A nurse is preparing to administer insulin to a client who has type 1 diabetes mellitus. Which of the following actions by the nurse demonstrates proper technique for mixing regular and NPH insulin in the same syringe?

The nurse injects air into the NPH vial first, then into the regular vial.

The nurse draws up regular insulin first, then NPH insulin.

The nurse rolls the NPH vial between their palms before drawing up insulin.

The nurse wipes the rubber stoppers of both vials with alcohol swabs.

Answer and Explanation

The Correct Answer is B

A) Incorrect. The nurse should inject air into the regular vial first, then into the NPH vial. This can prevent contamination of the regular insulin with NPH insulin and ensure accurate dosing.

B) Correct. The nurse should draw up regular insulin first, then NPH insulin. This can prevent contamination of the regular insulin with NPH insulin and ensure accurate dosing. Regular insulin is clear and NPH insulin is cloudy.

C) Correct. The nurse should roll the NPH vial between their palms before drawing up insulin. This can resuspend the insulin particles that may have settled at the bottom of the vial and ensure uniform concentration.

D) Correct. The nurse should wipe the rubber stoppers of both vials with alcohol swabs before inserting needles. This can reduce the risk of infection and contamination.

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Correct Answer is B

Explanation

B) Correct. The nurse should obtain a blood sample from the client for a complete blood count as these symptoms can indicate agranulocytosis, a potentially fatal adverse effect of clozapine that causes a severe decrease in white blood cells and increases the risk of infection.

A) Incorrect. The nurse should not administer acetaminophen to the client as this drug can mask the signs of infection and delay diagnosis and treatment of agranulocytosis.

C) Incorrect. The nurse should encourage the client to drink plenty of fluids and rest, but this action alone would not address the potential serious adverse effect of agranulocytosis associated with clozapine. Obtaining a blood sample for a complete blood count is necessary to assess the client's white blood cell count and determine if agranulocytosis is present.

D) Incorrect. Discontinuing clozapine and notifying the provider is important, but it should be done after obtaining a blood sample for a complete blood count to confirm the presence of agranulocytosis. This allows for appropriate medical management and alternative treatment options to be initiated.

A. Instruct the client to take their morning dose of metformin with a sip of water on the day of surgery. B. Instruct the client to hold their metformin for 48 hours before and after surgery. C. Instruct the client to resume their metformin as soon as they can tolerate oral intake after surgery. D. Instruct the client to switch to insulin injections until they recover from surgery.

Correct Answer is B

Explanation

B) Correct. The nurse should instruct the client to hold their metformin for 48 hours before and after surgery as this drug can increase the risk of lactic acidosis in clients who are undergoing procedures that involve contrast media or who have impaired renal function due to dehydration or hypotension.

A) Incorrect. The nurse should not instruct the client to take their morning dose of metformin with a sip of water on the day of surgery as this can cause hypoglycemia during anesthesia or interfere with contrast media if used during surgery.

C) Incorrect. The nurse should not instruct the client to resume their metformin as soon as they can tolerate oral intake after surgery as this can cause lactic acidosis if the client's renal function is not fully restored or if they receive contrast media during surgery or postoperatively.

D) Incorrect. The nurse should not instruct the client to switch to insulin injections until they recover from surgery as this can cause hyperglycemia or hypoglycemia depending on the type and dose of insulin used and the client's nutritional status and blood glucose levels.

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A nurse is preparing to administer insulin to a client who has type 1 diabetes mellitus. Which of the following actions by the nurse demonstrates proper technique for mixing regular and NPH insulin in the same syringe?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has schizophrenia and is taking clozapine. The nurse notices that the client has a fever, sore throat, and malaise. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is reviewing the medication list of a client who has diabetes mellitus and is scheduled for surgery. The client takes metformin orally twice a day. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

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A nurse is preparing to administer insulin to a client who has type 1 diabetes mellitus. Which of the following actions by the nurse demonstrates proper technique for mixing regular and NPH insulin in the same syringe?

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