History and Physical

The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes and no other significant medical histor The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover.

For each nursing action below, click to specify if the action is indicated, contraindicated or non-essential.

Verify that the client can count carbohydrates

Restart the IV fluids until the tray arrives

Give insulin lispro 4 units

Give insulin glargine 12 units

Mix the insulin lispro and insulin glargine in one syringe

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"B"}}

Choice A rationale: Indicated. This is important for a client with type 1 diabetes, as counting carbohydrates helps in calculating the appropriate insulin dose and maintaining glycemic control.

Choice B rationale: Non-essential. The client is already admitted to the surgical floor and does not require restarting the IV fluids unless there is a specific medical indication.

Choice C rationale: Contraindicated. Insulin doses should be prescribed by a healthcare provider based on the patient's blood glucose levels and individual insulin requirements. The nurse should follow the prescribed insulin orders and not administer insulin without an order.

Choice D rationale: Indicated. Insulin glargine is a long-acting basal insulin used to provide a steady background insulin level throughout the day. The nurse should administer the prescribed insulin glargine dose as ordered.

Choice E rationale: Contraindicated. Insulin lispro is a rapid-acting insulin, and insulin glargine is a long-acting insulin. Mixing different types of insulin in one syringe can alter their pharmacokinetics and lead to inconsistent blood glucose control. Insulin lispro and insulin glargine should be administered separately.

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Correct Answer is C

Explanation

a) Assess the client for side effects of carbamazepine:

This option might seem reasonable as monitoring for side effects is essential with any medication, especially one with a narrow therapeutic range like carbamazepine. However, the client's level of 8.4 mcg/L is within the therapeutic range (4 to 12 mcg/mL), so there's no immediate indication that side effects are likely to occur solely based on this level.

b) Notify the healthcare provider of the carbamazepine level:

While it's important to keep the healthcare provider informed about the client's condition, in this case, the carbamazepine level is within the therapeutic range. There's no urgent need to notify the provider unless there are other concerning factors not mentioned in the scenario.

c) Administer the carbamazepine as prescribed:

This is the correct answer. The client's morning carbamazepine level of 8.4 mcg/L falls within the therapeutic range (4 to 12 mcg/mL). Therefore, the evening dose should be administered as prescribed to maintain therapeutic levels and control the client's condition.

d) Withhold this dose of the carbamazepine:

Withholding the dose based solely on the morning carbamazepine level of 8.4 mcg/L, which is within the therapeutic range, would not be appropriate. Withholding the dose without consulting the healthcare provider could potentially lead to suboptimal management of the client's condition.

A. Prevents the formation of kidney stones. B. Increases the strength of the urine stream. C. Decreases pain and burning during urination D. Promotes excretion of uric acid in the urine.

Correct Answer is D

Explanation

Choice A rationale: Probenecid does not prevent kidney stones. Its primary function is to increase the excretion of uric acid in the urine.

Choice B rationale: Probenecid does not affect the strength of the urine stream. Its action is specific to uric acid excretion.

Choice C rationale: Probenecid is not used to alleviate pain and burning during urination. Its main indication is for gout and hyperuricemia.

Choice D rationale: Probenecid is a uricosuric drug used to treat gout and hyperuricemia. It works by inhibiting the reabsorption of uric acid in the kidneys, which promotes its excretion in the urine. By increasing uric acid excretion, probenecid helps to reduce the concentration of uric acid in the blood and prevent gout attacks.

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Naxlex Comprehensive Predictor Exams

Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 8.4 mcg/L (35.6 mcmol/L). Which action should the nurse take? Carbamazepine level [Reference Range: 4 to 12 mcg/mL or 16.9 to 50.8 mcmol/L]

Correct Answer is C

Explanation

The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug?

Correct Answer is D

Explanation

The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse report to the healthcare provider?

After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm3 (2.5 x 109/L) to 5,000/mm3 (5 x 10°/L). Which action should the nurse implement? White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 109/L)]

A client on alcohol withdraw protocol suddenly begins to have a seizure in his bed. After several minutes the seizure has not ended and the nurse suspects the client is suffering from status epilepticus. What is the priority action the nurse will take?

A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]

While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?

Exhibits The nurse notifies the provider that the client is having trouble remembering to take his second dose of captopril. Which ACE inhibitors can be given only once per day? Select all that apply.