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. What instruction should be included in the client's teaching plan when prescribed montelukast (Singulair) for asthma?

• A. Take the medication as needed for asthma attacks.
• B. Take the medication in the evening.
• C. Increase fluid intake while taking this medication.
• D. Use the medication before exercise.

Correct answer: B

Rationale: The correct instruction to include in the teaching plan for a client prescribed montelukast (Singulair) is to take the medication in the evening. Montelukast is most effective when taken in the evening to provide optimal control of asthma symptoms. It is not intended for use as a rescue medication for asthma attacks. There is no specific recommendation to increase fluid intake or use the medication before exercise in relation to montelukast therapy.

3. A client is prescribed allopurinol (Zyloprim) for chronic gout. Which instruction should the nurse include in the teaching plan?

• A. Take the medication with a full glass of water.
• B. Increase your intake of purine-rich foods.
• C. Stop taking the medication if you experience a gout attack.
• D. Take the medication with or without food.

Correct answer: A

Rationale: The correct instruction for a client prescribed allopurinol (Zyloprim) for chronic gout is to take the medication with a full glass of water. This helps prevent kidney stones which can be a side effect of the medication. It is important for the client to avoid purine-rich foods to help manage gout symptoms. They should continue taking the medication even during a gout attack as prescribed by the healthcare provider. Allopurinol can be taken with or without food, so there is no need to take it on an empty stomach. Therefore, option A is the correct choice. Options B, C, and D are incorrect as increasing purine-rich foods is not recommended, stopping the medication during a gout attack is not advised, and allopurinol can be taken with or without food.

4. After administering acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer, the nurse should have which item available for potential use?

• A. Ambu bag
• B. Intubation tray
• C. Nasogastric tube
• D. Suction equipment

Correct answer: D

Rationale: Acetylcysteine is administered via inhalation as a mucolytic. It helps liquefy secretions, making it easier for the client to clear them. However, in some cases, the increased volume of liquefied secretions may be challenging for the client to manage, leading to the potential need for suction equipment to assist in clearing the airway. Therefore, the nurse should have suction equipment available after administering acetylcysteine to address any issues related to excessive secretions.

5. Meperidine hydrochloride (Demerol) is prescribed for a client with pain. Which of the following would the nurse monitor for as a side effect of this medication?

• A. Diarrhea
• B. Bradycardia
• C. Hypertension
• D. Urinary retention

Correct answer: D

Rationale: Meperidine hydrochloride (Demerol) is an opioid analgesic that can cause various side effects. Common side effects include respiratory depression, orthostatic hypotension, tachycardia, drowsiness, constipation, and urinary retention. Diarrhea is not a common side effect of Meperidine hydrochloride. Bradycardia and hypertension are not typically associated with this medication. Therefore, the nurse should monitor for urinary retention as a potential side effect of Meperidine hydrochloride.

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