Which patient would be a concern for the nurse when administering mannitol (Osmitrol)?

A patient who is extremely hypertensive.

A patient who has increased intracranial pressure.

A patient who is in congestive heart failure (CHF).

A patient who has fluid volume overload.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Hypertension is not a primary contraindication for mannitol use. While it's important to monitor blood pressure during mannitol administration, it's not the most concerning factor in this scenario.

Mannitol can even be used cautiously in hypertensive patients with conditions like intracranial hypertension or acute renal failure, where its benefits may outweigh the potential risks of exacerbating hypertension.

Choice B rationale:

Mannitol is actually indicated for the treatment of increased intracranial pressure (ICP). It works by drawing fluid from the brain tissues into the bloodstream, thereby reducing pressure within the skull.

Therefore, a patient with ICP would not be a concern for mannitol administration; rather, they would be a potential candidate for its use.

Choice D rationale:

While fluid volume overload can be a concern with mannitol use, it's typically managed with careful monitoring and fluid restriction.

The more significant concern in this scenario is congestive heart failure (CHF).

Choice C rationale:

Mannitol is contraindicated in patients with congestive heart failure (CHF). Here's why:

Increased Circulating Volume: Mannitol is an osmotic diuretic, meaning it draws fluid from the tissues into the bloodstream, increasing circulating blood volume. This can overload the already compromised heart in CHF patients, leading to worsening heart failure and pulmonary edema.

Elevated Blood Pressure: Mannitol can also cause a transient increase in blood pressure due to its osmotic effects. This can further strain the heart and worsen CHF symptoms.

Renal Impairment: CHF patients often have impaired renal function, which can reduce their ability to excrete mannitol effectively. This can lead to fluid retention and electrolyte imbalances, further complicating CHF management.

In summary, administering mannitol to a patient with CHF could potentially lead to:

Exacerbation of heart failure symptoms Pulmonary edema

Worsening renal function Electrolyte imbalances Increased risk of mortality

Therefore, it's crucial to avoid mannitol use in patients with CHF and to closely monitor fluid status and electrolytes in those who must receive it for other indications.

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Correct Answer is A

Explanation

Choice A rationale:
NPH insulin is an intermediate-acting insulin that typically peaks 6-12 hours after administration.
Given that the insulin was administered at 1700 (5:00 PM), the peak action would be expected to occur between 2100 (9:00 PM) and 0500 (5:00 AM).
This time frame aligns with the known pharmacokinetics of NPH insulin.
It's crucial for nurses to be aware of the peak action times of different insulin types to effectively manage blood glucose levels and adjust insulin doses accordingly.
Choice B rationale:
Incorrect. NPH insulin does have a peak action, as explained above.
It's important to understand that even intermediate-acting insulins have a period of peak activity when they exert their strongest glucose-lowering effect.
Choice C rationale:

Incorrect. This time frame is too early to represent the peak action of NPH insulin. The peak action typically occurs later, between 6-12 hours after administration.
Choice D rationale:
Incorrect. This time point is too specific to accurately represent the peak action of NPH insulin.
The peak action can vary within the 6-12 hour window, depending on individual factors and injection site.

A. Albuterol (Proventil) B. Oxygen C. Nitroglycerin D. Aspirin

Correct Answer is B

Explanation

Choice A rationale:

Albuterol (Proventil) is a bronchodilator that is used to treat acute asthma attacks and chronic obstructive pulmonary disease (COPD). It works by relaxing the smooth muscles in the airways, which allows more air to flow into the lungs. While albuterol can be helpful in relieving shortness of breath, it is not the first-line treatment for a patient with chest pain and low oxygen saturation. This is because albuterol does not address the underlying cause of the chest pain, which is likely a lack of oxygen to the heart muscle.

Choice C rationale:

Nitroglycerin is a vasodilator that is used to treat angina (chest pain) and heart failure. It works by relaxing the blood vessels, which allows more blood to flow to the heart. Nitroglycerin can be helpful in relieving chest pain, but it is not the first-line treatment for a patient with low oxygen saturation. This is because nitroglycerin can actually worsen hypoxemia (low oxygen levels in the blood) by dilating blood vessels in the lungs.

Choice D rationale:

Aspirin is a blood thinner that is used to prevent and treat blood clots. It is often given to patients with chest pain who are suspected of having a heart attack. However, aspirin is not the first-line treatment for a patient with low oxygen saturation. This is because aspirin does not address the underlying cause of the low oxygen saturation, which is likely a problem with the lungs or heart.

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Which patient would be a concern for the nurse when administering mannitol (Osmitrol)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse has administered NPH insulin at 1700. At what time would the nurse anticipate the peak action of this insulin?

Correct Answer is A

Explanation

A patient who is experiencing chest pain and shortness of breath is brought to the emergency department.The nurse assesses a heart rate of 98 beats per minute, bilateral lung crackles, and an oxygen saturation of 90%. What will the nurse expect to administer initially to this patient?

Correct Answer is B

Explanation

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