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The nurse reviews the laboratory values. What question(s) can the nurse ask the client based on the laboratory results? Select all that apply.

Are you taking any supplements?

Have you experienced itching or hives?

Have you noticed that your skin is dry?

Have you noticed the need to urinate less often?

Do you use any salt substitutes?

Have you experienced urgency to urinate?

Answer and Explanation

Correct Answer : A

Choice A reason:

Asking if the client is taking any supplements is important because certain supplements can affect blood urea nitrogen (BUN) levels. For example, high protein supplements can increase BUN levels, while others might interact with medications or affect kidney function.

Choice B reason:

Inquiring about itching or hives is relevant for identifying potential allergic reactions or side effects from medications or supplements. However, it is not directly related to the BUN levels.

Choice C reason:

Dry skin can be a symptom of various conditions, including dehydration or kidney issues. While it is a useful question, it does not directly address the BUN levels.

Choice D reason:

Asking if the client has noticed the need to urinate less often is crucial for assessing kidney function. Reduced urine output can indicate kidney dysfunction, which can affect BUN levels.

Choice E reason:

Using salt substitutes is relevant because some contain potassium, which can affect kidney function and electrolyte balance. This question helps assess potential dietary influences on BUN levels.

Choice F reason:

Experiencing urgency to urinate can be a symptom of urinary tract issues or other conditions. While it is important to know, it is not directly related to the BUN levels.

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Correct Answer is D

Explanation

Choice A reason:

Assessing for hypoglycemia between meals is important, but it is not the most critical intervention. Insulin lispro is a rapid-acting insulin that peaks quickly, so timing meals with insulin administration is crucial to prevent hypoglycemia.

Choice B reason:

Checking blood glucose levels every six hours is a good practice for monitoring overall glucose control, but it does not address the immediate need to coordinate insulin administration with meals to prevent hypoglycemia.

Choice C reason:

Keeping an oral liquid or glucose source available is essential for treating hypoglycemia if it occurs. However, the primary focus should be on preventing hypoglycemia by ensuring that meals are timed appropriately with insulin administration.

Choice D reason:

Providing meals at the same time insulin is given is the most important intervention. Insulin lispro acts rapidly, and if meals are not timed correctly, there is a high risk of hypoglycemia. Ensuring that the client eats at the same time as the insulin injection helps maintain stable blood glucose levels.

A. Temperature. B. Respiratory rate. C. Pulse rate. D. Blood pressure.

Correct Answer is B

Explanation

Choice A Reason:

While monitoring temperature is important for overall health assessment, it is not the most critical vital sign to check first in the context of opioid-induced lethargy. Opioids primarily affect the respiratory system, and respiratory depression is a significant risk. Therefore, temperature is not the priority in this scenario.

Choice B Reason:

Respiratory rate is the most critical vital sign to check first. Opioids can cause respiratory depression, which can be life-threatening. A decreased respiratory rate is a key indicator of opioid overdose or severe side effects. Monitoring the respiratory rate allows the nurse to assess the severity of the respiratory depression and take immediate action if necessary.

Choice C Reason:

Pulse rate is also an important vital sign, but it is secondary to respiratory rate in this context. While opioids can affect heart rate, the immediate concern with opioid-induced lethargy is respiratory depression. Therefore, checking the respiratory rate takes precedence over the pulse rate.

Choice D Reason:

Blood pressure is another vital sign that should be monitored, but it is not the first priority in this situation. Opioids can cause hypotension, but the primary and most immediate concern is respiratory depression. Therefore, the respiratory rate should be assessed first to ensure the client’s airway and breathing are adequate.

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The nurse reviews the laboratory values. What question(s) can the nurse ask the client based on the laboratory results? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro?

Correct Answer is D

Explanation

The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which vital sign should the nurse obtain first?

Correct Answer is B

Explanation

A client who is taking furosemide reports experiencing leg cramps, a cough, feeling tired, and palpitations. Which action should the nurse take first?

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