Patient Data

Exhibits

The nurse should base insulin lispro administration on the client's anticipated intake of 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

Restart the IV fluids until the tray arrives

Give insulin glargine 12 units

Mix the insulin lispro and insulin glargine in one syringe

Verify that the client intake matches the carbohydrate count

Answer and Explanation

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

Give insulin lispro 4 units: Administering insulin lispro before the meal tray arrives is contraindicated because it can cause hypoglycemia if the client does not eat immediately. Insulin lispro should be given based on the exact carbohydrate intake, which cannot be determined until food is present.

Restart the IV fluids until the tray arrives: Restarting the IV fluids is indicated because it helps maintain hydration, especially important for a client with hyperglycemia and recent surgery. Fluids support perfusion and protect against dehydration while waiting for the client's nutritional intake to resume.

Give insulin glargine 12 units: Giving insulin glargine now is contraindicated because the client already received her scheduled dose earlier in the morning before surgery. Re-administering it could cause insulin stacking and dangerously low blood sugar later.

Mix the insulin lispro and insulin glargine in one syringe: Mixing insulin lispro and insulin glargine together is contraindicated because glargine is designed to maintain a stable, long-acting release. Mixing it can alter its absorption profile, making it unsafe to combine in the same syringe.

Verify that the client intake matches the carbohydrate count: This action is indicated because insulin lispro is prescribed to match the carbohydrate content of meals. Verifying the number of carbohydrates ensures the correct lispro dose is administered and helps prevent dosing errors and hypoglycemia.

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Correct Answer is C

Explanation

A. Chemical burn: Ketorolac is an NSAID used to manage pain and inflammation in the eye, but chemical burns require immediate irrigation and specialized treatment rather than simply addressing inflammation. Reviewing for chemical burns is not the key concern before administering ketorolac.

B. Foreign body: The presence of a foreign body in the eye would necessitate removal and possibly different treatment approaches. However, ketorolac would not be contraindicated solely because of a foreign body once it is addressed.

C. Corneal abrasion: Ketorolac should be used cautiously or avoided if there is a corneal abrasion because it can delay healing and increase the risk of corneal damage. Therefore, reviewing for a history of corneal abrasion is essential before administering this medication.

D. Radiation exposure: Radiation exposure to the eye would be managed differently, often requiring other supportive measures. It does not specifically contraindicate the use of ophthalmic ketorolac.

A. Assess the client's vital signs. B. Review the client's culture and sensitivity reports. C. Implement neutropenic precautions. D. Inform the client that the medication has been effective.

Correct Answer is D

Explanation

A. Assess the client's vital signs: While it is always important to monitor vital signs, the increase in white blood cell (WBC) count indicates a positive response to filgrastim, and there is no immediate concern requiring urgent vital sign assessment based on the WBC count alone.

B. Review the client's culture and sensitivity reports: Reviewing culture reports is necessary when managing an active infection, but the question does not indicate the client currently has an infection. The focus here is evaluating the medication's effectiveness.

C. Implement neutropenic precautions: Neutropenic precautions are necessary when the WBC count is critically low. Since the client's WBC has improved into the low-normal range, these precautions are no longer necessary.

D. Inform the client that the medication has been effective: Filgrastim is used to stimulate WBC production. The client's WBC count has increased to the normal range after five doses, demonstrating that the medication is working effectively as intended.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client receives a prescription for ophthalmic ketorolac. Prior to administering the medication, the nurse should review the electronic medical record (EMR) for which condition?

Correct Answer is C

Explanation

After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm3 (2.5 x 10 /L) to 5,000/mm3 (5 x 105/L). Which action should the nurse implement?Reference Range:White Blood Cell (WBC) [5,000 to 10,000/mm3 (5 to 10 x 109/L)]

Correct Answer is D

Explanation

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Patient Data Exhibits The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.

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 glargine to start working in dropdown. and to continue working for dropdown.

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