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 The nurse must inject the corresponding amount of air for the dose needed, ensuring that the insulin can be withdrawn smoothly and accurately without bubbles, which could affect the dose.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 B
Explanation
Answer: B. You can take a shower 1 day after your procedure.
Rationale:
A. You can resume a regular diet 3 days after your procedure:
There is typically no need to delay resuming a regular diet for three days after a cardiac catheterization. Most clients can resume their usual diet shortly after the procedure once they are fully awake and any nausea has resolved.
B. You can take a shower 1 day after your procedure:
It is generally safe to shower the day after a cardiac catheterization as long as the insertion site remains protected. Clients should avoid soaking in a bath or swimming until the site is fully healed to prevent infection.
C. You can begin exercising 2 days after your procedure:
Strenuous activities, including exercise, should generally be avoided for a few days to a week following a cardiac catheterization. This allows time for the insertion site to heal and reduces the risk of complications such as bleeding.
D. You can return to school 1 week after your procedure:
Most clients can return to school or normal activities within a few days, provided they feel well and avoid excessive physical exertion. A full week off is typically not necessary unless specified by the healthcare provider based on the individual’s recovery.

Correct Answer is D
Explanation
As individuals age, there is a natural decline in kidney function. This can result in a reduced ability to filter and excrete medications and their metabolites from the body. The decreased kidney function can lead to a longer half-life of medications, increased drug accumulation, and an increased risk of adverse drug reactions. It is important for the nurse to adjust medication dosages and frequencies based on the individual's renal function to prevent drug toxicity.
Increased liver function: Aging is associated with a gradual decline in liver function. While there may be some individual variations, in general, liver function decreases rather than increases with age. However, changes in liver function can affect the metabolism and elimination of medications. Some medications may require dosage adjustments based on liver function, but it is not a common physiological change in older adults.
Increased metabolism: Aging is generally associated with a decrease in metabolism rather than an increase. The metabolic rate tends to slow down with age, which can affect the pharmacokinetics of medications. Slower metabolism can result in medications taking longer to be metabolized and cleared from the body, potentially leading to prolonged drug effects.
Decreased pulmonary function: While it is true that lung function decreases with age, the impact on medication administration is not as significant compared to kidney function. Medications are usually administered through non-pulmonary routes (e.g., oral, intravenous, transdermal), and decreased pulmonary function primarily affects the absorption of inhaled medications. However, certain respiratory conditions or compromised lung function may influence medication choices or require adjusted dosing.

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