretation by the nurse?
The client has signs of toxicity and should discontinue the medication until the health care provider is contacted.
The nurse cares for a client receiving intermittent infusion of ceftriaxone IV. Prior to administering the next does, the health care provider orders 10 units of heparin IV. The nurse understands the heparin is ordered for which reason?
Maintain the patency of the IV
The nurse cares for a client receiving colestipol. The nurse encourages the client to ingest an adequate amount of which vitamins?
Vitamin A Vitamin D Vitamin K
The nurse instructs a client diagnosed with atrial fibrillation receiving lisinopril. Which statement, if made by the client to the nurse, indicates the need for further teaching?
“I have to switch to a salt substitute instead of iodized salt.”
The nurse assesses a client who has been taking minocycline for acne for over a year. The nurse observes for signs of *Candida* superinfection by examining which part of the body?
The client’s tongue
The nurse observes another nurse administer a parenteral injection. The nurse pulls the client’s skin to one side and holds the skin, inserts the needle at a 90° angle, injects the medication, withdraws the needle, and releases the skin. The nurse is using which technique to administer the medication?
Z-track injection
The client has filled a prescription for dorzolamide for newly diagnosed glaucoma. The nurse knows the client needs additional education if the client makes which statement?
“Although I had a reaction to sulfa medications, I don’t need to worry about eye drops.”
The nurse cares for an elderly client taking finasteride. The nurse instructs the client about possible adverse effects. The nurse knows the *most* likely adverse effect of finasteride includes which finding?
Decreased libido and impotence
An older client has been taking sustained-release nitroglycerin for several years. The client heard an advertisement for sildenafil and ask the nurse if there should be any concerns about taking both in the same day. Which response by the nurse is *best*?
“Taking both together can result in hypotension, which could be fatal.”
The nurse plans to administer both regular and intermediate-acting insulin to a client diagnosed with type 1 diabetes. Which actions by the nurse reflect correct understanding of the proper administration procedure?
The nurse draws up the regular insulin first, then the intermediate-acting insulin.
The nurse instructs a group of pregnant clients about Lamaze techniques. During class, the nurse hears one participant tall another participant, “Taking medication during pregnancy is very risky, so you should stop taking the medication your health care provider prescribed.” Which response by the nurse is *best*?
“Depending on the medication and the trimester of pregnancy, appropriate choices can be made.”
The nurse on the medical unit expects which medication to be administered to the client newly diagnosed with type 2 diabetes mellitus who is experiencing hyperglycemia?
Glipizide
The nurse instructs a client diagnosed with bipolar disorder receiving lithium 300 mg three times a day. The nurse determines that the teaching is *effective* if the client makes which statement?
“I will eat a moderate amount of sodium.”
The health care provider orders cefaclor 10 mg/kg every 12 hours for a child weighing 44 lb. The medication comes in an oral suspension that contains 250 mg/5 mL. How many mL should the nurse administer for each dose?
4 ml 44/2.2= 20 20 x 10 = 200 (200mg/250mg) x 5 mL = 4mL
The nurse instructs a client receiving probenecid. It is *most* important for the nurse to make which statement?
“Drink at least eight glasses of water each day.”
The nurse identifies which medication is used for the treatment of Parkinson’s disease?
Trihexyphenidyl
The emergency department nurse is notified that a client is being brought in with a probable acetaminophen overdose. Which medication does the nurse prepare to administer?
Acetylcysteine.
The nurse assesses a client taking the contraceptive norgestrel. It is *most* important for the nurse to follow up on which statement?
“My ankles and feet are swelling.”
The nurse identifies which of the following medications is prescribed for patients diagnosed with hypothyroidism?
Levothyroxine sodium (Synthroid).
The nurse cares for a client receiving carbamazepine (Tegretol). The nurse understands that carbamazepine (Tegretol) is administered for which of the following diseases?
Diabetic neuropathy and trigeminal neuralgia.
The clinic nurse receives a phone call from a young adult whose sexual partner is being treated for trichomoniasis with metronidazole. The nurse expects the health care provider to make which recommendation?
Prescribe metronidazole for the young adult.
The nurse understands that the similarities between a Schedule I drug and a Schedule V drug include which of the following?
Both Schedule I drugs and Schedule V drugs have some abuse potential.
The nurse teaches a pregnant client about taking carbonyl iron. It is *most* important for the nurse to include which statement?
“Sit up right for 15 to 30 minutes after taking medication.”
A client has just been diagnosed with rheumatoid arthritis and the health care provider ordered prednisone. Which *most* important point does the nurse include when teaching the client about this medication?
The dose of prednisone must be increased and decrease gradually.
Th home care nurse cares for a client diagnosed with type 1 diabetes. The client injects rapid-acting insulin subcutaneously at 1145. The nurse knows the peak action of rapid-acting insulin occurs at which time?
1245 to 1345
The home care nurse visits a client and learns the health care provider has prescribes methotrexate. The nurse knows that methotrexate is used to treat which conditions?
Cancer, arthritis, and psoriasis
The health care provider orders gabapentin for a client reporting neuralgia. The client tells the nurse the client has difficulty swallowing pills. Which response by the nurse is *best*?
“Open the capsule and sprinkle it in juice or on applesauce.”
The nurse administers the initial dose of furosemide for a client diagnosed with pulmonary edema. It is *most* important for the nurse to provide the client with adequate access to which piece of equipment?
A toilet
The nurse understands the phentermine (Adipex-P) is most prescribed for which of the following clients?
A client who is obese
The health care provider prescribes promethazine for the client. The nurse know that promethazine is prescribed for which situations?
-Going on a cross-ocean cruise -Having an elective operation -Enhancing pain medication after surgery
A client diagnosed with acute gout has been taking daily ibuprofen as prescribed for four weeks. The client tells the nurse that a ringing sound has developed in the ears. Which is the *best* interpretation by the nurse?
The client has signs of toxicity and should discontinue the medication until the health care provider is contacted.
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