WASTEWATER TREATMENT
OPERATOR EXAM TEST PAPER
QUESTIONS SOLUTIONS GRADED A+
◉ 23.) A client who has been newly diagnosed with diabetes
mellitus has been stabilized with daily insulin injections. Which
information should the nurse teach when carrying out plans for
discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage.
Answer: 2. Rotate the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual
exercise. If acetone is found in the urine, it may possibly indicate the
need for additional insulin. To minimize the discomfort associated
with insulin injections, the insulin should be administered at room
temperature. Injection sites should be systematically rotated from
one area to another. The client should be instructed to give
injections in one area, about 1 inch apart, until the whole area has
been used and then to change to another site. This prevents
dramatic changes in daily insulin absorption.
,◉ 24.) A nurse is reinforcing teaching for a client regarding how to
mix regular insulin and NPH insulin in the same syringe. Which of
the following actions, if performed by the client, indicates the need
for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into
the vial Answer: 1. Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin
preparation, the regular insulin is drawn into the syringe first. This
sequence will avoid contaminating the vial of regular insulin with
insulin of another type. Options 2, 3, and 4 identify the correct
actions for preparing NPH and regular insulin.
◉ 25.) A home care nurse visits a client recently diagnosed with
diabetes mellitus who is taking Humulin NPH insulin daily. The
client asks the nurse how to store the unopened vials of insulin. The
nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature. Answer: 2. Refrigerate the
insulin.
,Rationale:
Insulin in unopened vials should be stored under refrigeration until
needed. Vials should not be frozen. When stored unopened under
refrigeration, insulin can be used up to the expiration date on the
vial. Options 1, 3, and 4 are incorrect.
◉ 26.) Glimepiride (Amaryl) is prescribed for a client with diabetes
mellitus. A nurse reinforces instructions for the client and tells the
client to avoid which of the following while taking this medication?
1. Alcohol
2. Organ meats
3. Whole-grain cereals
4. Carbonated beverages Answer: 1. Alcohol
Rationale:
When alcohol is combined with glimepiride (Amaryl), a disulfiram-
like reaction may occur. This syndrome includes flushing,
palpitations, and nausea. Alcohol can also potentiate the
hypoglycemic effects of the medication. Clients need to be instructed
to avoid alcohol consumption while taking this medication. The
items in options 2, 3, and 4 do not need to be avoided.
◉ 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile
dysfunction. A nurse reviews the client's medical record and would
question the prescription if which of the following is noted in the
client's history?
, 1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins Answer: 3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in
the corpus cavernosum of the penis, thus sustaining an erection.
Because of the effect of the medication, it is contraindicated with
concurrent use of organic nitrates and nitroglycerin. Sildenafil is not
contraindicated with the use of vitamins. Neuralgia and insomnia
are side effects of the medication.
◉ 28.) The health care provider (HCP) prescribes exenatide (Byetta)
for a client with type 1 diabetes mellitus who takes insulin. The
nurse knows that which of the following is the appropriate
intervention?
1. The medication is administered within 60 minutes before the
morning and evening meal.
2. The medication is withheld and the HCP is called to question the
prescription for the client.
3. The client is monitored for gastrointestinal side effects after
administration of the medication.
4. The insulin is withdrawn from the Penlet into an insulin syringe
to prepare for administration. Answer: 2. The medication is withheld
and the HCP is called to question the prescription for the client.
OPERATOR EXAM TEST PAPER
QUESTIONS SOLUTIONS GRADED A+
◉ 23.) A client who has been newly diagnosed with diabetes
mellitus has been stabilized with daily insulin injections. Which
information should the nurse teach when carrying out plans for
discharge?
1. Keep insulin vials refrigerated at all times.
2. Rotate the insulin injection sites systematically.
3. Increase the amount of insulin before unusual exercise.
4. Monitor the urine acetone level to determine the insulin dosage.
Answer: 2. Rotate the insulin injection sites systematically.
Rationale:
Insulin dosages should not be adjusted or increased before unusual
exercise. If acetone is found in the urine, it may possibly indicate the
need for additional insulin. To minimize the discomfort associated
with insulin injections, the insulin should be administered at room
temperature. Injection sites should be systematically rotated from
one area to another. The client should be instructed to give
injections in one area, about 1 inch apart, until the whole area has
been used and then to change to another site. This prevents
dramatic changes in daily insulin absorption.
,◉ 24.) A nurse is reinforcing teaching for a client regarding how to
mix regular insulin and NPH insulin in the same syringe. Which of
the following actions, if performed by the client, indicates the need
for further teaching?
1. Withdraws the NPH insulin first
2. Withdraws the regular insulin first
3. Injects air into NPH insulin vial first
4. Injects an amount of air equal to the desired dose of insulin into
the vial Answer: 1. Withdraws the NPH insulin first
Rationale:
When preparing a mixture of regular insulin with another insulin
preparation, the regular insulin is drawn into the syringe first. This
sequence will avoid contaminating the vial of regular insulin with
insulin of another type. Options 2, 3, and 4 identify the correct
actions for preparing NPH and regular insulin.
◉ 25.) A home care nurse visits a client recently diagnosed with
diabetes mellitus who is taking Humulin NPH insulin daily. The
client asks the nurse how to store the unopened vials of insulin. The
nurse tells the client to:
1. Freeze the insulin.
2. Refrigerate the insulin.
3. Store the insulin in a dark, dry place.
4. Keep the insulin at room temperature. Answer: 2. Refrigerate the
insulin.
,Rationale:
Insulin in unopened vials should be stored under refrigeration until
needed. Vials should not be frozen. When stored unopened under
refrigeration, insulin can be used up to the expiration date on the
vial. Options 1, 3, and 4 are incorrect.
◉ 26.) Glimepiride (Amaryl) is prescribed for a client with diabetes
mellitus. A nurse reinforces instructions for the client and tells the
client to avoid which of the following while taking this medication?
1. Alcohol
2. Organ meats
3. Whole-grain cereals
4. Carbonated beverages Answer: 1. Alcohol
Rationale:
When alcohol is combined with glimepiride (Amaryl), a disulfiram-
like reaction may occur. This syndrome includes flushing,
palpitations, and nausea. Alcohol can also potentiate the
hypoglycemic effects of the medication. Clients need to be instructed
to avoid alcohol consumption while taking this medication. The
items in options 2, 3, and 4 do not need to be avoided.
◉ 27.) Sildenafil (Viagra) is prescribed to treat a client with erectile
dysfunction. A nurse reviews the client's medical record and would
question the prescription if which of the following is noted in the
client's history?
, 1. Neuralgia
2. Insomnia
3. Use of nitroglycerin
4. Use of multivitamins Answer: 3. Use of nitroglycerin
Rationale:
Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide in
the corpus cavernosum of the penis, thus sustaining an erection.
Because of the effect of the medication, it is contraindicated with
concurrent use of organic nitrates and nitroglycerin. Sildenafil is not
contraindicated with the use of vitamins. Neuralgia and insomnia
are side effects of the medication.
◉ 28.) The health care provider (HCP) prescribes exenatide (Byetta)
for a client with type 1 diabetes mellitus who takes insulin. The
nurse knows that which of the following is the appropriate
intervention?
1. The medication is administered within 60 minutes before the
morning and evening meal.
2. The medication is withheld and the HCP is called to question the
prescription for the client.
3. The client is monitored for gastrointestinal side effects after
administration of the medication.
4. The insulin is withdrawn from the Penlet into an insulin syringe
to prepare for administration. Answer: 2. The medication is withheld
and the HCP is called to question the prescription for the client.
