Patient Data

Exhibits

The nurse should base insulin lispro administration on the client's anticipated intake of carbohydrates. The tray has not yet arrived in the room.

For each nursing action below, click to specify if the action is indicated, contraindicated or nonessential. Each row must have one option selected.

Give insulin lispro 4 units

Restart the IV fluids until the tray arrives

Give insulin glargine 12 units

Mix the insulin lispro and insulin glargine in one syringe

Verify that the client intake matches the carbohydrate count

Answer and Explanation

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

Give insulin lispro 4 units: Administering insulin lispro before the meal tray arrives is contraindicated because it can cause hypoglycemia if the client does not eat immediately. Insulin lispro should be given based on the exact carbohydrate intake, which cannot be determined until food is present.

Restart the IV fluids until the tray arrives: Restarting the IV fluids is indicated because it helps maintain hydration, especially important for a client with hyperglycemia and recent surgery. Fluids support perfusion and protect against dehydration while waiting for the client's nutritional intake to resume.

Give insulin glargine 12 units: Giving insulin glargine now is contraindicated because the client already received her scheduled dose earlier in the morning before surgery. Re-administering it could cause insulin stacking and dangerously low blood sugar later.

Mix the insulin lispro and insulin glargine in one syringe: Mixing insulin lispro and insulin glargine together is contraindicated because glargine is designed to maintain a stable, long-acting release. Mixing it can alter its absorption profile, making it unsafe to combine in the same syringe.

Verify that the client intake matches the carbohydrate count: This action is indicated because insulin lispro is prescribed to match the carbohydrate content of meals. Verifying the number of carbohydrates ensures the correct lispro dose is administered and helps prevent dosing errors and hypoglycemia.

Nursing Test Bank

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Correct Answer is A

Explanation

A. Caution when changing from a sitting to a standing position: Carbidopa-levodopa can cause orthostatic hypotension, leading to dizziness and falls. Teaching the client to rise slowly and carefully helps prevent sudden drops in blood pressure and significantly reduces the risk of injury.

B. Ambulate using a four point cane or a walker with wheels: Assistive devices can help with mobility in Parkinson’s disease, but their use should be based on a physical therapist’s evaluation. Not every client will immediately require a walker or cane upon starting treatment.

C. Place small rugs on smooth surfaces such as tile or wood floors: Small rugs actually increase the risk of tripping and falling, especially for clients with Parkinson’s disease, who already have gait instability. It is safer to remove rugs rather than add them.

D. Obtain a hospital bed with side rails and an over bed trapeze: A hospital bed with side rails and an overbed trapeze might be necessary for clients with advanced Parkinson's disease who have significant mobility limitations or require assistance with repositioning in bed. However, for a newly diagnosed client, this level of equipment is likely unnecessary and could foster dependence.

A. Observe bowel movement pattern and take a stool softener. B. Do not drink grapefruit juice after taking morphine. C. Watch for signs of agitation and record any insomnia. D. Take the benzodiazepine at the same time of taking the morphine.

Correct Answer is A

Explanation

A. Observe bowel movement pattern and take a stool softener: Morphine commonly causes constipation due to reduced gastrointestinal motility. Recognizing this and taking preventive measures like a stool softener indicates a good understanding of how to manage one of the most frequent and bothersome side effects of opioid therapy.

B. Do not drink grapefruit juice after taking morphine: Grapefruit juice significantly interacts with certain medications, particularly those metabolized by CYP3A4 enzymes, but it has minimal clinical effect on morphine metabolism. This instruction is not relevant for morphine use.

C. Watch for signs of agitation and record any insomnia: While these symptoms can occasionally occur, they are not typical or expected side effects of morphine. More common effects include sedation, respiratory depression, and constipation.

D. Take the benzodiazepine at the same time of taking the morphine: Combining morphine with benzodiazepines increases the risk of severe sedation, respiratory depression, and overdose. Co-administration should be carefully managed and typically avoided unless specifically directed by the healthcare provider.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client recently diagnosed with Parkinson's disease receives a new prescription for carbidopa-levodopa. To reduce the client's risk for injury, which instruction should the nurse provide?

Correct Answer is A

Explanation

The nurse is providing discharge instructions for a client with metastatic cancer who is prescribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

Correct Answer is A

Explanation

Patient Data Exhibits The nurse prepares to give 2 units of insulin lispro. Which should the nurse double check with a second nurse? Select all that apply.

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