A nurse in a clinic is teaching a client who has diabetes mellitus about self-administration of insulin using a prefilled, multidose pen. Which of the following instructions should the nurse include?

Avoid pinching the skin when injecting the needle.

Use pen needles that have a safe-needle protection device attached.

Use the dominant hand to recap the needle before removing it from the pen device.

Remove the needle from the pen device before placing the needle in a sharps container.

Answer and Explanation

The Correct Answer is B

A. Avoid pinching the skin when injecting the needle:

This instruction is not specific to the use of a prefilled, multidose pen for insulin administration. Pinching the skin may be necessary for some injection techniques but is not directly related to the use of a prefilled pen.

B. Use pen needles that have a safe-needle protection device attached.

Using pen needles with a safe-needle protection device attached ensures safe handling and disposal of the needle after use, reducing the risk of accidental needlestick injuries. These devices help prevent accidental needlesticks by covering the needle after use, reducing the risk of transmission of bloodborne pathogens.

C. Use the dominant hand to recap the needle before removing it from the pen device:

Recapping needles is not recommended as it increases the risk of needlestick injuries. Additionally, the use of the dominant hand for recapping is not essential and may not be safe practice.

D. Remove the needle from the pen device before placing the needle in a sharps container:

It's crucial to dispose of needles safely in a sharps container immediately after use without removing the needle from the pen device. Removing the needle before disposal increases the risk of needlestick injuries. The entire pen needle unit, including the needle, should be disposed of intact into an appropriate sharps container to minimize the risk of injury to healthcare workers and others handling the waste.

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Correct Answer is B

Explanation

A.An 18-gauge, 1-inch needle is too large for subcutaneous injections like heparin. Heparin is administered subcutaneously using a smaller needle (e.g., 25- or 27-gauge) to minimize tissue trauma.

B.Heparin should be injected into the subcutaneous tissue, typically in the abdomen, but at least 2 inches (5.1 cm) away from the umbilicus to avoid the rich vascular supply and reduce the risk of bleeding or bruising in this area.

C.Air bubbles should not be expelled from prefilled syringes of heparin because the air bubble ensures the full dose is delivered and helps prevent medication from leaking into the subcutaneous tissue, reducing bruising at the injection site. Prefilled syringes are designed with this in mind.

D.Massaging the injection site after administering heparin increases the risk of bruising and bleeding due to the anticoagulant effects of heparin. Gentle pressure may be applied to prevent bleeding, but massaging should be avoided.

A. Place the bedside table 0.9 m (3 feet) away from the bed. B. Provide the client with a night light. C. Elevate full-length side rails on both sides of the client's bed. D. Keep the client's room temperature at 18° C (64.4° F).

Correct Answer is B

Explanation

A. Place the bedside table 0.9 m (3 feet) away from the bed:

While having a bedside table nearby can be convenient for clients to access essential items, the specific distance of 0.9 m (3 feet) is not a standard guideline for falls prevention. Placing the bedside table closer to the bed may actually improve accessibility for the client, but it's not the most crucial action for falls prevention in this scenario.

B. Provide the client with a night light.

Falls prevention strategies aim to create a safe environment for clients at risk of falling. Providing a night light helps improve visibility during nighttime, reducing the risk of falls due to poor lighting. It assists clients in navigating their surroundings safely, especially when getting out of bed during the night.

C. Elevate full-length side rails on both sides of the client's bed:

Using full-length side rails on the bed can increase the risk of entrapment and injury, especially for clients at risk of falls. Current evidence suggests that the use of physical restraints, such as full-length side rails, does not effectively prevent falls and may contribute to adverse outcomes.

D. Keep the client's room temperature at 18°C (64.4°F):

While maintaining a comfortable room temperature is important for client comfort, the specific temperature of 18°C (64.4°F) is not a standard guideline for falls prevention. Instead, ensuring a comfortable temperature range based on individual client preferences and environmental factors is appropriate.

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A nurse in a clinic is teaching a client who has diabetes mellitus about self-administration of insulin using a prefilled, multidose pen. Which of the following instructions should the nurse include?

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