A client has a prescription for NPH insulin 25 units before breakfast and insulin aspart before meals and hour of sleep per sliding scale. The sliding scale parameters are:. 0 units for finger stick glucose less than 170 mg/dL;. 5 units for finger stick glucose 171 to 219 mg/dL;. 10 units for finger stick glucose 220 to 269 mg/dL;. 15 units for finger stick glucose 270 to 300 mg/dL.

Call healthcare provider for finger stick glucose greater than 300 mg/dL. The client's 0730 finger stick glucose is 271 mg/dL. What is the total amount of insulin this client should receive? (Enter numeric value only.).

This is the best response for the PN to provide because it sets a clear and firm boundary for the adolescent and discourages inappropriate or sexual comments. The PN should also redirect the adolescent's attention to another topic or activity and document the incident.

A. The size of my breasts is of no concern to you is not the best response because it may sound defensive or sarcastic and may not deter the adolescent from making similar comments in the future.

C. Do you really think so? is not the best response because it may encourage or reinforce the adolescent's inappropriate or sexual comments and may imply that the PN is interested or flattered by them.

D. If you talk like that again, I will tell your parents is not the best response because it may sound threatening or punitive and may not address the underlying issue of the adolescent's behavior. The PN should inform the parents only if the behavior persists or escalates.

The correct answer is choice A: Descriptions of numbness and tingling in fingers distal to the AVF.

Choice A rationale:

Descriptions of numbness and tingling in fingers distal to the arteriovenous fistula (AVF) suggest possible nerve compression or impaired blood flow, which are concerning findings. These symptoms could indicate reduced perfusion to the distal extremities and require immediate attention to prevent further complications.

Choice B rationale:

A loud and consistent bruit auscultated at the AVF site is an expected finding and indicates adequate blood flow through the fistula. A bruit is the sound of turbulent blood flow and is commonly heard over functional AV fistulas.

Choice C rationale:

Bruising at the AVF site is a common occurrence after the creation of the fistula. It is expected due to the surgical intervention and the manipulation of blood vessels. As long as the bruising is not severe or accompanied by other concerning symptoms, it does not need immediate reporting.

Choice D rationale:

The absence of the radial pulse distal to the AVF and the presence of the ulnar pulse are normal findings in a functioning AV fistula. The AV fistula diverts blood flow away from the radial artery, leading to a diminished pulse. This is not a cause for concern as long as the ulnar pulse is present, indicating adequate perfusion to the hand.