A nurse is preparing regular and NPH insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take?

Shake both insulin vials for 2 min before withdrawing the doses.

Administer the mixture within 5 min of preparing it.

Withdraw the NPH insulin before the regular insulin.

Inject air into the regular insulin vial before injecting air into the NPH vial.

None

Answer and Explanation

The Correct Answer is B

A. Shaking insulin vials can cause bubbles and denature the insulin, especially NPH, which should be gently rolled between the hands to mix. Vigorous shaking can reduce effectiveness and increase the risk of inaccurate dosing.

B. Once regular and NPH insulin are drawn into the same syringe, the mixture should be administered promptly, ideally within 5 minutes, to maintain potency and prevent clumping. Delays can alter absorption and efficacy of the insulin.

C. The correct technique is to withdraw regular insulin first and then NPH, not the other way around. Drawing NPH first could contaminate the regular insulin vial with NPH, affecting rapid-acting insulin activity.

D. Air should be injected into each vial to equalize pressure before withdrawing the insulin, but the sequence should be air into NPH first, then air into regular insulin, to avoid contamination. Incorrect sequencing can introduce NPH into the regular insulin vial.

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Correct Answer is B

Explanation

A. Protective environment. This is incorrect because a protective environment is used for immunocompromised clients, not for those with bacterial meningitis.
B. Droplet. This is correct because bacterial meningitis is transmitted through respiratory secretions. Droplet precautions, including wearing a mask when within 3 to 6 feet of the client, are necessary to prevent the spread of infection.
C. Contact. This is incorrect because bacterial meningitis is not primarily transmitted through direct contact with surfaces or bodily fluids, making contact precautions unnecessary.
D. Airborne. This is incorrect because bacterial meningitis does not spread through airborne particles that remain suspended in the air, so airborne precautions are not required.

A. A client who has heart failure and received furosemide IV 8 hr ago B. A client who was admitted 24 hr ago with chest pain C. A client who had a seizure 48 hr ago and is on seizure precautions D. A client who is scheduled to have a colonoscopy in 12 hr

Correct Answer is D

Explanation

A. A client who has heart failure and received furosemide IV 8 hr ago:
Clients with heart failure require ongoing monitoring for fluid balance, electrolyte levels, and signs of worsening symptoms. IV furosemide indicates active treatment, so this client is not stable for discharge.

B. A client who was admitted 24 hr ago with chest pain:
A client with recent chest pain requires further evaluation for acute coronary syndrome (ACS). Even if pain has resolved, monitoring for cardiac events is essential. This client is not stable for discharge.

C. A client who had a seizure 48 hr ago and is on seizure precautions:
Recent seizures require continued monitoring to assess for recurrence, medication adjustments, and safety precautions. This client is not stable for discharge.

D. A client who is scheduled to have a colonoscopy in 12 hr:
A colonoscopy is an elective procedure and does not require hospitalization. This client is stable and can be discharged to free up resources for mass casualty victims.

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A nurse is preparing regular and NPH insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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