Exhibits

The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.

St. John's Wort

Corticosteroids

Fluconazole

Ibuprofen

Oral contraceptives

Answer and Explanation

Correct Answer : A,B,C,F

Choice A rationale: St. John's Wort is an herbal supplement that can interact with various medications, including insulin, and may alter blood glucose levels. It can reduce the effectiveness of insulin, leading to decreased blood glucose control. It is essential for the client to inform the healthcare provider about any use of St. John's Wort to adjust the insulin regimen accordingly.

Choice B rationale: Corticosteroids can increase blood glucose levels by promoting insulin resistance and inhibiting insulin action. Clients with diabetes may require adjustments in their insulin dosage while taking corticosteroids to prevent hyperglycemia.
Choice C rationale: Fluconazole is an antifungal medication that can affect blood glucose levels. It may increase the hypoglycemic effects of insulin, leading to lower blood glucose levels. The
client's insulin regimen may need to be adjusted while taking fluconazole.
Choice D rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not typically have a direct impact on blood glucose levels in people with diabetes.
Choice E rationale: Epinephrine is a hormone that may transiently increase blood glucose levels in response to stress, but it is not a home medication that the client would be taking regularly.
Choice F rationale: Oral contraceptives, specifically combination hormonal contraceptives containing estrogen and progestin, can impact blood glucose levels. They may lead to insulin resistance and, in some cases, increase blood glucose levels. The healthcare provider may need to adjust the insulin dosage for better glycemic control.

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Correct Answer is ["B","C","D"]

Explanation

Choice A rationale: Quinapril is an ACE inhibitor and, like captopril, is typically given twice daily. It does not have an extended duration of action that would allow for once-daily dosing.

Choice B rationale: Lisinopril is an ACE inhibitor that can be given once per day. It has a long duration of action, which allows for once-daily dosing. This makes it a convenient option for patients who have difficulty remembering to take their medications multiple times a day.

Choice C rationale: Ramipril is another ACE inhibitor that can be given once per day. Like lisinopril, it has an extended duration of action, allowing for once-daily dosing.

Choice D rationale: Trandolapril is an ACE inhibitor that can also be given once per day. It has a prolonged duration of action, which supports once-daily dosing for optimal blood pressure control.

Choice E rationale: Captopril itself is listed in the options, and it is not an ACE inhibitor that can be given only once per day. Captopril has a short duration of action and is usually prescribed for twice-daily dosing.

A. The insulin vial for color and clarity B. The history and physical with the diabetes diagnosis listed C The dose of insulin drawn up in the syringe C. The sliding scale insulin lispro order E The expiration date on the insulin vial D. The site for the insulin administration G The insulin concentration H The type of insulin to be administered F. The site for the insulin administration G. The insulin concentration H. The type of insulin to be administered

Correct Answer is ["A","C","E","G"]

Explanation

Choice A rationale: This is essential to ensure that the insulin is not discolored or cloudy, as these changes could indicate a problem with the insulin's stability or effectiveness.
Choice B rationale: While it is essential to have a complete history and physical for proper patient care, double-checking this with another nurse is not necessary in the immediate administration of insulin lispro.
Choice C rationale: Double-checking the dose of insulin in the syringe is crucial to avoid medication errors and ensure that the correct amount is being administered to the patient.
Choice D rationale: The sliding scale order is not mentioned in the information provided, and since it is not part of the immediate insulin administration, it does not need to be double-checked in this context.
Choice E rationale: Checking the expiration date is necessary to ensure that the insulin is still within its usable period. Using expired insulin can lead to reduced potency and potentially ineffective blood sugar control.
Choice F rationale: The information provided in the nurse's notes does not indicate that insulin administration is due at a specific site (e.g., subcutaneous injection). Therefore, there is no need for a second nurse to double-check the site at this moment. However, it's important for the administering nurse to choose the appropriate site following the facility's guidelines and rotate injection sites to prevent lipodystrophy.

Choice G rationale: Different types of insulin come in different concentrations (e.g., U-100, U-200). It's important to confirm that the correct concentration is being used to ensure accurate dosing.
Choice H rationale: The nurse should verify that the insulin to be administered is indeed insulin lispro, as indicated in the medication order. Administering the wrong type of insulin can have significant implications for the patient's blood sugar control.

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Exhibits The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Exhibits The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril. Which ACE inhibitors can be given only once per day? Select all that apply.

Correct Answer is ["B","C","D"]

Explanation

Find information about a client below. Exhibits What should the nurse double-check with a second nurse? Select all that apply.

Correct Answer is ["A","C","E","G"]

Explanation

A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

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 client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?

The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse report to the healthcare provider?

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 .

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.

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care?

Exhibits

The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.