The nurse is planning to discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse include in the discharge teaching?

Teach the client self-injection skills for daily subcutaneous administration.

Demonstrate how to select dose based on before meal blood sugar readings.

Explain to the family how to inject this medication for severe hypoglycemia.

Provide information on increasing medication dosage if ketoacidosis occurs.

Answer and Explanation

The Correct Answer is A

Insulin glargine is a long-acting insulin that is given once daily at the same time every day via subcutaneous injection. Therefore, it is essential to teach the client self-injection skills for daily subcutaneous administration to ensure proper administration of insulin.

Option b is incorrect because insulin glargine is typically given at the same dose every day, not based on before meal blood sugar readings.

Option c is incorrect because insulin glargine is not used for the treatment of severe hypoglycemia, and it should not be administered by someone who is not trained to do so.

Option d is incorrect because ketoacidosis is a serious complication of diabetes mellitus that requires urgent medical atention, and increasing medication dosage is not appropriate for this condition.

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Correct Answer is D

Explanation

Metoclopramide is a medication used to treat nausea and vomiting, including those caused by chemotherapy. However, it has a potential adverse eﬀect of causing extrapyramidal symptoms (EPS), which are involuntary movements of the body, such as muscle spasms, twitching, or restlessness. These symptoms can be distressing for patients and can interfere with their quality of life. EPS can be a sign of tardive dyskinesia, a serious and irreversible neurological disorder.

Therefore, it is essential for the nurse to monitor the client for any signs of EPS and report them immediately to the healthcare provider to prevent further complications. Unusual irritability, diarrhea, and nausea are also potential adverse eﬀects of metoclopramide, but they are not as concerning as EPS.

A. Reports on increased energy levels and decreased fatigue. B. Takes concurrent iron therapy without adverse eﬀects. C. The hemoglobin level increased to 12 grams/dL (120mmol/L). D. Food diary shows increased consumption of iron rich foods.

Correct Answer is C

Explanation

Epoetin alfa is a medication that stimulates the production of red blood cells and is commonly used to treat anemia in patients with chronic kidney disease. Hemoglobin level is the most important parameter to monitor the eﬀectiveness of epoetin alfa therapy. An increase in hemoglobin level indicates an improvement in the patient's anemia and suggests that the medication is eﬀective.

While options a, b, and d are also important considerations in the management of anemia, they do not provide a definitive indication of the eﬀectiveness of epoetin alfa therapy. Reports of increased energy levels and decreased fatigue can be subjective and inﬂuenced by many factors. Taking concurrent iron therapy without adverse eﬀects is important to support the production of red blood cells but does not confirm the eﬀectiveness of epoetin alfa. Increased consumption of iron-rich foods can be helpful in managing anemia, but it does not provide a direct indication of the eﬀectiveness of epoetin alfa therapy.

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The nurse is planning to discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse include in the discharge teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse eﬀect is most important for the nurse to report?

Correct Answer is D

Explanation

A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is eﬀective?

Correct Answer is C

Explanation

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