A nurse is preparing for the admission of a client who has a seizure disorder. Which of the following supplies should the nurse place at the bedside for the client?

NG tube

Tongue blade

Suction machine

Syringe containing lorazepam

Answer and Explanation

The Correct Answer is C

A) NG tube: A nasogastric (NG) tube is not typically required for a client with a seizure disorder unless they have specific feeding or aspiration concerns that require tube feeding. During a seizure, the priority is to ensure airway clearance and prevent injury, not necessarily to provide nutrition through an NG tube.

B) Tongue blade: It is a common myth that tongue blades should be used to prevent a client from biting their tongue during a seizure. However, using a tongue blade can be dangerous as it can cause injury to the mouth or teeth, or even cause choking. The nurse should never attempt to place anything in the client's mouth during a seizure.

C) Suction machine: A suction machine is essential for maintaining airway patency during or after a seizure. Clients with seizure disorders may be at risk for aspiration, and the suction machine can be used to clear secretions from the mouth to prevent choking or aspiration pneumonia. This is the most appropriate supply to place at the bedside.

D) Syringe containing lorazepam: While lorazepam (a benzodiazepine) is sometimes used for acute seizure management, it is not a routine item to have immediately at the bedside unless specifically ordered for emergency seizure intervention. The nurse should follow protocol and administer medications as prescribed, but a syringe of lorazepam is not typically pre-placed at the bedside.

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Correct Answer is C

Explanation

A) "I should expect my periods to resume in 1 month.": This statement suggests a misunderstanding of the procedure. After a vaginal hysterectomy, periods will not resume because the uterus is removed. If a client expresses such expectations, it may indicate a lack of understanding about the procedure's outcomes and risks, meaning informed consent may not have been adequately given.

B) "I will have a large scar on my stomach after this procedure.": A vaginal hysterectomy is typically performed through the vaginal canal, not requiring an abdominal incision. Therefore, this statement reflects a misunderstanding of the procedure's approach, and would indicate that the client has not been fully informed about the surgical method.

C) "I am thankful I am done having children.": This statement indicates that the client has understood one of the key reasons for having a vaginal hysterectomy. The procedure typically results in the inability to conceive children, which is an important consideration for informed consent. It shows the client is aware of the consequences and is making an informed decision.

D) "I will no longer need regular gynecological examination.": This statement reflects a misunderstanding. Even after a hysterectomy, it’s important for clients to continue routine gynecological exams, as they may still need to monitor other aspects of their reproductive health, including the vagina and ovaries (if retained). It indicates that the client may not have been fully informed about post-operative care requirements.

A. "Draw up the insulin lispro and insulin glargine in separate syringes. B. "Take an extra dose of insulin lispro prior to aerobic exercise." C. ‘’Expect insulin glargine to be cloudy." D. "Anticipate that the insulin glargine will peak in 3 hours."

Correct Answer is A

Explanation

A) "Draw up the insulin lispro and insulin glargine in separate syringes.":
Insulin lispro (a rapid-acting insulin) and insulin glargine (a long-acting insulin) should be administered separately, as they have different properties and mechanisms of action. Mixing them in one syringe can affect their effectiveness and may cause inaccurate dosing. Therefore, the nurse should instruct the client to draw up each insulin in a separate syringe to ensure proper administration and action of both insulins.

B) "Take an extra dose of insulin lispro prior to aerobic exercise.":
Taking an extra dose of insulin lispro before exercise is not recommended unless directed by a healthcare provider. Exercise can lower blood glucose levels, and additional insulin may increase the risk of hypoglycemia. Instead, clients with diabetes are typically advised to monitor their blood glucose levels before and after exercise and adjust their insulin dose or carbohydrate intake accordingly, under the guidance of their healthcare provider.

C) "Expect insulin glargine to be cloudy.":
Insulin glargine is a clear, long-acting insulin. It should not be cloudy. If the insulin appears cloudy, it may be a sign that the insulin has been improperly stored or is no longer effective. The nurse should educate the client to inspect the insulin for cloudiness or particles and to discard any insulin that appears abnormal.

D) "Anticipate that the insulin glargine will peak in 3 hours.":
Insulin glargine is a long-acting insulin that does not have a pronounced peak. It provides a steady release of insulin over 24 hours and helps to maintain baseline insulin levels. It is not meant to peak like rapid-acting or short-acting insulins. Therefore, this instruction is incorrect, as insulin glargine does not follow the same peak-action pattern as other insulins.

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A nurse is preparing for the admission of a client who has a seizure disorder. Which of the following supplies should the nurse place at the bedside for the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

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