Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse accidentally administers the medication metformin instead of metoprolol to a client.
Which of the following actions should the nurse take?
A. Obtain the client’s HDL level.
Choice A is wrong because HDL (high-density lipoprotein) is a type of cholesterol that is not affected by metformin or metoprolol.
B. Monitor the client’s thyroid function levels.
Choice B is wrong because thyroid function levels are not affected by metformin or metoprolol.
C. Collect the client’s uric acid level.
Choice C is wrong because uric acid level is not affected by metformin or metoprolol. Uric acid is a waste product that can cause gout if it accumulates in the joints. Normal ranges for blood glucose are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals. Normal ranges for HDL are 40 to 60 mg/dL for men and 50 to 60 mg/dL for women. Normal ranges for thyroid function levels vary depending on the specific test, but generally they are between 0.4 and 4.0 mIU/L for TSH (thyroid-stimulating hormone), 4.5 to 11.2 mcg/dL for T4 (thyroxine), and 80 to 180 ng/dL for T3 (triiodothyronine). Normal ranges for uric acid are 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women.
D. Check the client’s glucose level.
Metformin is a medication used to lower blood glucose levels in people with type 2 diabetes. Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. If the nurse accidentally gives metformin instead of metoprolol, the client may experience hypoglycemia (low blood sugar), which can cause symptoms such as sweating, shakiness, confusion, and loss of consciousness. Therefore, the nurse should check the client’s glucose level and treat hypoglycemia if needed.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Pharmacology 2019 Proctored Exam. Take the full exam now
Full Explanation
Metformin is a medication used to lower blood glucose levels in people with type 2 diabetes. Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. If the nurse accidentally gives metformin instead of metoprolol, the client may experience hypoglycemia (low blood sugar), which can cause symptoms such as sweating, shakiness, confusion, and loss of consciousness. Therefore, the nurse should check the client’s glucose level and treat hypoglycemia if needed.
Choice A is wrong because HDL (high-density lipoprotein) is a type of cholesterol that is not affected by metformin or metoprolol.
Choice B is wrong because thyroid function levels are not affected by metformin or metoprolol.
Choice C is wrong because uric acid level is not affected by metformin or metoprolol.
Uric acid is a waste product that can cause gout if it accumulates in the joints. Normal ranges for blood glucose are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.
Normal ranges for HDL are 40 to 60 mg/dL for men and 50 to 60 mg/dL for women.
Normal ranges for thyroid function levels vary depending on the specific test, but generally they are between 0.4 and 4.0 mIU/L for TSH (thyroid-stimulating hormone), 4.5 to 11.2 mcg/dL for T4 (thyroxine), and 80 to 180 ng/dL for T3 (triiodothyronine).
Normal ranges for uric acid are 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women.
Similar Questions
A nurse is providing teaching to a client who has a new prescription for theophylline, a sustained-release capsule.
Which of the following statements by the client indicates an understanding of the teaching?
A. “I may sprinkle the medication in applesauce.”.
Choice A is wrong because the client should not sprinkle the medication in applesauce or any other food. Theophylline is a sustained-release capsule that should be swallowed whole and not crushed or chewed.
B. “I can take my medication in the morning with my coffee.”.
Choice B is wrong because the client should avoid caffeine while on this medication, as it can increase the side effects of theophylline, such as nausea, vomiting, headache, and irregular heart rate.
C. “I should limit my fluid intake while on this medication.”.
Choice C is wrong because the client should not limit fluid intake while on this medication, unless instructed by the doctor. Fluid intake helps prevent dehydration and kidney problems that can affect theophylline levels in the blood.
D. “I will need to have blood levels drawn.”.
The client will need to have blood levels drawn to monitor the therapeutic and toxic levels of theophylline, a bronchodilator that is used to treat symptoms of asthma and other lung conditions. The normal range of theophylline in the blood is 10 to 20 mcg/mL.
Full Explanation
The client will need to have blood levels drawn to monitor the therapeutic and toxic levels of theophylline, a bronchodilator that is used to treat symptoms of asthma and other lung conditions. The normal range of theophylline in the blood is 10 to 20 mcg/mL.
Choice A is wrong because the client should not sprinkle the medication in applesauce or any other food. Theophylline is a sustained-release capsule that should be swallowed whole and not crushed or chewed.
Choice B is wrong because the client should avoid caffeine while on this medication, as it can increase the side effects of theophylline, such as nausea, vomiting, headache, and irregular heart rate.
Choice C is wrong because the client should not limit fluid intake while on this medication unless instructed by the doctor.
Fluid intake helps prevent dehydration and kidney problems that can affect theophylline levels in the blood.
A nurse is caring for a client who is taking lithium and reports starting a new exercise program.
The nurse should assess the client for which of the following electrolyte imbalances?
A. Hypomagnesemia.
Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.
B. Hypocalcemia.
Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.
C. Hyponatremia.
Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.
D. Hypokalemia.
Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise. However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are: Sodium: 135-145 mmol/L Magnesium: 0.7-1.1 mmol/L Calcium: 2.1-2.6 mmol/L Potassium: 3.5-5.0 mmol/L
Full Explanation
Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.
Strenuous exercise can also cause hyponatremia by increasing sweat loss and fluid intake. Therefore, a client who is taking lithium and starting a new exercise program is at risk of developing hyponatremia.
Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.
Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.
Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise.
However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are:
Sodium: 135-145 mmol/L
Magnesium: 0.7-1.1 mmol/L
Calcium: 2.1-2.6 mmol/L
Potassium: 3.5-5.0 mmol/L
A nurse is administering naloxone to a client who has developed an adverse reaction to morphine.
The nurse should identify which of the following findings is a therapeutic effect of naloxone?
A. Decreased blood pressure.
Choice A is wrong because decreased blood pressure is not a therapeutic effect of naloxone. In fact, naloxone can cause hypertension (high blood pressure) as a side effect due to opioid withdrawal.
B. Decreased nausea.
Choice B is wrong because decreased nausea is not a therapeutic effect of naloxone. Nausea is a common side effect of morphine, but naloxone does not affect it directly. Naloxone can actually cause nausea and vomiting as a side effect due to opioid withdrawal.
C. Increased respiratory rate.
A therapeutic effect of naloxone is the reversal of opioid-induced respiratory depression, which is one of the most dangerous complications of opioid overdose. Naloxone works by binding to opioid receptors, displacing opioids, and restoring normal respiratory drive. An increase in respiratory rate after administration indicates that naloxone is effective.
D. Increased pain relief.
Choice D is wrong because increased pain relief is not a therapeutic effect of naloxone. Pain relief is a desired effect of morphine, but naloxone antagonizes it by blocking the opioid receptors. Naloxone can cause pain and discomfort as a side effect due to opioid withdrawal.
Full Explanation
A therapeutic effect of naloxone is the reversal of opioid-induced respiratory depression, which is one of the most dangerous complications of opioid overdose. Naloxone works by binding to opioid receptors, displacing opioids, and restoring normal respiratory drive. An increase in respiratory rate after administration indicates that naloxone is effective.
Choice A is wrong because decreased blood pressure is not a therapeutic effect of naloxone.
In fact, naloxone can cause hypertension (high blood pressure) as a side effect due to opioid withdrawal.
Choice B is wrong because decreased nausea is not a therapeutic effect of naloxone. Nausea is a common side effect of morphine, but naloxone does not affect it directly.
Naloxone can actually cause nausea and vomiting as a side effect due to opioid withdrawal.
Choice D is wrong because increased pain relief is not a therapeutic effect of naloxone.
Pain relief is a desired effect of morphine, but naloxone antagonizes it by blocking the opioid receptors.
Naloxone can cause pain and discomfort as a side effect due to opioid withdrawal.