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.

Answer and Explanation

The Correct Answer is D

A. Shake both insulin vials for 2 min before withdrawing the doses. Insulin vials should never be shaken, as this can create air bubbles and affect dosage accuracy. NPH insulin should be gently rolled between the hands to mix.
B. Administer the mixture within 5 min of preparing it. While insulin should be administered promptly, there is no strict 5-minute requirement.
C. Withdraw the NPH insulin before the regular insulin. Regular insulin should be drawn up first to prevent contamination with the cloudy NPH insulin.
D. Inject air into the regular insulin vial before injecting air into the NPH vial. Air should be injected into the regular insulin first, then into the NPH insulin vial, before withdrawing the doses in the correct order.

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Correct Answer is C

Explanation

A. Asking "Why do you think that alternative therapies are a better choice?" may come across as judgmental or challenging the client’s decision rather than supporting it. This is not therapeutic.
B. "You should consult with your family before seeking other treatments." assumes that the client’s decision depends on their family, which disregards autonomy.
C. "What has your doctor told you about your treatment options?" is an open-ended question that allows the client to express concerns while ensuring they have the necessary information to make an informed decision. This is the best response.
D. "I will come back to talk to you about your decision when you feel better." invalidates the client’s feelings and delays an important discussion.

A. Choose the client's dominant arm for IV access whenever possible. B. Select a site proximal to previous venipuncture sites. C. Initiate IV access on the palmar side of the client's wrist. D. Insert a larger gauge IV catheter to prevent phlebitis.

Correct Answer is B

Explanation

A. Choose the client's dominant arm for IV access whenever possible. The nondominant arm is preferred to minimize interference with daily activities.
B. Select a site proximal to previous venipuncture sites. This is the appropriate action because using a site above a previous one ensures better vein integrity and reduces complications.
C. Initiate IV access on the palmar side of the client's wrist. This site should be avoided as it is more painful and increases the risk of nerve damage.
D. Insert a larger gauge IV catheter to prevent phlebitis. A smaller gauge catheter is preferred when possible, as larger catheters can increase the risk of vein irritation and phlebitis.

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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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