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. A healthcare professional prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the professional reviews the action of the medication and understands that it:

• A. Releases bicarbonate in exchange for primarily sodium ions
• B. Releases sodium ions in exchange for primarily potassium ions
• C. Releases potassium ions in exchange for primarily sodium ions
• D. Releases sodium ions in exchange for primarily bicarbonate ions

Correct answer: B

Rationale: Sodium polystyrene sulfonate, such as Kayexalate, is a cation exchange resin that functions by releasing sodium ions in exchange for primarily potassium ions. This medication is commonly used to treat hyperkalemia, a condition characterized by elevated levels of potassium in the blood.

3. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium (Spiriva). Which instruction should the nurse include in the teaching plan?

• A. Use the medication as a rescue inhaler.
• B. Rinse your mouth after using the inhaler.
• C. Take the medication on an empty stomach.
• D. Take the medication with a full glass of water.

Correct answer: B

Rationale: Tiotropium (Spiriva) is not a rescue inhaler but a maintenance medication for COPD. The correct instruction for the nurse to include in the teaching plan is to advise the client to rinse their mouth after using the inhaler. This practice helps prevent dry mouth and throat irritation, common side effects of tiotropium. There are no specific recommendations to take tiotropium on an empty stomach or with a full glass of water.

4. A client is receiving furosemide (Lasix) and is being discharged. What should the nurse include in the teaching plan?

• A. Consume potassium-rich foods.
• B. Take the medication in the morning.
• C. Change positions slowly to prevent dizziness.
• D. Maintain an adequate fluid intake.

Correct answer: C

Rationale: The correct answer is to instruct the client to change positions slowly to prevent dizziness. Furosemide (Lasix) is a diuretic that can lead to orthostatic hypotension, causing dizziness. Consuming potassium-rich foods is essential to prevent hypokalemia when taking furosemide. Taking the medication in the morning helps reduce the need for frequent urination at night. Encouraging the client to maintain an adequate fluid intake is crucial to prevent dehydration while on this medication.

5. A child is hospitalized with a diagnosis of lead poisoning. The healthcare provider assisting in caring for the child would prepare to assist in administering which of the following medications?

• A. Activated charcoal
• B. Sodium bicarbonate
• C. Syrup of ipecac
• D. Dimercaprol (BAL in Oil)

Correct answer: D

Rationale: Dimercaprol (BAL in Oil) is a chelating agent indicated for lead poisoning. It works by binding to lead and facilitating its removal from the body. Activated charcoal is used for certain types of poisoning by adsorbing toxins, while sodium bicarbonate can be used to treat acidosis. Syrup of ipecac is no longer recommended for poison treatment due to potential risks.

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