A client who weighs 176 pounds is admitted to the intensive care unit with a serum glucose level of 600 mg/dL (33.3 mmol/L). Regular insulin at a rate of 0.1 unit/kg/hour is prescribed. The pharmacy provides a solution of regular insulin 100 units/100 mL of normal saline.

The nurse should set the infusion pump to deliver how many mL/hours?

(Enter numeric value only.)

Answer and Explanation

The Correct Answer is ["8"]

Step 1: Convert the client's weight from pounds to kilograms. 176 pounds ÷ 2.2 = 80 kg

Step 2: Determine the total units of insulin needed per hour. 80 kg × 0.1 unit/kg/hour = 8 units/hour

Step 3: Determine the volume of insulin solution needed per hour. (8 units) ÷ (100 units/100 mL) = (8 units) ÷ (1 unit/mL) = 8 mL/hour

So, the nurse should set the infusion pump to deliver 8 mL/hour.

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Correct Answer is A

Explanation

Choice A reason: Administering IV furosemide (a diuretic) is crucial for managing the client's symptoms of fluid overload, as indicated by enema and elevated brain natriuretic peptide (BNP) levels. Furosemide helps reduce the volume of fluid in the body, relieving symptoms of heart failure and improving breathing. It addresses the most urgent need for the client.

Choice B reason: Inserting an indwelling urinary catheter might be necessary for accurate measurement of urine output, especially in a client receiving diuretic therapy. However, it is not the most immediate intervention needed to stabilize the client's condition.

Choice C reason: Monitoring for telemetry ST segment changes is important for clients with cardiac conditions. While it is necessary for ongoing assessment, it does not address the immediate need to relieve fluid overload and improve the client's respiratory status.

Choice D reason: Giving a bronchodilator per inhaler can help with respiratory symptoms related to emphysema. However, in this scenario, the primary issue is fluid overload due to heart failure, which needs to be addressed first with diuretic therapy.

A. Haematocrit of 30% (0.30 volume fraction). B. Facial puffiness and periorbital enema. C. Further decline in level of consciousness. D. Cold and dry skin.

Correct Answer is C

Explanation

Choice A reason: A haematocrit of 30% is below the normal range and indicates anaemia, which is common in hypothyroidism. However, it does not require immediate intervention compared to a decline in consciousness.

Choice B reason: Facial puffiness and periorbital enema are common signs of hypothyroidism but do not require immediate intervention. They are more indicative of chronic, rather than acute, issues.

Choice C reason: A further decline in level of consciousness is critical and warrants immediate action. It can indicate a myxoedema coma, a severe complication of hypothyroidism that is life-threatening and requires urgent treatment.

Choice D reason: Cold and dry skin is a common symptom of hypothyroidism but does not require immediate intervention compared to a decline in consciousness.

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Naxlex Comprehensive Predictor Exams

A client with a history of emphysema and heart failure is admitted to the emergency department with enema, coughing, and shortness of breath. The client's laboratory value for brain natriuretic peptide is elevated. Which prescription is most important for the nurse to implement?

Correct Answer is A

Explanation

A client who has a history of hypothyroidism was admitted with lethargy and confusion. Which additional finding warrants immediate action by the nurse?

Correct Answer is C

Explanation

The nurse calculates the body mass index (BMI) for an adult client who is obese. Which additional assessment finding places the client at high risk for cardiac disease?

The nurse is caring for an older adult client with Alzheimer's disease who becomes increasingly agitated and is speaking to someone who is not visible to the nurse. Which action should the nurse implement?

The chest x-ray for a client who is admitted for pneumonia shows a pleural effusion with decreased air flow in the entire left upper lobe. After auscultating the left upper lobe, which breath sounds documented by the nurse verify the x-ray findings?

A client with ulcerative colitis is admitted to the medical unit during an acute exacerbation. The nurse should instruct the unlicensed assistive personnel (UAP) to report which finding related to the client's bowel movements?

After placing a client who is having a seizure in the side-lying position, which intervention should the nurse implement?

The nurse is obtaining vital sign measurements every 15 minutes for a client who had an emergency appendectomy and currently has a temperature of 101.4°F (38.6°C). Which vital sign measurements should the nurse report to the healthcare provider?

The nurse is assessing clients in an outpatient diabetic clinic. Which entry provides the best indication that the client is adhering to the prescribed diabetic regimen?

When teaching a client with Parkinson's disease, which rationale for the prescription of carbidopa-levodopa should the nurse include?