Question

A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

Answer 1

Correct Answers:

1400

Rationale :

⏰NPH insulin is an intermediate-acting insulin that has an onset of action in 1–2 hours, peaks around 6–8 hours, and lasts up to 18 hours.

📉The peak time is when the client is most at risk for hypoglycemia, which is why the nurse should monitor closely around 1400 if given at 0730.

💉Hypoglycemia symptoms such as sweating, shakiness, and confusion can develop rapidly during this peak window.

🔄Understanding insulin pharmacokinetics is essential in planning care, ensuring meal timing and glucose monitoring are synchronized to prevent hypoglycemia.

📌core message

NPH insulin peaks about 6–8 hours after administration, making mid-afternoon the highest hypoglycemia risk.

Answer 2

Correct Answers:

Stop infusing the client's intravenous antibiotic

Rationale :

🚨Anaphylaxis is a medical emergency that can occur quickly after exposure to allergens like antibiotics, presenting with respiratory distress and circulatory compromise.

💉The first nursing action during suspected anaphylaxis is to stop the causative agent to prevent worsening symptoms.

🧯Although epinephrine is the definitive treatment, it must be administered after stopping the drug and ensuring the line is available.

💁‍♂️Vital signs and oxygen can follow, but they should not delay the immediate discontinuation of the offending IV medication.

📌core message

In suspected anaphylaxis, the nurse’s first action must be to stop the medication causing the reaction.

Answer 3

Correct Answers:

weight gain of 40 lbs. (18 kg) over the past 2 months
currently prescribed aripiprazole, a second-generation antipsychotic agent
sits & plays video games for 10-14 hours per day
random blood glucose was 218 mg/dL with labs drawn 1 month ago

Rationale :

⚖️Rapid weight gain is a major risk factor for insulin resistance and can precipitate type 2 diabetes, particularly when abdominal fat increases.

💊Second-generation antipsychotics like aripiprazole are known to affect glucose metabolism and weight, increasing the risk of diabetes.

🕹️A sedentary lifestyle significantly reduces insulin sensitivity, especially when combined with poor dietary habits.

🧪A random blood glucose >200 mg/dL meets one of the diagnostic criteria for diabetes and must not be ignored.

🥗Eating grilled chicken salads is a healthy habit and not a risk factor.

📌core message

Risk factors for type 2 diabetes include weight gain, antipsychotic use, sedentary behavior, and elevated glucose levels.

Answer 4

Correct Answers:

Serum creatinine 26 mg/dL

Rationale :

🧪Trimethoprim-sulfamethoxazole is excreted through the kidneys and must be avoided in clients with severely impaired renal function.

⚠️A creatinine level of 26 mg/dL indicates critical renal dysfunction, making the drug contraindicated due to risk of toxicity.

📊Normal creatinine ranges are about 0.6–1.3 mg/dL; levels this high require renal-adjusted dosing or alternative therapies.

🩸Other lab values like platelets, hemoglobin, and glucose do not contraindicate this medication.

📌core message

Trimethoprim-sulfamethoxazole is contraindicated in severe renal impairment, as shown by extremely high creatinine levels.

Answer 5

Correct Answers:

"Use a bath thermometer to test water temperature."

Rationale :

🦶Peripheral neuropathy results in reduced sensation, especially in the feet, making clients unable to detect dangerous temperatures.

🌡️Using a bath thermometer ensures water is at a safe temperature, preventing accidental burns or scalding.

🧦Wearing socks indoors offers some protection, but it does not eliminate risk during bathing or heat exposure.

🩺Daily foot exams are crucial, but preventing injury in the first place is a more immediate safety priority.

📌core message

Clients with diabetic neuropathy must use a bath thermometer to prevent thermal injuries from undetected hot water.

Answer 6

Correct Answers:

Complete all doses of metronidazole in your prescription
Do not drink alcohol while taking metronidazole and for 2 days after you finish the pills.
Use a barrier form of contraception while taking medication

Rationale :

💊Completing the full course of antibiotics ensures eradication of the infection and prevents resistance.

🍷Alcohol with metronidazole causes a disulfiram-like reaction, leading to severe nausea, vomiting, and hypotension—thus must be avoided.

🛡️Metronidazole may reduce the effectiveness of hormonal contraceptives, so a barrier method is advised during treatment.

🟡Urine discoloration is typically dark brown, not pale yellow, and straining urine is irrelevant to this drug.

📌core message

Metronidazole requires strict alcohol avoidance, full course adherence, and backup contraception use.

Answer 7

Correct Answers:

Review results of liver function studies

Rationale :

🧪Dark urine can indicate liver dysfunction, and glipizide is metabolized hepatically, requiring liver monitoring.

🧫The nurse should check for elevated liver enzymes or signs of drug-induced hepatotoxicity.

💉Testing urine for blood may rule out hematuria, but liver function evaluation is more relevant in this context.

🚱Increased water intake does not address the potential organ toxicity suggested by the symptom.

📌core message

Dark urine in a client taking glipizide may indicate liver toxicity, requiring prompt review of liver function tests.

Answer 8

Correct Answers:

mental status = lethargic, oriented X 3 but unsure of reason for presenting for care
respiratory rate = 31 , deep

Rationale :

🧠Lethargy and confusion are common in diabetic ketoacidosis (DKA) due to dehydration and acid-base imbalance.

🌬️A deep, rapid respiratory rate (Kussmaul respirations) reflects the body’s attempt to compensate for metabolic acidosis.

📉The provided ABG in option B is alkalotic, which is inconsistent with DKA.

❤️Bradycardia is not typical in DKA; clients often present with tachycardia due to dehydration and stress.

📌core message

In DKA, clients often present with lethargy and Kussmaul respirations due to metabolic acidosis.

Answer 9

Correct Answers:

obtain a blood glucose reading.

Rationale :

🧪The nurse must first determine whether the symptoms—sweating, anxiety, headache—are due to hypoglycemia by checking the blood glucose level.

🎯This step is critical to confirm the cause before initiating treatment like glucose or glucagon.

📉Administering glucagon without confirming hypoglycemia may be inappropriate and risky.

🩺Vital signs and physician notification can wait until the nurse has objective glucose data.

📌core message

When symptoms suggest hypoglycemia, the first step is to check blood glucose before acting.

Answer 10

Correct Answers:

Offer the client an analgesic if prescribed.

Rationale :

🩺Costovertebral tenderness is a classic symptom of pyelonephritis and is expected in acute cases.

💊The priority nursing response is to manage pain by offering the prescribed analgesic.

📞Notifying the physician is not necessary unless symptoms worsen.

🛌Prone positioning or massage is not appropriate in acute kidney infections and may worsen discomfort.

📌core message

In pyelonephritis, costovertebral tenderness is expected and should be addressed with prescribed pain management.

1 :
A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

2 :
Ten minutes after initiating an intravenous antibiotic, the client complains of shortness of breath, itching, and difficulty swallowing. What is the nurse's initial action?

3 :
What factors in the history of a client with schizoaffective disorders puts the client at higher risk for type 2 diabetes? (Select all that apply)

4 :
A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

5 :
A client diagnosed with diabetes has severe peripheral neuropathy, resulting in numbness and reduced sensation. Which intervention should the nurse teach the client to prevent injury as a result of this complication?

6 :
A client is prescribed metronidazole, an antimicrobial agent, orally for 10 days. When performing discharge teaching, which statement(s) should be included in the instruction? (Select all that apply)

7 :
The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

8 :
What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (Select all that apply)

9 :
A client on glipizide, a sulfonylurea, reports to the nurse feeling anxious, sweaty & has a headache. The nurse's initial action is to:

10 :
A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

1 : A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

2 : Ten minutes after initiating an intravenous antibiotic, the client complains of shortness of breath, itching, and difficulty swallowing. What is the nurse's initial action?

3 : What factors in the history of a client with schizoaffective disorders puts the client at higher risk for type 2 diabetes? (Select all that apply)

4 : A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

5 : A client diagnosed with diabetes has severe peripheral neuropathy, resulting in numbness and reduced sensation. Which intervention should the nurse teach the client to prevent injury as a result of this complication?

6 : A client is prescribed metronidazole, an antimicrobial agent, orally for 10 days. When performing discharge teaching, which statement(s) should be included in the instruction? (Select all that apply)

7 : The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

8 : What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (Select all that apply)

9 : A client on glipizide, a sulfonylurea, reports to the nurse feeling anxious, sweaty & has a headache. The nurse's initial action is to:

10 : A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?

1 :
A client receives 20 units of isophane insulin suspension (NPH) insulin at 0730. The nurse teaches the client that signs of hypoglycemia are most likely to occur at what time?

2 :
Ten minutes after initiating an intravenous antibiotic, the client complains of shortness of breath, itching, and difficulty swallowing. What is the nurse's initial action?

3 :
What factors in the history of a client with schizoaffective disorders puts the client at higher risk for type 2 diabetes? (Select all that apply)

4 :
A newly admitted client has been prescribed sulfamethoxazole/trimethoprim. The nurse understands that this medication is contraindicated based on which lab result?

5 :
A client diagnosed with diabetes has severe peripheral neuropathy, resulting in numbness and reduced sensation. Which intervention should the nurse teach the client to prevent injury as a result of this complication?

6 :
A client is prescribed metronidazole, an antimicrobial agent, orally for 10 days. When performing discharge teaching, which statement(s) should be included in the instruction? (Select all that apply)

7 :
The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?

8 :
What clinical manifestation(s) should the nurse expect in a client with uncontrolled diabetes mellitus and ketoacidosis? (Select all that apply)

9 :
A client on glipizide, a sulfonylurea, reports to the nurse feeling anxious, sweaty & has a headache. The nurse's initial action is to:

10 :
A 72-year-old client is admitted to the medical-surgical unit with a diagnosis of acute pyelonephritis. The client complains of costovertebral tenderness. What it the most appropriate nursing intervention?