Question

A nurse is preparing to administer O. 9% sodium chloride IV infusion 1000 mL bag at a rate Of 200 mL/hr for a client who has rhabdomyolysis. The nurse should expect the IV pump to infuse over how many hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Answer 1

Correct Answers:

5

Rationale :

✍️ Total volume = 1000 mL

✍️ Rate = 200 mL/hr

Time = 1000 ÷ 200

5 hours

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Answer 2

Correct Answers:

Administer the bronchodilator inhaler first, followed by the corticosteroid inhaler

Rationale :

🔷 Bronchodilators open the airways, enhancing the delivery and absorption of the corticosteroid.

🔷 Administering corticosteroids first would reduce their effectiveness due to limited airway access.

🔷 This sequence ensures maximum therapeutic benefit.

🔷 The client should also rinse their mouth after using corticosteroids.

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Answer 3

Correct Answers:

Albuterol via Jet nebulizer

Rationale :

🟣 Albuterol is a short-acting beta2-adrenergic agonist (SABA), which works by relaxing bronchial smooth muscle and quickly reversing bronchospasm during acute asthma attacks.

🟣 Administering it via jet nebulizer ensures optimal particle delivery deep into the airway, especially when the client is having difficulty with inhaler technique due to labored breathing.

🟣 This route is preferred in moderate to severe exacerbations because it does not rely on patient coordination, unlike a metered-dose inhaler.

🟣 The onset of action is within minutes, and it provides immediate symptom relief such as reduced wheezing and improved airflow.

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Answer 4

Correct Answers:

42 units

Rationale :

✍️ Formula:

Total Dose (units)=Regular Insulin+ NPH Insulin

✍️Given.

Regular insulin = 14 units

NPH insulin = 28 units

✍️ Calculation:

14 units+28 units

42 units

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Answer 5

Correct Answers:

2

Rationale :

✍🏿Formula:

Number of Tablets=Required Dose (mcg)÷Tablet Strength (mcg/tablet)

✍🏿Given:

Required Dose = 100 mcg

Tablet Strength = 50 mcg/tablet

✍🏿Calculation:

100 mcg÷50 mcg/tablet

2 tablets

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Answer 6

Correct Answers:

“I can keep the current vial of insulin in use stored at room temperature."

Rationale :

🟡 Once opened, most insulin vials can be kept at room temperature (15–30°C or 59–86°F) for up to 28 days, unless specified otherwise by the manufacturer.

🟡 Storing insulin in-use at room temperature improves injection comfort and maintains stability for everyday use.

🟡 Unopened vials should be refrigerated, but insulin should never be frozen as freezing denatures the hormone, rendering it ineffective.

🟡 Discarding vials after only a few doses or keeping them past the expiration date on the vial compromises safety and cost-efficiency.

🟡 Teaching proper storage ensures optimal effectiveness and reduces waste.

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Answer 7

Correct Answers:

4 to 14 hr.

Rationale :

🔶 NPH insulin is an intermediate-acting insulin with an onset of 1–2 hours, peak action from 4 to 14 hours, and a total duration of about 16–24 hours.

🔶 The peak window is the time of highest hypoglycemia risk, so clients should be advised to have meals or snacks timed accordingly.

🔶 Nurses must monitor for symptoms like sweating, confusion, shakiness, and intervene quickly if hypoglycemia develops.

🔶 NPH is typically administered twice daily, and timing around meals is key to matching insulin action to glucose levels.

🔶 Regular blood glucose monitoring is essential, especially during the peak period, to prevent hypoglycemia-related complications.

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Answer 8

Correct Answers:

Sim's

Rationale :

🟤 Sim's position, which involves lying on the left side with the right knee bent, aligns the rectum in a straight path for ease of suppository insertion.

🟤 This position uses gravity to facilitate retention of the medication and reduce discomfort.

🟤 The nurse should ensure privacy, lubrication of the suppository, and instruction on breathing techniques to relax the anal sphincter.

🟤 Suppositories should be inserted past the internal sphincter (approximately 1 inch for adults) to prevent expulsion.

🟤 The client should remain in position for 5–10 minutes post-insertion to ensure absorption.

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Answer 9

Correct Answers:

Regular insulin should be administered IV with frequent blood glucose monitoring to ensure appropriate dosage adjustments and prevent hypoglycemia.

Rationale :

🔴 Regular insulin is the only insulin that can be administered intravenously, commonly used in DKA, HHS, or perioperative settings.

🔴 It has a rapid onset (within minutes) when given IV and requires continuous blood glucose monitoring, often every 1–2 hours.

🔴 The goal is to titrate the infusion to maintain a target glucose range, avoiding hypoglycemia and other complications.

🔴 IV insulin is typically administered via a continuous infusion, not bolus, to allow for steady glucose control.

🔴 Protocols vary, but safety measures include renal monitoring and electrolyte replacement, especially potassium.

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Answer 10

Correct Highlights :

Respirations less labored, bilateral wheezing decreased.
Client states chest does not seem to be as tight.
No use of accessory muscles with breathing.
Respiratory rate 20/min
Oxygen saturation 95% on room air

Rationale :

Improved Respiratory Assessment:

⏺️The client's decreased use of accessory muscles and less labored respirations indicate relief from bronchospasm, which confirms that the albuterol was effective.

⏺️Albuterol is a short-acting beta2 agonist that promotes bronchodilation within minutes, and these findings demonstrate its desired effect.

Decreased Wheezing:

⏺️The reduction in bilateral wheezing reflects improved air movement in the lower airways, signaling that the medication is actively reversing airway constriction.

⏺️This outcome confirms successful receptor binding and bronchodilation.

Client’s Subjective Improvement:

⏺️The client's report of decreased chest tightness is an important subjective indicator of improved airflow and relief from respiratory distress.

⏺️Self-reported symptom relief is a critical part of evaluating medication effectiveness, especially in asthma care.

Normalized Respiratory Rate:

⏺️The decrease in respiratory rate from 26/min to 20/min demonstrates clinical improvement in ventilation, moving the client closer to a normal range (12–20 breaths/min).

⏺️This suggests reduced work of breathing and improved gas exchange.

Increased Oxygen Saturation:

⏺️ The SpO₂ improvement from 93% to 95% confirms that the albuterol improved oxygenation, a key therapeutic goal during an asthma exacerbation.

⏺️Adequate oxygen levels reflect effective airway opening and gas exchange.

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Custom PNSG1600 EXAM 4 Respiratory &amp Endocrine

No.

2 :
A client with asthma is prescribed multiple inhalers including a bronchodilator and a corticosteroid inhaler. In what order should the nurse administer these inhalers?

3 :
A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following prescriptions should the nurse anticipate?

4 :
A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

5 :
A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

6 :
A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

7 :
A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration?

8 :
A nurse is preparing to administer a rectal suppository to a client. The nurse should instruct the client to lie in which of the following positions while in bed?

9 :
When administering regular insulin via the IV route, which of the following statements is correct?

10 :
A school nurse is assisting in the care of an adolescent age child.

Correct Highlights :

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Custom PNSG1600 EXAM 4 Respiratory &amp Endocrine

No.

2 : A client with asthma is prescribed multiple inhalers including a bronchodilator and a corticosteroid inhaler. In what order should the nurse administer these inhalers?

3 : A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following prescriptions should the nurse anticipate?

4 : A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

5 : A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

6 : A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

7 : A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration?

8 : A nurse is preparing to administer a rectal suppository to a client. The nurse should instruct the client to lie in which of the following positions while in bed?

9 : When administering regular insulin via the IV route, which of the following statements is correct?

10 : A school nurse is assisting in the care of an adolescent age child.

Correct Highlights :

2 :
A client with asthma is prescribed multiple inhalers including a bronchodilator and a corticosteroid inhaler. In what order should the nurse administer these inhalers?

3 :
A nurse is caring for a client who is experiencing an acute asthma attack. Which of the following prescriptions should the nurse anticipate?

4 :
A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneous daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe?

5 :
A nurse is preparing to administer levothyroxine 100 mcg PO daily. Available is levothyroxine 50 mcg tablets. How many tablets should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

6 :
A nurse is teaching a newly licensed nurse about insulin storage. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

7 :
A nurse is preparing to administer a client's daily dose of NPH insulin at 0730. The nurse should expect this type of insulin to peak within which of the following timeframes after administration?

8 :
A nurse is preparing to administer a rectal suppository to a client. The nurse should instruct the client to lie in which of the following positions while in bed?

9 :
When administering regular insulin via the IV route, which of the following statements is correct?

10 :
A school nurse is assisting in the care of an adolescent age child.