Ticket to clinical 10

A nurse is providing teaching for a client who has diabetes and a new prescription for insulin glargine. which of the following instructions should the nurse provide regarding this type of insulin?

* Insulin glargine has a duration of 3 to 6 hr. * Insulin glargine has a duration of 6 to 10 hr * Insulin glargine has a duration of 16 to 24 hr * Insulin glargine has a duration of 18 to 24 hr

A nurse is teaching a client who has a new prescription for NPH insulin. Which of the following instructions should the nurse include?

*"Discard the medication if it is cloudy" *"Briskly shake the medication before filling the syringe." *"Take this medication 15 medications before meals." *"Eat a snack 8 hours after taking this medication." Answer: "Eat a snack 8 hours after taking this medication." (NPH insulin peaks in 6-14 hours after dosing. The client is at risk for HYPOglycemia and might require a snack at this time. Clients should check blood glucose 8-10 hours after administration of NPH insulin. If HYPOglycemic, consume a small snack of 15 grams of carbs and recheck blood glucose again in 15 min.)

A nurse is evaluating teaching with a client who is receiving continuous subcutaneous insulin via an external insulin pump. which of the following statements by the client indicates a need for further teaching?

*"I will change the needle every 3 days." *"I should store all unused insulin in the refrigerator." *"If I skip lunch, I will skip my mealtime dose of insulin." *"I will use insulin glargine in my insulin pump." Answer: "I will use insulin glargine in my insulin pump." (The client should use a short-acting insulin in the pump. The pump is designed to administer rapid-acting or short acting insulin 24 hours a da. Glargine is classified as a long-acting insulin and is administered at the same time each day to maintain stable blood glucose concentration for a 24 hours period.)

A nurse is a client who is taking metformin XR for type 2 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

*"Take the medication with a meal." *"You may cruz or chew the medication." *"This medication may cause an increase in perspiration." *"This medication may turn your urine orange." "Take the medication with a meal." ( This will help the client avoid HYPOglycemia and GI upset and to provide the most absorption of the medication.)

A nurse is teaching a client how to draw up regular insulin and NPH insulin into the same syringe. Which of the following instructions should the nurse include?

*Draw up the NPH insulin into the syringe first *Inject into the regular insulin first *Shake the NPH insulin until it is well mixed *Discard regular insulin that appears cloudy Answer: Discard regular insulin if cloudy (as it should be clear. NPH insulin is the one that has a cloudy appearance since it is a suspension that needs to be rolled between your hands to mix.)

A nurse is providing teaching to a female client who has type 2 diabetes and a new prescription for pioglitazone. Which of the following instructions should the nurse include in the teaching (SATA)

*Expect urine to be darkened *Monitor daily weight *Increase calcium intake *Use oral contraceptives to avoid pregnancy *Take tablets whole Answer: *Monitor daily weight *Increase calcium intake (*Monitor weight daily is correct. Pioglitazone may lead to fluid retention and worsen heart failure. Clients should monitor weight and report any rapid gains to the provider. *Increase calcium intake is correct. Pioglitazone increases the risk of fractures in women. Clients should be advised to exercise and ensure adequate intake of vitamin D and calcium to protect bone health.)

A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take?

*Give the insulin at 0700. *Give the insulin when the breakfast tray arrives. *Give insulin 30 min after breakfast with the client's other routine medicines. *Give the insulin at 0730. Answer: Give the insulin at 0730.

A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication?

*Grapefruit juice *Milk *Alcohol *Coffee Answer: Alcohol

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who has diabetes mellitus. When mixing the two types of insulin, which of the following actions should the nurse take first?

*Inject 10 units of air into the regular insulin vial. *Inject 20 units of air into the NPH insulin vial. *Withdraw 10 units of insulin from the regular insulin vial. *Replace the needle for withdrawal with a safety needle Answer: Inject 20 units of air into the NPH insulin vial. (The first action the nurse should take is to inject 20 units of air into the NPH insulin vial because this insulin is the intermediate-acting insulin, which will be drawn up last in order to avoid contaminating the regular insulin with NPH insulin)

A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client. What is the sequence of events the nurse should follow? (Move the steps of mixing insulin on the left into the box on the right, placing them in the selected order of performance. All steps must be used.)

*Inject air into NPH insulin vial. *Withdraw short-acting insulin into syringe. *Roll NPH vial between palms of hands. *Inspect vials for contaminants. *Inject air into regular insulin vial. *Add intermediate insulin to syringe. Answer: 1. Inspect vials for contaminants. 2. Roll NPH vial between palms of hands. 3. Inject air into NPH insulin vial. 4. Inject air into regular insulin vial. 5. Withdraw short-acting insulin into syringe. 6. Add intermediate insulin to syringe

A nurse is teaching a client who has new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching?

*Keep the open vial of insulin at room temperature *Inject the insulin into a large muscle *Aspirate the medication prior to administration *Administer the insulin in two separate injections Answer: Keep the open vial of insulin at room temperature. (to minimize tissue injury and to reduce the risk for lipodystrophy.)

A nurse is admitting an older client who has diabetic neuropathy with painful, burning feet. Which of the following interventions should the nurse anticipate the health care provider to prescribe?

*Place a bed cradle on the client's bed *Inspect the client's feet once weekly *Apply graduated compression stockings to the client's lower extremities *Put a heating pad on the client's feet Answer: Place a bed cradle on the client's bed. (bed cradle reduces pain by preventing sheets from touching the hypersensitive skin)

A nurse administers desmopressin to a client who has a diagnosis of diabetes insipidus. The nurse recognizes that which the following laboratory findings indicate a therapeutic effect of the medication?

*Serum sodium 146 mEq/L *Blood glucose 80 mg/dL *Urine specific gravity 1.015 *Blood urea nitrogen (BUN) 15 mg/dL Answer: Urine specific gravity 1.015 (A therapeutic effect of the medication would be urine specific gravity within the expected reference range, which is 1.010-1.025)