The nurse is caring for a client who has a finger stick blood glucose level of 130 mg/dL (7.21 mmol/L). Prior to administering the scheduled dose of acarbose, the nurse is informed that morning meal trays will be 30 minutes late. Which action should the nurse take?Reference Range:
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Notify the healthcare provider.

Administer the medication.

Hold the medication until the meal trays arrive.

Obtain another finger stick blood glucose level.

Answer and Explanation

The Correct Answer is C

A. Notify the healthcare provider: Notification of the healthcare provider is not immediately necessary just because of a meal delay. The nurse can manage the situation appropriately by adjusting the medication timing to ensure patient safety without requiring immediate provider involvement.

B. Administer the medication: Acarbose should be taken with the first bite of food to effectively delay carbohydrate absorption. Administering it without food available increases the risk of hypoglycemia, especially since the glucose level is already slightly elevated but within a manageable range.

C. Hold the medication until the meal trays arrive: Acarbose must be taken with the first mouthful of food to match the timing of glucose absorption. Holding the medication until the meal arrives ensures optimal therapeutic effect and prevents unnecessary hypoglycemia.

D. Obtain another finger stick blood glucose level: Rechecking the blood glucose is unnecessary at this time. The primary concern is coordinating the medication with food intake, not monitoring glucose trends over a short 30-minute delay.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Contact the healthcare provider (HCP) immediately if suicidal thoughts occur: Antidepressants like sertraline can increase the risk of suicidal thoughts, especially during the early stages of treatment. Immediate reporting of such thoughts is critical to ensure the client’s safety and prevent harm.

B. Contact the healthcare provider (HCP) immediately if muscle stiffness occurs: Although rare, muscle stiffness could signal serotonin syndrome if occurs with a constellation of symptoms including confusion, agitation, fever, sweating and tremors, not just stiffness. Suicidal ideation presents a more immediate and life-threatening risk in clients starting antidepressants and requires the highest priority.

C. Increase activity level to include a daily exercise routine: While exercise is beneficial for managing depression, it is supportive therapy and not the most urgent teaching point compared to recognizing and reporting suicidal ideation associated with antidepressant use.

D. Avoid processed meats, red wine, and Swiss cheese: This dietary restriction is necessary when taking monoamine oxidase inhibitors (MAOIs) to prevent hypertensive crises. Sertraline is a selective serotonin reuptake inhibitor (SSRI), so these dietary precautions are not required.

A. When using the discus, have the client breathe out rapidly into the mouthpiece. B. Offer the discus to the client for use during an acute asthma attack. C. Explain that the client should not use the discus more than twice daily. D. Clients using the discus may experience decreased blood pressure.

Correct Answer is C

Explanation

A. When using the discus, have the client breathe out rapidly into the mouthpiece: Clients should exhale away from the mouthpiece before inhaling the medication. Breathing out into the mouthpiece can blow away the powdered medication, making the dose ineffective.

B. Offer the discus to the client for use during an acute asthma attack: Fluticasone and salmeterol are used for long-term control of asthma, not for immediate relief during an acute attack. A short-acting bronchodilator like albuterol is needed for acute symptom management.

C. Explain that the client should not use the discus more than twice daily: The fluticasone/salmeterol combination is typically prescribed for use twice daily. Exceeding the recommended frequency increases the risk of side effects such as throat irritation, infections, and cardiovascular effects.

D. Clients using the discus may experience decreased blood pressure: While beta-agonists can sometimes have cardiovascular effects, salmeterol is a long-acting beta-agonist primarily targeting the airways. Decreased blood pressure is not a common or expected side effect of fluticasone/salmeterol inhalers. Increased heart rate or palpitations are more potential cardiovascular effects, but significant hypotension is unlikely.

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Naxlex Comprehensive Predictor Exams

A client with postpartum depression receives a prescription for sertraline. Which information is most important for the nurse to include in client teaching?

Correct Answer is A

Explanation

To control asthma, a client in a residential treatment facility uses a fluticasone propionate and salmeterol discus inhalation system, which provides an inhaled powdered form of these combined medications. Which instruction should the nurse provide to this client's caregivers?

Correct Answer is C

Explanation

A client who is taking dextroamphetamine-amphetamine extended-release tablets for attention deficit hyperactivity disorder (ADHD), reports about having difficulty sleeping at night. Which assessment is most important for the nurse to obtain?

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 to dropdown

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

Patient Data Exhibits Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

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.

A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

When administering zolpidem to an older adult client, which computer documentation indicates that the desired outcome has been achieved?