Nursing Elites

1. A client with type 2 Diabetes Mellitus is starting Repaglinide. Which statement by the client indicates understanding of the administration of this medication?

• A. I'll take this medicine with my meals.
• B. I'll take this medicine 30 minutes before I eat.
• C. I'll take this medicine just before I go to bed.
• D. I'll take this medicine as soon as I wake up in the morning.

Correct answer: B

Rationale: The correct answer is B. Repaglinide causes a rapid, short-lived release of insulin. It is crucial for the client to take this medication 15-30 minutes before each meal to synchronize the peak insulin availability with mealtime glucose elevation, maximizing its effectiveness in controlling blood sugar levels. Choice A is incorrect because taking the medicine with meals may not optimize its action. Choice C is incorrect as taking the medicine before going to bed is not in line with its mechanism of action. Choice D is incorrect as taking the medicine upon waking up does not coincide with mealtime glucose elevation.

2. What nursing interventions should you perform when a patient is on Albuterol? (Select all that apply)

• A. Assess lung sounds, pulse, and blood pressure before administering
• B. Monitor for changes in behavior
• C. Observe for paradoxical bronchospasms
• D. Both A and C

Correct answer: D

Rationale: The correct nursing interventions to perform when a patient is on Albuterol include assessing the patient's lung sounds, pulse, and blood pressure before administering the medication to monitor for cardiovascular side effects like increased heart rate. Additionally, it is crucial to observe for paradoxical bronchospasms, a rare but serious adverse reaction where the medication causes a worsening of bronchospasm instead of relief. Monitoring for changes in behavior is not directly related to Albuterol administration and is not a standard nursing intervention for patients receiving this medication, making choice B incorrect. Therefore, the correct answer is D as it includes the essential nursing actions for patients on Albuterol.

3. A healthcare professional is educating clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the professional inform the clients to expect a peak effect 1 to 5 hr after administration?

• A. Insulin glargine
• B. NPH insulin
• C. Regular insulin
• D. Insulin lispro

Correct answer: C

Rationale: Regular insulin typically exhibits a peak effect approximately 1 to 5 hours after administration. It is important for clients to be aware of this timing to ensure optimal management of their blood glucose levels. Insulin glargine, NPH insulin, and Insulin lispro have different onset and peak times compared to Regular insulin. Insulin glargine has a slow, steady release with no pronounced peak, NPH insulin peaks around 4 to 12 hours after administration, and Insulin lispro has a rapid onset and a peak effect around 0.5 to 2.5 hours after administration. Therefore, Regular insulin is the correct choice for a peak effect within the specified time frame.

4. What is the antidote for Warfarin?

• A. Vitamin D
• B. Vitamin C
• C. Vitamin K
• D. Vitamin B6

Correct answer: C

Rationale: Vitamin K is the antidote for Warfarin toxicity as it helps reverse the anticoagulant effects of Warfarin. Warfarin works by inhibiting vitamin K-dependent clotting factors, and administering vitamin K can replenish these factors, thereby counteracting the anticoagulant effects of Warfarin. Vitamin D, Vitamin C, and Vitamin B6 do not have the specific mechanism to counteract the anticoagulant effects of Warfarin, making them incorrect choices.

5. A healthcare provider is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The healthcare provider should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

• A. Bursitis
• B. Sinusitis
• C. Depression
• D. Glaucoma

Correct answer: D

Rationale: Oxybutynin is an anticholinergic medication that can increase intraocular pressure. It is contraindicated in clients with glaucoma due to the potential to worsen the condition by further elevating intraocular pressure, leading to harm. Choosing option D, Glaucoma, as the correct answer is crucial for the client's safety and to prevent exacerbation of their eye condition. Options A, B, and C are not contraindications for Oxybutynin use and are unrelated to the pharmacological effects of this medication.

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