The nurse is caring for a client who has a finger stick blood glucose level of 130 mg/dL (7.21 mmol/L). Prior to administering the scheduled dose of acarbose, the nurse is informed that morning meal trays will be 30 minutes late. Which action should the nurse take?Reference Range:
Glucose [74 to 106 mg/dL (4.1 to 5.9 mmol/L)]

Notify the healthcare provider.

Administer the medication.

Hold the medication until the meal trays arrive.

Obtain another finger stick blood glucose level.

Answer and Explanation

The Correct Answer is C

A. Notify the healthcare provider: Notification of the healthcare provider is not immediately necessary just because of a meal delay. The nurse can manage the situation appropriately by adjusting the medication timing to ensure patient safety without requiring immediate provider involvement.

B. Administer the medication: Acarbose should be taken with the first bite of food to effectively delay carbohydrate absorption. Administering it without food available increases the risk of hypoglycemia, especially since the glucose level is already slightly elevated but within a manageable range.

C. Hold the medication until the meal trays arrive: Acarbose must be taken with the first mouthful of food to match the timing of glucose absorption. Holding the medication until the meal arrives ensures optimal therapeutic effect and prevents unnecessary hypoglycemia.

D. Obtain another finger stick blood glucose level: Rechecking the blood glucose is unnecessary at this time. The primary concern is coordinating the medication with food intake, not monitoring glucose trends over a short 30-minute delay.

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Correct Answer is B

Explanation

A. Administer an oral analgesic and evaluate its effectiveness before applying the new patch: There is no need to switch to oral analgesics if the client is already well-managed on a fentanyl patch. The focus should be on properly managing the patch schedule rather than changing the route of administration.

B. Apply the new patch in a different location after removing the original patch: Proper protocol for transdermal patches includes removing the old patch before applying a new one to prevent overdose. The new patch should be placed on a different skin site to avoid skin irritation and ensure even drug absorption.

C. Place the patch on the client's shoulder and leave both patches in place for 12 hours: Leaving both patches in place can lead to dangerously high serum fentanyl levels and significant respiratory depression. Only one patch should be used at a time unless otherwise specifically prescribed.

D. Remove the patch and consult with the healthcare provider (HCP) about the client's pain resolution: It is unnecessary to contact the HCP immediately if the client is pain-free and the scheduled time for patch replacement has arrived. Standard procedure should be followed by simply removing the old patch and applying the new one.

A. Ask the client to describe her dietary intake history for the last several days. B. Instruct the client to increase her intake of saturated fats over the next week. C. Advise the client to stop taking the drug and contact her healthcare provider (HCP). D. Obtain a stool specimen to evaluate for occult blood and fat content.

Correct Answer is A

Explanation

A. Ask the client to describe her dietary intake history for the last several days: Orlistat works by inhibiting fat absorption, and excessive intake of dietary fats can cause oily stools and gas. Assessing the client’s recent diet helps determine if her symptoms are due to high fat consumption, which can then be managed through dietary adjustments.

B. Instruct the client to increase her intake of saturated fats over the next week: Increasing fat intake would likely worsen her symptoms, as orlistat prevents fat absorption, leading to more pronounced gastrointestinal side effects if fat intake remains high.

C. Advise the client to stop taking the drug and contact her healthcare provider (HCP): Stopping orlistat is unnecessary at this stage. Oily stools are a common and expected side effect if dietary fat intake is not controlled, so addressing dietary habits is the first and more appropriate intervention.

D. Obtain a stool specimen to evaluate for occult blood and fat content: There is no indication that the client’s symptoms suggest gastrointestinal bleeding. The oily stools are an anticipated effect of fat malabsorption caused by orlistat, not a sign of occult blood loss.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When preparing to apply a scheduled fentanyl transdermal patch, the nurse notes that the previously applied patch is intact on the client's upper back and the client denies pain. Which action should the nurse take?

Correct Answer is B

Explanation

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take?

Correct Answer is A

Explanation

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