Exhibits

It is 1800, and the client has a scheduled dose of insulin glargine due. The client has a regular diet tray ordered with 60 carbohydrates. The tray has not yet arrived in the room.

For each nursing action below, click to specify if the action is indicated, contraindicated or nonessential. Each row must have one option selected.

Give insulin lispro 4 units

Verify that the client can count carbohydrates

Mix the insulin lispro and insulin glargine in one syringe

Give insulin glargine 12 units

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"A"}}

Give insulin lispro 4 units: Contraindicated - Insulin lispro is a rapid-acting insulin that should be given in relation to meal intake. Since the client's meal tray has not arrived, administering insulin lispro could lead to hypoglycemia.
Verify that the client can count carbohydrates: Nonessential - While it’s useful to know if a client can count carbohydrates, it’s not critical for administering scheduled long-acting insulin like insulin glargine.
Mix the insulin lispro and insulin glargine in one syringe: Contraindicated - Insulin glargine is a long-acting insulin and should not be mixed with other insulins in the same syringe.
Give insulin glargine 12 units: Indicated - Insulin glargine is a long-acting insulin that is typically given at a set time each day and is not dependent on immediate food intake, so it is appropriate to administer the scheduled dose.

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Correct Answer is B

Explanation

A. Increased lacrimation may cause discomfort but does not directly contribute to a risk of injury.
B. Miotics constrict the pupil, leading to decreased night vision, which increases the client's risk for injury, particularly in low-light conditions.
C. Sensitivity to light (photophobia) may cause discomfort but is less likely to contribute directly to injury.
D. Diminished color perception can occur but does not typically pose a significant risk for injury compared to decreased night vision.

A. Advise the caregiver that the purpose of the medication is to promote sleep, so a change in medication may be needed. B. Explain to the caregiver that insomnia is a common and temporary side effect when the medication is first started. C. Instruct the caregiver to withhold the medication until the dosage can be decreased to ensure the client's safety. D. Notify the healthcare provider that the dosage of the medication may need to be increased to manage the client's insomnia.

Correct Answer is B

Explanation

A. Rivastigmine is used to improve cognitive function in Alzheimer's disease and not specifically to promote sleep, so suggesting a medication change is not appropriate without further assessment.
B. Insomnia can be a side effect of rivastigmine, especially when starting the medication. It is often temporary and should improve as the body adjusts.
C. Withholding the medication or changing the dosage without guidance from the healthcare provider could impact the client's cognitive function and should not be done based on a single side effect.
D. Increasing the dosage of rivastigmine is not a solution for insomnia and could potentially exacerbate other side effects.

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Body system	Potential nursing intervention
Cardiovascular	Monitor vital signs continuously Provide warmth Echocardiogram Defibrillator at bedside
Immunological	Administer steroid Assess rash IV fluids Administer antihistamine
Respiratory	Assess lung sounds Pain medication Provide calm environment Chest x-ray

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is "risk for injury." This nursing problem is based on which etiology?

Correct Answer is B

Explanation

During a home visit, the nurse assesses a client with Alzheimer's disease who recently started a new prescription for rivastigmine. The caregiver reports that the client seems to be thinking more clearly but is not sleeping well at night. Which action should the nurse take?

Correct Answer is B

Explanation

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