At 8 a.m. the nurse is reviewing patient assignments and notes one of the patients has a current blood glucose of 264. Breakfast is routinely served at 8:30. The following orders are noted in the chart. What action should the nurse take? Accucheck before meals and at bedtime with sliding scale insulin aspart SQ: Glucose 0-150 Administer 0 units; 151-200 Administer 2 units; 201-250 Administer 4 units: 251-300 Administer 6 units: 301-350 Administer 8 units; 351- 400 Administer 10 units; >400 Notify physician.

Provide 2 units insulin aspart 50

Provide 6 units insulin aspart 50

Provide 10 units insin apart SQ

Provide 4 units insulin aspart 50

Answer and Explanation

The Correct Answer is B

A. This option corresponds to the blood glucose range of 151-200. However, the patient's current blood glucose level is 264, which falls into the range of 251-300. Therefore, administering 2 units would not be appropriate in this case.

B. The patient's current blood glucose level is 264, which falls into the range of 251-300. According to the sliding scale insulin aspart orders, for this range, 6 units should be administered. This option aligns with the patient's blood glucose level and the prescribed protocol.

C. This option corresponds to the blood glucose range of 351-400. The patient's blood glucose level of 264 does not fall into this range, so administering 10 units would be excessive and potentially lead to hypoglycemia.

D. This option corresponds to the blood glucose range of 201-250. The patient's current blood glucose level is 264, which falls into the range of 251-300. Therefore, administering 4 units would not be sufficient to address the elevated blood glucose level.

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Correct Answer is B

Explanation

A. Incorrect. Taking levothyroxine with breakfast may reduce its absorption due to food interference.

B. Correct. Levothyroxine should be taken in the morning on an empty stomach, at least 30 minutes before any other medications or food, to ensure optimal absorption.

C. Incorrect. Taking levothyroxine in the evening with a snack is not recommended. It should be taken on an empty stomach for best results.

D. Incorrect. Taking levothyroxine in the morning before breakfast is advised, but it should also be done on an empty stomach. Additionally, there's no need to avoid other medications if they do not interfere with its absorption.

A. Check the pedal pulses. B. Request prescription for a relaxant. C. Verify the most recent calcium level. D. Administer an oral potassium supplement.

Correct Answer is C

Explanation

A. Checking the pedal pulses is important for assessing circulation, but it may not directly address the cause of the muscle spasms. In this case, addressing the electrolyte imbalance is a higher priority.

B. Requesting a relaxant might provide temporary relief for muscle spasms, but it does not address the potential underlying cause. It's important to identify and treat the root issue.

C. Correct. Severe muscle spasms in a client post-thyroidectomy could indicate hypocalcemia, as the parathyroid glands, which regulate calcium levels, can be affected during the surgery. Verifying the most recent calcium level will help determine if this is the cause.

D. Administering an oral potassium supplement addresses a different electrolyte imbalance (hypokalemia), which is not typically associated with muscle spasms following a thyroidectomy. Calcium levels are more relevant in this context.

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Naxlex Comprehensive Predictor Exams

When preparing to provide morning medications, the nurse would give levothyroxine (Synthroid) ordered daily in which of the following ways?

Correct Answer is B

Explanation

A nurse is caring for a client who is 1 day postoperative following a thyroidectomy and reports severe muscle spasms of the lower extremities. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a client who is 1 day postoperative following a subtotal thyroidectomy. The client reports a tingling sensation in the hands, the soles of the feet, and around the lips. For which of the following findings should the nurse assess the client?

A nurse working for a home health agency is teaching a client who has diabetes mellitus about disease management. Which of the following glycosylated hemoglobin (HbA1c) values should the nurse include in the teaching as an indicator that the client is appropriately controlling his glucose levels?

A nurse is assessing a client who has hypoparathyroidism. Which of the following findings should the nurse expect?

A nurse is caring for a client who is 1 day postoperative following a transsphenoidal hypophysectomy. While assessing the client, the nurse notes a large area of clear drainage seeping from the nasal packing. Which of the following should be the nurse's initial action?

A nurse is reviewing the laboratory results for four clients. The nurse should recognize which of the following clients has a manifestation of hypoparathyroidism?

The nurse is assessing a patient with Cushing syndrome. Which finding should the nurse report for immediate follow-up?

A client is being discharged after having a thyroidectomy. Which discharge instructions are appropriate for this client? Select all that apply.

A nurse is caring for a client who is being evaluated for acromegaly. Which of the following manifestations should the nurse expect to find during assessment? (Select all that apply.)