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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 history. The appendectomy was completed without Issue, and the client will be admitted to the surgical floor to recover.

The PN prepares to give 2 units of Insulin lispro.

What should the PN double-check with a second nurse?

Select all that apply.

The sliding scale insulin lispro order

The type of insulin to be administered

The insulin vial for color and clarity

The dose of insulin drawn up in the syringe

The expiration date on the insulin vial

The history and physical with the diabetes diagnosis listed

The insulin concentration

The site for the insulin administration

Answer and Explanation

Correct Answer : C,D,E,G

The PN should double-check the following with a second nurse:

The dose of insulin drawn up in the syringe: Double-checking the dose of insulin is essential to ensure the correct amount is being administered to the client.
The insulin vial for color and clarity: Insulin should be clear and free of particles or discoloration. Checking the vial for any abnormalities ensures the integrity and quality of the insulin.
The expiration date on the insulin vial: Insulin should not be used beyond its expiration date. Verifying the expiration date helps ensure that the insulin is still effective and safe for administration.
The insulin concentration: Different concentrations of insulin are available, such as

U-100 and U-500. Double-checking the concentration ensures that the correct type of insulin is being administered.

It's important to note that the other options listed are not necessary for double-checking with a second nurse in this context:

The sliding scale insulin lispro order: Sliding scale insulin is typically used to adjust insulin doses based on blood glucose levels. However, in this case, the given dose of 2 units of insulin lispro may be a specific prescription for the client's diabetes management and not related to the acute appendicitis.
The type of insulin to be administered: The type of insulin, in this case, is specified as insulin lispro. Confirming the type of insulin is important, but it is not a part of the double-checking process since it is already specified.
The history and physical with the diabetes diagnosis listed: The client's medical history and diabetes diagnosis are important aspects of their overall care but are not directly related to double-checking the administration of insulin.
The site for insulin administration: The specific site for insulin administration may depend on the client's individual preference or medical condition, but it is not a part of the double-check process. The double-check is primarily focused on the accuracy of the medication itself.

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Correct Answer is D

Explanation

This is the correct answer because BUN and creatinine are the most important laboratory values to monitor for nephrotoxicity, which is the damage or injury to the kidneys caused by certain drugs or chemicals.
Nephrotoxicity can impair the kidneys' ability to filter waste products from the blood, resulting in elevated levels of BUN and creatinine. The normal range for BUN is 7 to 20 mg/dL, and for creatinine is 0.6 to 1.2 mg/dL. The practical nurse (PN) should review these values before administering an antibiotic that can cause nephrotoxicity, such as aminoglycosides, cephalosporins, vancomycin, or sulfonamides. The PN should also monitor the client for signs and symptoms of nephrotoxicity, such as decreased urine output, edema, hypertension, fatigue, nausea, and confusion.

A. Minimize the number of refined grains in the diet B. Eliminate sugary beverages and juices from the diet C. Increase the amount of dietary fiber D. Double the usual amount of protein in the diet E. Only select feed items with no fat F. Take a cinnamon supplement

Correct Answer is ["A","B","C"]

Explanation

Minimize the number of refined grains in the diet: Refined grains, such as white bread, white rice, and pasta, have had their bran and germ removed, resulting in a loss of fiber and nutrients. Including more whole grains in the diet, such as whole wheat bread, brown rice, and whole grain pasta, can help maintain stable blood sugar levels and reduce the risk of type 2 diabetes.
Eliminate sugary beverages and juices from the diet: Sugary beverages, including soda, fruit juices, and sweetened teas, can contribute to weight gain and an increased risk of type 2 diabetes. Encouraging the client to choose water, unsweetened tea, or other sugar-free beverages can help reduce the intake of added sugars.
Increase the amount of dietary fiber: Fiber-rich foods, such as fruits, vegetables, whole grains, legumes, and nuts, can help regulate blood sugar levels and improve insulin sensitivity. Encouraging the client to include these foods in their diet can be beneficial in reducing the risk of type 2 diabetes.

Incorrect:

D- Double the usual amount of protein in the diet: While protein is an essential nutrient, doubling the usual amount of protein in the diet may not be necessary or appropriate for everyone. It is important to follow individualized dietary recommendations and consult with a healthcare provider or registered dietitian for specific protein needs.

E- Only select food items with no fat: It is not necessary or advisable to eliminate all fat from the diet. Healthy fats, such as those found in avocados, nuts, seeds, and olive oil, are important for overall health. Choosing foods with healthier fats and moderating intake of saturated and trans fats is a more balanced approach to nutrition.

F- Take a cinnamon supplement: While cinnamon has been studied for its potential effects on blood sugar control, it is not a proven or recommended treatment for reducing the risk of type 2 diabetes. It's important to focus on overall dietary patterns and lifestyle factors rather than relying solely on supplements

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Naxlex Comprehensive Predictor Exams

Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

Correct Answer is D

Explanation

Discussed the DASH diet with the client and gave examples of appropriate portion sizes. Review H and P, nurse's note, and laboratory results. What other nutritional recommendations would be helpful for this client in reducing the risk for type 2 diabetes? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

At the first dressing change, the practical nurse (PN) tells the client that her mastectomy incision is healing well, but the client refuses to look at the incision and refuses to talk about it. Which response by the PN to the client's silence is best?

Prior to an invasive examination of a hospitalized client, a consent form should be obtained. Which action best describes the responsibility of the practical nurse (PN)?

The practical nurse (PN) is monitoring the neurological vital signs of a client with a recently closed head injury. Which vital sign trends indicate increased intracranial pressure (ICP) and should be reported to the charge nurse?

The medication aide at a long-term care facility is sick and requests to go home before all medications are administered. Which action should the practical nurse (PN) take in this situation?

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