A nurse is caring for a client who has a prescription for NPH insulin 10 units and regular insulin 15 units subcutaneously. After injecting 10 units of air into the NPH insulin vial, which of the following actions should the nurse take next?

The correct answer is Choice A, Hot cocoa.

Choice A rationale:

Hot cocoa contains the least amount of caffeine among the options provided.A standard 240 mL (8 oz) cup of hot cocoa contains approximately 5 mg of caffeine. This is significantly less than the other beverages listed. Hot cocoa is made by adding cocoa powder and sugar or chocolate syrup to hot milk.The drink contains very little cacao, so the caffeine content is very low. Therefore, if a client is looking to reduce their dietary caffeine intake, hot cocoa would be a suitable choice.

Choice B rationale:

A cola soft drink contains more caffeine than hot cocoa.A standard 240 mL (8 oz) serving of a cola soft drink contains approximately 24-31 mg of caffeine. Cola is a popular flavor of soda around the world.Although the kola nut, from which the flavor of cola soda comes from, does naturally contain caffeine, the majority of the caffeine in cola is added by the manufacturer. Therefore, a cola soft drink would not be the best choice for a client looking to reduce their caffeine intake.

Choice C rationale:

Instant coffee contains even more caffeine.A standard 240 mL (8 oz) cup of instant coffee contains approximately 57-96 mg of caffeine.With instant coffee, caffeine measurements are based on the amount of the instant coffee powder used to make the drink. The caffeine content of coffee itself varies enormously.According to the USDA, 1 rounded teaspoon of instant coffee (1.8 grams in weight) contains 57 mg of caffeine.No matter how much water, milk, or creamer you add to the coffee - the amount of caffeine will remain the same. Therefore, instant coffee would not be a suitable choice for a client looking to reduce their caffeine intake.

Choice D rationale:

Brewed green tea also contains more caffeine than hot cocoa.An 8-ounce (240 mL) cup of green tea generally supplies around 20 to 45 milligrams of caffeine.This makes green tea a gentler alternative in terms of caffeine content, suitable for those who prefer a milder pick-me-up. However, it still contains more caffeine than hot cocoa. Therefore, while green tea is a healthier choice compared to cola soft drinks and instant coffee, it still contains more caffeine than hot cocoa.

The correct answer is choiceb. Support the client’s decision to stop the treatment.

Choice A rationale:

While discussing the decision with family can be important, the nurse’s primary responsibility is to respect and support the client’s autonomy and decision-making capacity. Encouraging the client to discuss with family is secondary to supporting their decision.

Choice B rationale:

Supporting the client’s decision to stop treatment respects their autonomy and right to make decisions about their own care.This is a fundamental principle in nursing ethics and patient-centered care.

Choice C rationale:

Discussing alternative treatment methods may be appropriate in some contexts, but in this case, the client has already made a decision to stop dialysis. The nurse should focus on supporting this decision rather than suggesting alternatives.

Choice D rationale:

Asking the facility chaplain to visit the client can be supportive, but it should not be the nurse’s primary action. The nurse should first support the client’s decision and then offer additional support services as needed.