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A client in DKA is ordered regular insulin at 5 units per hour for the current blood glucose level. The institution protocol is to add 125 units of regular insulin to a 250 mL bag of normal saline. What is the correct rate for the nurse to set the IV pump for this dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Answer and Explanation

The Correct Answer is ["10"]

125 units of insulin in 250 mL of normal saline

Step 2: Calculate the concentration of insulin per mL.

Concentration = 125 units ÷ 250 mL
Concentration = 0.5 units/mL

Step 3: Determine the required rate of insulin administration.

Ordered dose = 5 units per hour

Step 4: Calculate the IV flow rate.

Flow rate (mL/hr) = Ordered dose ÷ Concentration
Flow rate (mL/hr) = 5 units ÷ 0.5 units/mL
Flow rate (mL/hr) = 10 mL/hr

The nurse should set the IV pump to 10 mL/hr.

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Correct Answer is B

Explanation

Choice A reason: Effective coughing after medication administration is not specifically required for the use of metered dose inhalers like albuterol and beclomethasone. While coughing can help clear mucus from the airways, it is not a necessary step in the administration of these medications. The primary focus should be on proper inhaler technique to ensure the medication reaches the lungs effectively.

Choice B reason: Rinsing the mouth after beclomethasone administration is crucial. Beclomethasone is an inhaled corticosteroid, and rinsing the mouth helps prevent oral thrush, a common side effect of inhaled steroids. Thrush is a fungal infection that can develop in the mouth and throat due to the residue of the medication. Proper rinsing and spitting out the water can significantly reduce the risk of this infection.

Choice C reason: Using beclomethasone as needed when breathing normally is incorrect. Beclomethasone is a maintenance medication that should be used regularly as prescribed, not on an as-needed basis. It helps control chronic inflammation in the airways and prevent asthma symptoms. Using it only when symptoms are not present would not provide the consistent anti-inflammatory effect needed to manage asthma effectively.

Choice D reason: Taking the beclomethasone first, followed by the albuterol, is incorrect. The correct sequence is to use the albuterol first. Albuterol is a bronchodilator that works quickly to open up the airways, making it easier for the beclomethasone to reach deeper into the lungs and be more effective

A. Exhale quickly and forcefully through the mouth. B. Inhale sharply with a “huff” sound. C. Inhale deeply through pursed lips. D. Exhale slowly through pursed lips.

Correct Answer is D

Explanation

Pursed-lip breathing is a technique used to help manage shortness of breath and improve ventilation. It involves breathing in through the nose and exhaling slowly through pursed lips, as if blowing out a candle. This method helps to keep the airways open longer, allowing more air to escape and reducing the work of breathing.

Choice A reason:

Exhale quickly and forcefully through the mouth is not the correct intervention for pursed-lip breathing. Exhaling quickly and forcefully can cause the airways to collapse, making it harder to breathe out all the air. This can lead to air trapping and increased shortness of breath, which is counterproductive for clients with respiratory issues.

Choice B reason:

Inhale sharply with a “huff” sound is also not correct for pursed-lip breathing. Huff coughing is a technique used to clear mucus from the airways, not to manage breathing patterns. Inhaling sharply can cause irritation and may not provide the controlled breathing needed for effective gas exchange.

Choice C reason:

Inhale deeply through pursed lips is incorrect. The correct technique for pursed-lip breathing involves inhaling through the nose, not through pursed lips. Inhaling through the nose helps to filter and humidify the air, making it easier on the lungs and airways.

Choice D reason:

Exhale slowly through pursed lips is the correct intervention. This technique helps to prolong exhalation, which reduces the respiratory rate and improves ventilation. By keeping the airways open longer, it helps to release trapped air and improve oxygenation. This method is particularly beneficial for clients with chronic obstructive pulmonary disease (COPD) and asthma, as it helps to reduce the work of breathing and improve overall respiratory function.

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Naxlex Comprehensive Predictor Exams

A client is diagnosed with asthma. The therapeutic regimen using metered dose inhalers includes albuterol 2 puffs and beclomethasone 2 puffs. The nursing plan of care must include teaching regarding:

Correct Answer is B

Explanation

The nurse is preparing to teach a client how to effectively perform pursed-lip breathing. The nurse would include which intervention in the teaching?

Correct Answer is D

Explanation

The nurse is assisting the client with arm and shoulder exercises on the first post-op day following a right-sided thoracotomy. The client reports pain with the exercise and wants to know why they must be performed. What explanation should the nurse provide? The exercises:

A nurse on a medical-surgical unit is performing an admission assessment of a client who has COPD with emphysema. The client reports that they have a frequent productive cough and shortness of breath. The nurse should anticipate which of the following assessment findings for this client?

The nurse is changing a client’s abdominal dressing and notes a separation of the incision line. The underlying tissue is protruding from the wound. The nurse should plan to do which of the following in the initial care of this wound?

A client who receives an antihypertensive medication daily is NPO except medications for surgery. The most recent blood pressure recording is 174/88. What action should the nurse take first?

The nurse is discharging a client newly diagnosed with tuberculosis. Which medications should be included in the discharge planning? (SELECT ALL THAT APPLY)

The physician prescribed albuterol, beclomethasone, and zafirlukast for a client being discharged with asthma. The client tells the nurse he can’t remember what to take before exercising. The best response by the nurse would be:

The nurse is completing an admission assessment on a client diagnosed with asthma. What clinical manifestations are typical of the disorder?

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