A nurse is preparing to administer 5 units of regular insulin and 20 units of NPH insulin to a client who has type 1 diabetes mellitus. Which of the following actions should the nurse take first?
Inject 20 units of air into the vial of NPH insulin.
Inject 5 units of air into the vial of regular insulin.
Withdraw 20 units of NPH insulin from the vial.
Withdraw 5 units of regular insulin from the vial.
The Correct Answer is A
Answer: (A) Inject 20 units of air into the vial of NPH insulin.
Rationale:
A) Inject 20 units of air into the vial of NPH insulin:
Injecting air into the vial of NPH insulin is the first step to prevent creating a vacuum, which could make it difficult to withdraw the insulin later. The nurse must inject the corresponding amount of air for the dose needed, ensuring that the insulin can be withdrawn smoothly and accurately without bubbles, which could affect the dose.
B) Inject 5 units of air into the vial of regular insulin:
Injecting air into the regular insulin vial is also necessary before withdrawing the insulin, but it should be done after injecting air into the NPH vial. This sequence ensures that no NPH insulin contaminates the regular insulin vial when the nurse withdraws the doses later.
C) Withdraw 20 units of NPH insulin from the vial:
Withdrawing NPH insulin should be done after air is injected into both vials and after the regular insulin has been drawn up. This sequence prevents the mixing of the two types of insulin and ensures accurate dosing, which is crucial for maintaining the correct blood glucose levels.
D) Withdraw 5 units of regular insulin from the vial:
Withdrawing regular insulin is critical to do before the NPH insulin to prevent contamination of the regular insulin with NPH, which could alter the onset and peak times of the regular insulin. However, it should follow the steps of injecting air into both vials, starting with the NPH vial.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A hemoglobin (Hgb) level of 8.8 mg/dL indicates anemia, which is a decrease in the oxygen-carrying capacity of the blood. Fatigue and tiredness are common symptoms of anemia. When the body does not have enough hemoglobin to transport oxygen effectively, it can lead to feelings of fatigue and a lack of energy.
The other options are not directly associated with a low hemoglobin level:
b) "I have noticed that my fingernails are becoming thicker." Thicker fingernails are not typically associated with a low hemoglobin level. Changes in fingernails can be atributed to various factors, but they are not directly related to anemia.
c) "I have to go to the bathroom all the time." Frequent urination is not typically associated with a low hemoglobin level. It can be related to other factors such as urinary tract infections, diabetes, or diuretic use, among others.
d) "I notice that my hands are always shaky." Hand tremors are not directly associated with a low hemoglobin level. Tremors can have various causes, such as neurological conditions, medication side effects, or excessive caffeine intake, but they are not directly linked to anemia.
Correct Answer is B
Explanation
Answer: B. Compare the result with the baseline reading
Rationale:
A. Check the client's heart rate on the oximeter:
Although checking the heart rate may provide context for assessing the client's overall status, it does not address the primary concern of the low oxygen saturation. Understanding the client's baseline saturation level takes priority to guide further actions effectively.
B. Compare the result with the baseline reading:
Comparing the reading with the client's baseline is essential. For clients with chronic respiratory conditions, baseline oxygen levels may naturally be lower. Identifying if this 88% saturation is typical or unusual for the client helps determine the need for further intervention or adjustment.
C. Decrease the amount of oxygen administered:
Reducing oxygen flow when the saturation is low is contraindicated, as it could worsen hypoxia. Instead, increasing oxygen may be warranted if the reading remains below the baseline after further assessment.
D. Perform another reading while the client ambulates:
Repeating the reading during ambulation may worsen hypoxia and is not ideal without understanding baseline oxygenation at rest. Re-evaluation at rest or in a different position may be more appropriate for accurate assessment.
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