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 with hypertension is prescribed amlodipine. The nurse should monitor for which potential adverse effect?

• A. Peripheral edema
• B. Bradycardia
• C. Hypertension
• D. Increased appetite

Correct answer: A

Rationale: Corrected Rationale: Amlodipine is known to cause peripheral edema as a potential adverse effect due to its vasodilatory properties. This can lead to fluid accumulation in the extremities. Monitoring for peripheral edema in patients taking amlodipine is crucial to identify and manage this side effect promptly. Choices B, C, and D are incorrect because amlodipine is not associated with causing bradycardia, hypertension (as the patient already has hypertension), or increased appetite as adverse effects.

3. A client with a history of atrial fibrillation is prescribed digoxin. The nurse should monitor for which sign of digoxin toxicity?

• A. Bradycardia
• B. Tachycardia
• C. Nausea
• D. Vomiting

Correct answer: A

Rationale: Bradycardia is a common sign of digoxin toxicity. Digoxin, a medication used to treat atrial fibrillation, can lead to toxicity manifesting as various cardiac dysrhythmias, with bradycardia being a notable indicator. Monitoring for bradycardia is crucial as it can indicate the need for dosage adjustment or discontinuation of digoxin to prevent adverse effects. Tachycardia, nausea, and vomiting are not typically associated with digoxin toxicity, making them incorrect choices for monitoring in a client receiving this medication.

4. The healthcare provider notes that a client has a new prescription for 20 mEq of potassium. The IV site is inflamed but not tender, and has a blood flashback. What action should the healthcare provider take?

• A. Obtain a liter of normal saline with 20 mEq of KCl
• B. Contact the healthcare provider to clarify the prescription
• C. Withhold the prescription medication until a new IV is started
• D. Fax the prescription to the pharmacy for immediate dispensing

Correct answer: B

Rationale: The healthcare provider should contact the prescriber to clarify the prescription because an inflamed IV site may indicate potential issues with administering the medication. It is important to ensure that the prescription is appropriate and safe for the client before proceeding with administration. Option A is incorrect because administering potassium through an inflamed IV site can lead to further complications. Option C is not the best course of action as clarifying the prescription first is essential. Option D is also incorrect as the focus should be on ensuring the safety of the client before dispensing the medication.

5. A client with rheumatoid arthritis is prescribed methotrexate. The nurse should monitor for which common side effect of this medication?

• A. Liver toxicity
• B. Skin rash
• C. Hair loss
• D. Abdominal pain

Correct answer: A

Rationale: The correct answer is A: Liver toxicity. Methotrexate is known to cause liver toxicity, making regular monitoring of liver function essential. Monitoring liver function tests helps detect any signs of liver damage early, allowing for appropriate interventions to be implemented promptly.

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