Nursing Elites

1. A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is:

• A. 2 to 4 hours after administration
• B. 4 to 12 hours after administration
• C. 16 to 18 hours after administration
• D. 18 to 24 hours after administration

Correct answer: B

Rationale: Humulin NPH is an intermediate-acting insulin with a peak action time of 4 to 12 hours after administration. During this period, the risk of hypoglycemic reactions is highest. It is important for the client to be aware of this timing to prevent, recognize, and manage hypoglycemia effectively.

2. The healthcare provider prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. What is the appropriate intervention for the nurse?

• A. Administer the medication within 60 minutes before the morning and evening meal.
• B. Withhold the medication and question the prescription with the healthcare provider.
• C. Monitor the client for gastrointestinal side effects after administration of the medication.
• D. Withdraw the insulin from the Penlet into an insulin syringe to prepare for administration.

Correct answer: B

Rationale: Exenatide (Byetta) is specifically indicated for the treatment of type 2 diabetes mellitus and is not recommended for clients with type 1 diabetes mellitus who are taking insulin. Choice A is incorrect because exenatide should not be administered to a client with type 1 diabetes mellitus who takes insulin. Choice C is not the most appropriate initial action when the prescription is not suitable for the client. Choice D is unrelated to the administration of exenatide. Therefore, the appropriate intervention for the nurse is to withhold the medication and question the prescription with the healthcare provider to ensure the safety and appropriateness of the treatment plan for the client.

3. The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value should the nurse specifically monitor during treatment with this medication?

• A. Clotting time
• B. Uric acid level
• C. Potassium level
• D. Blood glucose level

Correct answer: B

Rationale: The correct answer is B, Uric acid level. Busulfan can cause an increase in uric acid levels, leading to hyperuricemia, renal stones, and acute renal failure. Monitoring uric acid levels is crucial to detect and manage potential complications associated with busulfan therapy.

4. A client is prescribed amlodipine (Norvasc) for hypertension. Which side effect should the nurse instruct the client to report to the healthcare provider?

• A. Dizziness
• B. Constipation
• C. Peripheral edema
• D. Dry cough

Correct answer: C

Rationale: The correct answer is C, 'Peripheral edema.' Amlodipine (Norvasc) can cause peripheral edema, which is an accumulation of fluid in the extremities and should be reported to the healthcare provider. Dizziness and constipation are possible side effects of amlodipine but are generally less concerning. Dry cough is more commonly associated with ACE inhibitors, not calcium channel blockers like amlodipine.

5. The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?

• A. Constipation
• B. Abdominal pain
• C. An episode of diarrhea
• D. Hematest-positive nasogastric tube drainage

Correct answer: C

Rationale: Loperamide hydrochloride (Imodium) is an antidiarrheal medication commonly used to manage episodes of diarrhea. It works by slowing down gut movement and reducing the frequency of bowel movements. Loperamide is not indicated for constipation, abdominal pain, or hematest-positive nasogastric tube drainage. It is specifically useful in acute and chronic diarrhea, such as in cases of inflammatory bowel disease, to help control symptoms and decrease fluid loss.

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