A nurse is caring for a client.

Exhibit 1 Nurses' Notes Day 1: Exhibit 2 Exhibit 3 Client reports fatigue, weight loss, night sweats, and a persistent cough.

Performed a purified protein derivative test on the client and obtained a QuantiFERON-TB Gold blood test as prescribed.

Bilateral breath sounds with crackles and scattered wheezes throughout.

Cough productive for yellow, purulent sputum.

What are the first two actions the nurse should take?

Administer antibiotics and bronchodilators.

Initiate airborne precautions and isolation.

Start the client on cough suppressants and antihistamines.

Obtain sputum culture and chest X-ray.

Answer and Explanation

The Correct Answer is D

The first two actions the nurse should take are to obtain a sputum culture and a chest X-ray.
These tests can help diagnose the cause of the client’s symptoms and guide treatment.
Choice A is wrong because administering antibiotics and bronchodilators should only be done after a diagnosis has been made.
Choice B is wrong because airborne precautions and isolation may not be necessary depending on the cause of the client’s symptoms.
Choice C is wrong because cough suppressants and antihistamines may not be appropriate treatments depending on the cause of the client’s symptoms.

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Correct Answer is B

Explanation

When preparing medication from a vial for subcutaneous injection for a client, the nurse should hold the vial with the top facing upward while injecting air into the vial.
This is because injecting air into the vial equalizes the pressure inside and makes it easier to withdraw the medication 1.
Choice A is wrong because holding the syringe so that bubbles collect at the level of the plunger is not necessary when preparing medication from a vial.
Choice C is wrong because injecting air into the vial with the eye of the needle immersed in the fluid can contaminate the medication.
Choice D is wrong because holding the syringe at a 45° angle is not necessary when verifying dosage.

A. Draw the intermediate-acting insulin into the syringe. B. Draw the short-acting insulin into the syringe. C. Inject air into the intermediate-acting insulin vial. D. Inject air into the short-acting insulin vial.

Correct Answer is C

Explanation

A.When mixing insulins, you should draw the short-acting insulin into the syringe first. This is done after injecting air into both vials (first into intermediate-acting, then into short-acting). Drawing intermediate-acting insulin first can contaminate the short-acting insulin vial with the longer-acting solution, which could alter the effectiveness of future doses.

B.Although this step is required when mixing insulins, it is not the first step. The nurse should first inject air into both vials to maintain vial pressure.

C.The nurse should inject air into the intermediate-acting insulin vial first because it helps prevent contamination and maintains the correct pressure within the vial. Intermediate-acting insulin, typically NPH (Neutral Protamine Hagedorn), is cloudy, and air injection into the vial allows for easy withdrawal later on without disrupting the order of mixing.

D.Injecting air into the short-acting insulin vial is necessary but should be done after injecting air into the intermediate-acting vial. By injecting air into both vials first, the nurse prevents a vacuum effect, which can make it difficult to draw up the insulin. After injecting air, the nurse can draw the short-acting insulin into the syringe before moving to the intermediate-acting insulin. This order minimizes the risk of contamination.

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Naxlex Comprehensive Predictor Exams

When preparing medication from a vial for a subcutaneous injection for a client, which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is mixing a short-acting insulin and an intermediate-acting insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

A charge nurse in a long-term care facility is preparing an educational program about delirium for newly hired nurses. Which of the following statements should the nurse plan to include?

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