Nursing Elites

1. In a capillary glucose measurement, a client is to receive 10 units of regular insulin and isophane insulin. How should the nurse prepare?

• A. Withdraw ten units of regular insulin from a vial
• B. Withhold the dose until regular insulin is available
• C. Obtain a new vial of regular insulin and withhold
• D. Pull up 30 units from a vial but only administer 10 units

Correct answer: B

Rationale: In insulin administration, regular insulin is typically administered before isophane insulin to manage blood glucose effectively. If regular insulin is not available, it is best to withhold the dose until it can be administered as prescribed. Choice A is incorrect as it suggests withdrawing from a specific vial without specifying regular insulin. Choice C is incorrect as obtaining a new vial of regular insulin may not be necessary if it becomes available shortly. Choice D is incorrect as administering 10 units from a mixture of regular and isophane insulin is not the correct approach.

2. A client is prescribed nitroglycerin sublingual tablets. The practical nurse should reinforce which instruction?

• A. Store the tablets in a cool, dry place.
• B. Take one tablet every 5 minutes until pain is relieved, up to three tablets.
• C. Swallow the tablets whole.
• D. Chew the tablets for faster relief.

Correct answer: A

Rationale: Nitroglycerin sublingual tablets are sensitive to heat and moisture, so they should be stored in a cool, dry place to maintain their efficacy. Storing them in a cool, dry place helps prevent degradation of the medication. Choice B is incorrect because nitroglycerin tablets should be taken as directed by the healthcare provider to avoid potential overdose or adverse effects. Choice C is incorrect because sublingual tablets should be placed under the tongue to dissolve and be absorbed, not swallowed, to ensure their quick action. Choice D is incorrect because sublingual tablets should not be chewed; they are meant to be absorbed through the tissues under the tongue, and chewing them may alter their effectiveness.

3. A client with pulmonary tuberculosis has been taking rifampin for 3 weeks. The client reports orange urine. What should be the nurse's next action?

• A. Notify the client's health care provider.
• B. Inform the client that this is not harmful.
• C. Assess the client for other signs of nephrotoxicity.
• D. Monitor the client's most recent creatinine level.

Correct answer: B

Rationale: The correct action for the nurse to take when a client reports orange urine after taking rifampin is to inform the client that this change is not harmful. Rifampin is known to cause orange discoloration of urine, which is a harmless side effect. There is no need to notify the health care provider as this is an expected outcome. Monitoring creatinine levels or assessing for nephrotoxicity is unnecessary in this situation, as rifampin does not typically cause kidney damage.

4. A client with bipolar disorder is taking lithium. Which client assessment data would indicate a potential adverse effect of lithium therapy?

• A. Increased appetite
• B. Dry mouth and increased thirst
• C. Tremors and polyuria
• D. Constipation

Correct answer: B

Rationale: When assessing a client taking lithium, dry mouth and increased thirst are indicators of potential adverse effects. Lithium can lead to nephrogenic diabetes insipidus, causing polyuria and subsequent increased thirst due to impaired water reabsorption in the kidneys. Tremors can also be a sign of lithium toxicity. Monitoring and recognizing these symptoms are crucial in managing lithium therapy and preventing further complications.

5. A client with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. The nurse should instruct the client to report which potential side effect?

• A. Dry mouth
• B. Blurred vision
• C. Nausea
• D. Tachycardia

Correct answer: A

Rationale: The correct answer is A: Dry mouth. Tiotropium, a commonly prescribed medication for COPD, can cause dry mouth as a side effect. While it may not be severe, clients should report it if it becomes bothersome. Dry mouth is a common side effect of tiotropium due to its anticholinergic properties. Blurred vision, nausea, and tachycardia are not typically associated with tiotropium use in the context of COPD.

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