NCLEX info

The nurse is collecting data on a client with hyperparathyroidism. Which question would elicit accurate information about this condition from the client?

"Are you experiencing pain in your joints?"

A client received 20 units of NPH insulin subcutaneously at 8:00 am. The nurse should check the client for a potential hypoglycemic reaction at which time?

5:00 pm

A nurse has reinforced instructions about measuring blood glucose levels to a client newly diagnosed with diabetes mellitus. The nurse determines that the client understands the procedure when making which most accurate statement?

"I should check my blood glucose level before eating each meal, regardless of how much I eat."

The nurse realizes that the client taking metformin needs further teaching when the client makes which statement?

"I should treat hypoglycemic episodes due to metformin with glucose tablets only."

The nurse is reinforcing instructions to the client about insulin glargine. The nurse determines that the client understands the action of the medication if the client makes which statement?

"I will give myself this medication subcutaneously once each night before bed."

L ispro insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which statement is made?

"I will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner."

A client informs the nurse that she has been taking acarbose as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?

A 2-hour postprandial serum glucose of 120 mg/dL

Potassium iodide is prescribed for a client. The nurse reinforces instructions to the client that the primary health care provider should be notified if the client experiences which symptom? Select all that apply.

A burning in the mouth A brassy taste in the mouth Soreness of the gums and teeth

The nurse is monitoring a client receiving glipizide. Which outcome indicates an ineffective response from the medication?

A glycosylated hemoglobin level of 12%

A client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. The primary health care provider plans to implement a diagnostic test to determine if the client is experiencing a myasthenic crisis and administers edrophonium. Which data would indicate that the client is experiencing a myasthenic crisis?

A temporary improvement in the condition

A client has been prescribed acarbose for treatment of diabetes mellitus. Client teaching regarding this medication should include which instructions? Select all that apply.

Abdominal cramping is common. 4. Side effects include excessive flatulence. 5. The medication should be taken with each meal.

A client receiving desmopressin begins to complain of a headache. The nurse notes that the client is listless and falls asleep easily. The nurse interprets that the client is most likely experiencing which reaction?

Adverse medication effects

A client is suspected of having myasthenia gravis, and the primary health care provider administers edrophonium to determine the diagnosis. After administration of this medication, which sign/symptom would indicate the presence of myasthenia gravis?

An increase in muscle strength

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which prescription should the nurse anticipate during therapy with the prednisone?

An increased amount of daily NPH insulin

The nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse should expect the primary health care provider to prescribe which? Select all that apply.

Calcitonin 3. Furosemide 4. Assist to ambulate PRN

A client is diagnosed with hypothyroidism, and levothyroxine is prescribed. The nurse notes that the client is presently taking warfarin sodium and anticipates that the primary health care provider will alter which medication dosage?

Decrease the dosage of warfarin sodium.

The nurse is collecting data from a client receiving pioglitazone 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1c (HbA1c)

Desmopressin acetate is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

The nurse is collecting data from a client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that metformin is taken daily. Based on this finding, the nurse elicits data from the client regarding the presence of which condition?

Diabetes mellitus

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply.

Diarrhea can occur secondary to metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes.

A glucocorticoid is prescribed for a client with adrenal insufficiency, and the nurse reinforces medication instructions to the client. The nurse determines that the client needs further teaching if the client states which action is necessary?

Discontinue the medication when symptoms subside.

The nurse is monitoring a client receiving desmopressin acetate for adverse effects to the medication. Which sign/symptom indicates the presence of an adverse effect?

Drowsiness

A daily dose of prednisone is prescribed for a client. The nurse reinforces instructions to the client regarding administration of the medication and instructs the client to take this medication at which time?

Early morning Corticosteroids (glucocorticoids) should be administered before 9:00 am. Administration at this time helps minimize adrenal insufficiency and mimics the burst of glucocorticoids released naturally by the adrenal glands each morning.

Fludrocortisone is prescribed for a client with Addison's disease. The primary health care provider needs to be notified if the client experiences which conditions? Select all that apply.

Edema Chest pain Muscle cramps

A client diagnosed with hypothyroidism is taking levothyroxine. The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. The appropriate nursing response to the client is based on which information?

Full therapeutic effect may take 1 to 3 weeks.

Metformin is prescribed for a client with type 2 diabetes mellitus. Which should the nurse tell the client is a common side effect of the medication?

Gastrointestinal (GI) disturbances

The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which disorder?

Graves' disease

A client has a fasting blood glucose of 268 mg/dL at 7:30 am. The sliding scale prescriptions are blood glucose 151 to 200 mg/dL, administer 3 units Humalog insulin; 201 to 250, administer 6 units Humalog insulin; 251 to 300 mg/dL, administer 9 units Humalog insulin; over 300 mg/dL contact the primary health care provider. Therefore, at 7:30 am, how many units of Humalog should be administered?

Humalog 9 units

The client with Cushing's syndrome had bilateral adrenalectomies and is now on corticosteroid therapy. The client also has a history of seizures. The nurse giving discharge instructions concerning corticosteroid therapy realizes there is a need for further teaching when the client makes which statement?

I know my doctor can now decrease my dosage of phenytoin.

The nurse reinforces instructions to a client with myxedema about the dosage, method of administration, and side effects of levothyroxine sodium. Which statement by the client indicates an understanding of the nurse's instructions?

I will report any episodes of palpitations, chest pain, or dyspnea."

An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse is reviewing the medical record and needs to contact the primary health care provider if there is a history of which condition?

Liver disease

A client has been diagnosed with hypoparathyroidism. Which food groups should be included in the diet?

Low in phosphorus and high in calcium

Potassium iodide is prescribed for a client. The client calls the nurse at the clinic and complains of a brassy taste and burning sensations in the mouth. How should the nurse respond?

Notify the primary health care provider.

Lispro insulin is prescribed for a child with type 1 diabetes mellitus. The nurse is reinforcing a teaching session with the child and mother about the onset, peak, and duration times of the insulin. The nurse provides which information about this type of insulin?

Onset of 15 to 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours

A client with diabetes mellitus visits a healthcare clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 mg/dL to 200 mg/dL (10.2 mmol/L to 11.4 mmol/L). Which medication, added to the client's regimen, may have contributed to the hyperglycemia?

Prednisone

The nurse assists with creating a plan of care for a client with hyperparathyroidism receiving calcitonin-human. Which outcome has the highest priority regarding this medication?

Reaching normal serum calcium levels

The nurse is reinforcing instructions to a client regarding intranasal desmopressin acetate. The nurse should tell the client that the medication has which side effect?

Runny nose

A client who is managing diabetes mellitus with insulin injections asks the nurse for information about any necessary changes in her diet to avoid hyperinsulinism. Which diet would be appropriate for the client?

Small frequent meals with protein, fat, and carbohydrates at each meal

A client diagnosed with hyperthyroidism will be taking propylthiouracil. The nurse reinforces medication instructions and determines that the client understands the information if the client states that it is most important to report which symptoms to the primary health care provider?

Sore throat

A client is scheduled for subtotal thyroidectomy. Potassium iodide is prescribed. The nurse understands that which outcome is the therapeutic effect of this medication?

Suppress thyroid hormone production.

A client with a partial right adrenalectomy is placed on corticosteroid replacement therapy. Which data would indicate that the client is experiencing an adverse effect related to the pharmacological treatment?

Tarry stools Glucocorticoids increase gastric secretion, and this can result in peptic ulcers and gastrointestinal bleeding. A sign of gastrointestinal bleeding is the presence of tarry (black) stools. Corticosteroids increase the blood glucose.

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate is prescribed for the client. What would the nurse explain to the client as the purpose of the medication?

To increase water reabsorption

The nurse reinforces medication instructions to a client who is taking levothyroxine. The nurse instructs the client to notify the primary health care provider (PHCP) if which sign/symptom occurs?

Tremors

A hospitalized client with severe seborrheic dermatitis is receiving treatments of topical glucocorticoid applications followed by the application of an occlusive dressing. The nurse monitors the client for which systemic effect that can occur as a result of this treatment?

adrenal suppression

The nurse is teaching a client, newly diagnosed with diabetes mellitus, to mix 24 units NPH and 12 units regular insulin in the same syringe. Which instructions should the nurse give to the client to take after wiping the vials with an alcohol wipe?

Inject 24 units of air into the NPH insulin vial.

The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply.

Insomnia Weight loss Mild heat intolerance

The nurse is assisting in preparing a care plan for a client with diabetes mellitus who has hyperglycemia. The nurse should focus on which potential problem for this client?

dehydration

Lispro insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which statement is made?

will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner."

A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states to monitor for which?

Anorexia, nausea, weakness, and fatigue

An adult client with hypothyroidism is admitted to the hospital. When reviewing the client's health record, the nurse notes that the client is taking a maintenance dose of levothyroxine. The nurse is also reviewing instructions concerning taking levothyroxine with the client. There is a need for further teaching when the client makes which statement?

I will take the pill with milk to keep from upsetting my stomach."

A client diagnosed with diabetes insipidus is beginning medication therapy with lypressin. The nurse realizes the client understands instructions if the client comments the medicine will be taken in which manner?

Intranasally to promote water reabsorption

Insulin glargine is prescribed for a client with diabetes mellitus. The nurse tells the client that which is the best time to take the insulin?

Once daily at the same time each day

Lispro insulin is prescribed three times a day, with the amount based on blood glucose levels. The nurse determines that the client understands teaching regarding lispro insulin if which statement is made?

I will take the lispro 10 to 15 minutes before I eat breakfast, lunch, and dinner."