A nurse prepares to administer insulin to a client at 1800. The client's medication administration ...

A nurse prepares to administer insulin to a client at 1800. The client's medication administration record contains the following information:
 
  - Insulin glargine: 12 units daily at 1800
  - Regular insulin: 6 units QID at 0600, 1200, 1800, 2400
  Based on the client's medication administration record, which action should the nurse take?
  a.
  Draw up and inject the insulin glargine first, and then draw up and inject the regular insulin.
  b.
  Draw up and inject the insulin glargine first, wait 20 minutes, and then draw up and inject the regular insulin.
  c.
  First draw up the dose of regular insulin, then draw up the dose of insulin glargine in the same syringe, mix, and inject the two insulins together.
  d.
  First draw up the dose of insulin glargine, then draw up the dose of regular insulin in the same syringe, mix, and inject the two insulins together.

Question 2

A nurse reviews the chart and new prescriptions for a client with diabetic ketoacidosis:
 
  Vital Signs and Assessment
  Laboratory
  Results
 
  Medications
  Blood pressure: 90/62 mm Hg
  Pulse: 120 beats/min
  Respiratory rate: 28 breaths/min
  Urine output: 20 mL/hr via catheter
  Serum potassium: 2.6 mEq/L
  Potassium chloride 40 mEq IV bolus STAT
  Increase IV fluid to 100 mL/hr
  Which action should the nurse take?
  a.
  Administer the potassium and then consult with the provider about the fluid order.
  b.
  Increase the intravenous rate and then consult with the provider about the potassium prescription.
  c.
  Administer the potassium first before increasing the infusion flow rate.
  d.
  Increase the intravenous flow rate before administering the potassium.

Question 3

A nurse prepares to administer prescribed regular and NPH insulin. Place the nurse's actions in the correct order to administer these medications.
 
  1. Inspect bottles for expiration dates.
  2. Gently roll the bottle of NPH between the hands.
  3. Wash your hands.
  4. Inject air into the regular insulin.
  5. Withdraw the NPH insulin.
  6. Withdraw the regular insulin.
  7. Inject air into the NPH bottle.
  8. Clean rubber stoppers with an alcohol swab.
  a.
  1, 3, 8, 2, 4, 6, 7, 5
  b.
  3, 1, 2, 8, 7, 4, 6, 5
  c.
  8, 1, 3, 2, 4, 6, 7, 5
  d.
  2, 3, 1, 8, 7, 5, 4, 6

Question 4

A nurse reviews the medication list of a client recovering from a computed tomography (CT) scan with IV contrast to rule out small bowel obstruction. Which medication should alert the nurse to contact the provider and withhold the prescribed dose?
 
  a. Pioglitazone (Actos)
  b. Glimepiride (Amaryl)
  c. Glipizide (Glucotrol)
  d. Metformin (Glucophage)

Question 5

A nurse reviews laboratory results for a client with diabetes mellitus who is prescribed an intensified insulin regimen:
 
  - Fasting blood glucose: 75 mg/dL
  - Postprandial blood glucose: 200 mg/dL
  - Hemoglobin A1c level: 5.5
  How should the nurse interpret these laboratory findings?
  a.
  Increased risk for developing ketoacidosis
  b.
  Good control of blood glucose
  c.
  Increased risk for developing hyperglycemia
  d.
  Signs of insulin resistance

Question 6

After teaching a client who is newly diagnosed with type 2 diabetes mellitus, the nurse assesses the client's understanding. Which statement made by the client indicates a need for additional teaching?
 
  a. I should increase my intake of vegetables with higher amounts of dietary fiber.
  b. My intake of saturated fats should be no more than 10 of my total calorie intake.
  c. I should decrease my intake of protein and eliminate carbohydrates from my diet.
  d. My intake of water is not restricted by my treatment plan or medication regimen.