The nurse provides sliding scale insulin administration instructions to an adult who was recently diagnosed with diabetes mellitus. The client demonstrates an understanding of the instructions provided by performing the procedure in which order? (Arrange with the first on top and the last on the bottom.)

Obtain blood glucose level.

Verify the insulin prescription.

Draw insulin into insulin syringe.

Cleanse the selected site.

Answer and Explanation

The Correct Answer is B,A,D,C

1. B. Verify the insulin prescription: The first step is to verify the prescription to ensure the correct type and dose of insulin before administering it. This ensures one is following the appropriate instructions.

2. A. Obtain blood glucose level: The next step is to check the client's blood glucose level to determine the amount of insulin needed based on the sliding scale.

3. D. Cleanse the selected site: After obtaining the blood glucose level, the next step is to prepare the injection site by cleaning it properly to prevent infection.

4. C. Draw insulin into insulin syringe: Finally, drawing the appropriate amount of insulin into the syringe, based on the sliding scale and the blood glucose level, to administer the injection.

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Correct Answer is B

Explanation

A. Diabetes mellitus: While diabetes mellitus can affect circulation and healing, it is not a direct contraindication for the use of lidocaine. However, monitoring for effects on circulation and neuropathy may be necessary in diabetic patients.

B. Heart block: Lidocaine is a local anesthetic that can have systemic effects, especially on the cardiovascular system. It can cause conduction abnormalities, including heart block, so it is crucial to assess for this condition before administering lidocaine to avoid exacerbating cardiac issues.

C. Gastric ulcers: Lidocaine's effects are primarily cardiac and neurological, and it does not have a known adverse effect on gastric ulcers that would require pre-administration review. This condition is more relevant for oral medications that can irritate the gastric mucosa.

D. Glaucoma: Lidocaine does not have a significant effect on intraocular pressure or glaucoma. The main concern with lidocaine is its effect on the heart and nervous system, rather than its impact on eye conditions.

A. Blood alcohol level of 0.09% (19.5 mmol/L). B. Weight loss of 10 lb (4.5 kg) in past month. C. Six hours of sleep in the past three days. D. Serum lithium level of 1.6 mEq/L (1.6 mmol/L).

Correct Answer is D

Explanation

A. Blood alcohol level of 0.09% (19.5 mmol/L): This alcohol level indicates mild intoxication. It can cause slurred speech and gait changes, but the effects are usually transient and less concerning than drug toxicity. It should be monitored, but is not as urgent as lithium toxicity.

B. Weight loss of 10 lb (4.5 kg) in past month: This degree of weight loss may suggest poor nutritional intake or a depressive episode, but it is not immediately life-threatening. It requires follow-up but does not explain the acute neurological signs the client is exhibiting.

C. Six hours of sleep in the past three days: Severe sleep deprivation can exacerbate mood instability in bipolar disorder, but it does not account for slurred speech or gait disturbances. This concern is significant for mental health management but not the priority in this situation.

D. Serum lithium level of 1.6 mEq/L (1.6 mmol/L): This is above the therapeutic range and suggests lithium toxicity, which can cause neurological signs such as slurred speech and ataxia. Immediate reporting is crucial to prevent progression to more severe toxicity, including seizures or coma.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who receives a prescription for parenteral lidocaine. Prior to administering the medication, the nurse should review the medical record for which condition?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

Exhibits The client has started to wake up more, opening her eyes without stimulation and looking around the room. Which should the nurse do as the client becomes more aware of her surroundings? Select all that apply.

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

A client who sustained an L-1 spinal cord injury six months ago that resulted in paraplegia is now experiencing spastic muscle movements in the lower extremities. Which intervention should the nurse implement?

After receiving report on an inpatient acute care unit, which client should the nurse assess first?

The nurse is speaking with the spouse of a client who has passed away unexpectedly. The spouse is very calm and says, "No, there must be a mistake." Which action should the nurse take?

A young adult is brought to the emergency department after taking a handful of drugs. The client is unresponsive, so an endotracheal tube (ETT) is inserted. How should the nurse determine if the ETT is correctly placed? Select all that apply.