History and Physical

The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes and no other significant medical histor The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.

For each nursing action below, click to specify if the action is indicated, contraindicated or non-essential.

Verify that the client can count carbohydrates

Restart the IV fluids until the tray arrives

Give insulin lispro 4 units

Give insulin glargine 12 units

Mix the insulin lispro and insulin glargine in one syringe

Answer and Explanation

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

Choice A rationale: Indicated. This is important for a client with type 1 diabetes, as counting carbohydrates helps in calculating the appropriate insulin dose and maintaining glycemic control.

Choice B rationale: Non-essential. The client is already admitted to the surgical floor and does not require restarting the IV fluids unless there is a specific medical indication.

Choice C rationale: Contraindicated. Insulin doses should be prescribed by a healthcare provider based on the patient's blood glucose levels and individual insulin requirements. The nurse should follow the prescribed insulin orders and not administer insulin without an order.

Choice D rationale: Indicated. Insulin glargine is a long-acting basal insulin used to provide a steady background insulin level throughout the day. The nurse should administer the prescribed insulin glargine dose as ordered.

Choice E rationale: Contraindicated. Insulin lispro is a rapid-acting insulin, and insulin glargine is a long-acting insulin. Mixing different types of insulin in one syringe can alter their pharmacokinetics and lead to inconsistent blood glucose control. Insulin lispro and insulin glargine should be administered separately.

Nursing Test Bank

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Correct Answer is C

Explanation

Choice A rationale; Family history of mental illness is important information to consider when assessing the client's overall mental health history, but it is not directly related to the immediate safety and effectiveness of duloxetine.

Choice B rationale: Weight change in the last month is relevant to monitoring for side effects of duloxetine, but it is not as critical as assessing liver function, which directly impacts the metabolism of the medication.

Choice C rationale: When planning care for a client starting on duloxetine, it is most important for the nurse to obtain liver function laboratory results. Duloxetine is primarily metabolized in the liver, and it is important to assess the client's liver function before starting the medication to ensure that the liver can process the drug effectively and safely. Clients with impaired liver function may require dose adjustments or be at higher risk for adverse effects, so obtaining liver function test results is crucial for safe medication management.

Choice D rationale: Recent use of other antidepressants is essential to avoid potential drug interactions, but it is not the most critical piece of information compared to assessing liver function, which directly affects the client's ability to process duloxetine.

A. Instruct the client to increase her intake of saturated fats over the next week. B. Ask the client to describe her dietary intake history for the last several days. C. Advise the client to stop taking the drug and contact her healthcare provider. D. Obtain a stool specimen to evaluate for occult blood and fat content.

Correct Answer is B

Explanation

Choice A rationale: This option is not appropriate as increasing saturated fat intake would exacerbate the oily stool and flatus symptoms caused by orlistat. Orlistat is specifically designed to reduce fat absorption, and increasing fat intake would be counterproductive and may worsen the side effects.

Choice B rationale: Asking a client to describe their dietary intake history is a standard practice in nutritional assessment. It provides a baseline for understanding current eating habits and identifying areas for improvement.

Choice C rationale: Advising a client to stop taking medication should only be done by a qualified healthcare provider who has full knowledge of the client's health history and current medications.

Choice D rationale: While obtaining a stool specimen for evaluation might be relevant in some situations, it is not the priority in this case. The oily stools and flatus are most likely related to the side effects of orlistat and do not typically require stool testing for confirmation. The more immediate action would be to address the symptoms by advising the client to stop taking the medication and contact her healthcare provider for further guidance.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?

Correct Answer is C

Explanation

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?

Correct Answer is B

Explanation

A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions?

Exhibits For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client's first dose of captopril.

Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 8.4 mcg/L (35.6 mcmol/L). Which action should the nurse take? Carbamazepine level [Reference Range: 4 to 12 mcg/mL or 16.9 to 50.8 mcmol/L]

Patient Data Exhibits Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. The nurse should expect for the insulin lispro to start working at dropdown and to peak at dropdown .

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem?

A nurse is caring for a client who has Parkinson's disease and is prescribed an anticholinergic. Which of the following therapeutic outcomes should the nurse expect to see?