Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Mr Ozz, a 45-year-old insulin-dependent diabetic, is admitted to the hospital with a diagnosis of pneumonia. He has been febrile since admission. His daily insulin requirement is 24 units of NPH. Every morning Albert is given NPH insulin at 0730. Meals are served at 0830, 1230, and 1830.
The nurse expects that the NPH insulin will reach its maximum effect (peak) between the hours of:
A. 1530 and 2130
This does not match the peak time of NPH insulin.
B. 1730 and 2330
This does not match the peak time of NPH insulin.
C. 1130 and 1330
This does not match the peak time of NPH insulin.
D. 1330 and 1930
This is because NPH insulin is an intermediate-acting insulin that has an onset of action of 1 to 2 hours, a peak of 6 to 12 hours, and a duration of 18 to 24 hours. Therefore, if Albert is given NPH insulin at 0730, the peak effect will occur between 1330 and 1930, which means that his blood glucose level will be lowest during this time.
This question is an excerpt from Nurse Dive's nursing test bank - Interprofessional Care of the Client and Family Across the Lifespan II Proctored Exam. Take the full exam now
Full Explanation
Choice A rationale: This does not match the peak time of NPH insulin.
Choice B rationale: This does not match the peak time of NPH insulin.
Choice C rationale: This does not match the peak time of NPH insulin.
Choice D rationale: This is because NPH insulin is an intermediate-acting insulin that has an onset of action of 1 to 2 hours, a peak of 6 to 12 hours, and a duration of 18 to 24 hours. Therefore, if Albert is given NPH insulin at 0730, the peak effect will occur between 1330 and 1930, which means that his blood glucose level will be lowest during this time.
Similar Questions
The medical reports of a client who suffered an accident show injuries at the sixth thoracic vertebra, lack of normal sympathetic outflow, bradycardia and low blood pressure. Which condition does the nurse suspect in the client?
A. Conus medullaris syndrome
Conus medullaris syndrome involves injury or compression to the end portion of the spinal cord and can present with various symptoms but not necessarily lack of normal sympathetic outflow leading to shock.
B. Concussion
Concussion is a mild traumatic brain injury, and the symptoms described align more with spinal cord injury leading to neurogenic shock.
C. Neurogenic shock
Neurogenic shock occurs due to the loss of sympathetic tone and is characterized by bradycardia, low blood pressure, and vasodilation following spinal cord injury at or above the level of the sixth thoracic vertebra.
D. Diffuse axonal injury
Diffuse axonal injury typically presents with more widespread brain injury-related symptoms and is not associated with the specific spinal cord-related symptoms described.
Full Explanation
Choice A rationale: Conus medullaris syndrome involves injury or compression to the end portion of the spinal cord and can present with various symptoms but not necessarily lack of normal sympathetic outflow leading to shock.
Choice B rationale: Concussion is a mild traumatic brain injury, and the symptoms described align more with spinal cord injury leading to neurogenic shock.
Choice C rationale: Neurogenic shock occurs due to the loss of sympathetic tone and is characterized by bradycardia, low blood pressure, and vasodilation following spinal cord injury at or above the level of the sixth thoracic vertebra.
Choice D rationale: Diffuse axonal injury typically presents with more widespread brain injury-related symptoms and is not associated with the specific spinal cord-related symptoms described.
The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?
A. Calcium 8.6 mg/dL
A calcium level of 8.6 mg/dL is within the normal range.
B. WBC 19,000 mm3
An elevated white blood cell count (WBC) of 19,000 mm3 indicates a potential infection or inflammatory process, requiring immediate attention, especially in a client receiving peritoneal dialysis.
C. Serum pH 7.33
A serum pH of 7.33 is within the normal range.
D. Hemoglobin 9 mg/dL
A hemoglobin level of 9 mg/dL might indicate anemia, but in a client receiving dialysis, it might not require immediate reporting unless it significantly drops further.
Full Explanation
Choice A rationale: A calcium level of 8.6 mg/dL is within the normal range.
Choice B rationale: An elevated white blood cell count (WBC) of 19,000 mm3 indicates a potential infection or inflammatory process, requiring immediate attention, especially in a client receiving peritoneal dialysis.
Choice C rationale: A serum pH of 7.33 is within the normal range.
Choice D rationale: A hemoglobin level of 9 mg/dL might indicate anemia, but in a client receiving dialysis, it might not require immediate reporting unless it significantly drops further.
A nurse is developing a plan of care for a client with a new diagnosis of Graves' disease.
Which of the following interventions does the nurse include in the plan of care?
A. Keeping the room well-lit at all time
Clients with Graves' disease may have increased sensitivity to light due to ocular manifestations like photophobia, so keeping the room well-lit may can cause eye irritation.
B. Encouraging frequent ambulation and exercise
Encouraging frequent ambulation and exercise may worsen the symptoms of hyperthyroidism, such as tachycardia, palpitations, and tremors.
C. Providing a high-calorie and high protein diet
This is because clients with Graves' disease have an increased metabolic rate and may experience weight loss, muscle wasting, and fatigue. A high- calorie and high protein diet can help prevent these complications and provide adequate nutrition for the client.
D. Placing extra blankets over the client
Placing extra blankets over the client may increase the body temperature and cause heat intolerance, which is another common symptom of Graves' disease.
Full Explanation
Choice A rationale: Clients with Graves' disease may have increased sensitivity to light due to ocular manifestations like photophobia, so keeping the room well-lit may can cause eye irritation.
Choice B rationale: Encouraging frequent ambulation and exercise may worsen the symptoms of hyperthyroidism, such as tachycardia, palpitations, and tremors.
Choice C rationale: This is because clients with Graves' disease have an increased
metabolic rate and may experience weight loss, muscle wasting, and fatigue. A high- calorie and high protein diet can help prevent these complications and provide adequate nutrition for the client.
Choice D rationale: Placing extra blankets over the client may increase the body temperature and cause heat intolerance, which is another common symptom of Graves' disease.