A client with a history of Addison's disease and flu-like symptoms accompanied by nausea and vomiting over the past week is brought to the facility. His wife reports that he acted confused and was extremely weak when he awoke that morning. The client's blood pressure is 90/58 mm Hg, his pulse is 116 beats/minute, and his temperature is 101° F (38.3° C). A diagnosis of acute adrenal insufficiency is made. What should the nurse expect to administer by I.V. infusion?

Methylprednisolone (Solu-medrol)

Hypotonic saline

Potassium (K-dur)

Regular Insulin

Answer and Explanation

The Correct Answer is A

A. Methylprednisolone (Solu-medrol):
Explanation: Acute adrenal insufficiency is a life-threatening condition characterized by a sudden deficiency of adrenal hormones. In this situation, intravenous glucocorticoids such as methylprednisolone are administered to replace the deficient hormones and stabilize the patient. This is the appropriate intervention to address the acute adrenal crisis.

B. Hypotonic saline:
Explanation: Hypotonic saline is not the first-line treatment for acute adrenal insufficiency. The priority is to replace glucocorticoids to address the adrenal hormone deficiency.

C. Potassium (K-dur):
Explanation: While electrolyte imbalances can occur in adrenal insufficiency, potassium replacement alone does not address the primary issue of glucocorticoid deficiency in acute adrenal insufficiency.

D. Regular Insulin:
Explanation: Regular insulin is not the primary treatment for acute adrenal insufficiency. Glucocorticoid replacement, such as methylprednisolone, is the key intervention.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "If a vial of insulin will be used up within 21 days, it may be kept at room temperature."
This statement suggests a duration of up to 21 days for room temperature storage after the vial is in use. However, most insulins can typically be stored at room temperature for up to 28 days after initial use. This recommendation might be more conservative than necessary for many types of insulin.

B. "If a vial of insulin will be used up within 2 weeks, it may be kept at room temperature."
This choice suggests a timeframe of 14 days for room temperature storage after opening the vial. However, for many insulins, the recommended duration for room temperature storage after opening is up to 28 days.

C. "If you are going to use up the vial within 1 month, it can be kept at room temperature."
This option extends the timeframe to 1 month for room temperature storage after the vial is in use. However, the generally recommended duration for many insulins is up to 28 days after opening.

D. "If a vial of insulin will be used up within 1 week, it may be kept at room temperature."
This choice suggests a very short duration of 7 days for room temperature storage after opening the vial. Most insulins can typically be stored at room temperature for a longer duration after initial use.

A. It is rapidly absorbed, has a fast onset of action B. Administer the total daily dosage in two doses C. Draw up the drug first, then add regular insulin D. Do not mix with other insulins

Correct Answer is D

Explanation

A. It is rapidly absorbed, has a fast onset of action:
Explanation: This statement is incorrect. Glargine (Lantus) actually has a slow onset of action and a prolonged duration of action. It is formulated to provide a steady level of insulin in the body over an extended period.

B. Administer the total daily dosage in two doses:
Explanation: This is not the recommended administration for glargine. It is typically administered once daily to provide basal insulin coverage over a 24-hour period.

C. Draw up the drug first, then add regular insulin:
Explanation: Mixing glargine with other insulins is not recommended. Glargine should be administered separately to maintain its extended duration of action. It should not be mixed with other insulins in the same syringe.

D. Do not mix with other insulins:
Explanation: This is the correct statement. Glargine should not be mixed with other insulins. It should be administered alone to maintain its "peakless" basal coverage. Mixing it with other insulins could alter its pharmacokinetics and compromise its effectiveness.

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Naxlex Comprehensive Predictor Exams

A nurse is conducting a class on how to self-manage insulin regimens. A client asks how long a vial of insulin can be stored at room temperature before it "goes bad." What would be the nurse's best answer?

Correct Answer is A

Explanation

Which of the following should be included in the teaching plan for a patient receiving glargine (Lantus), "peakless" basal insulin?

Correct Answer is D

Explanation

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