A nurse is preparing to mix a dose of NPH insulin and regular insulin into a single syringe. Which of the following actions should the nurse take first?
Withdraw dose of regular insulin.
Inject air into the vial of regular insulin.
Inject air into the vial of NPH insulin.
Withdraw dose of NPH insulin.
The Correct Answer is C
A. Withdraw dose of regular insulin: Withdrawing the regular insulin dose is performed after the air has been injected into both vials and the NPH insulin has been drawn up if using the “clear before cloudy” technique. Doing this first would risk disrupting the proper sequence and potentially contaminating the insulin.
B. Inject air into the vial of regular insulin: Air must be injected into the regular insulin vial before withdrawing the medication, but this step is performed after first injecting air into the NPH vial according to the standard procedure for mixing insulins. Starting with the regular insulin vial would not follow the recommended order.
C. Inject air into the vial of NPH insulin: Injecting air into the NPH insulin vial first is the initial step when preparing a mixed insulin dose. This step equalizes pressure inside the vial, allowing for easier withdrawal later, and follows the correct sequence of “air into cloudy first, then clear,” which prevents contamination of the regular insulin.
D. Withdraw dose of NPH insulin: Withdrawing NPH insulin is done after the regular insulin has been drawn into the syringe to maintain the correct “clear before cloudy” technique. Doing this first could result in accidental mixing or contamination of the regular insulin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. “I will overarticulate words when speaking.": Overarticulating words can distort speech and make it more difficult for a client with hearing loss to understand. Clear, normal articulation combined with visual cues is more effective for communication.
B. “I will repeat words not heard by the client": Repeating words is useful, but it is a secondary strategy. Effective communication begins with proper positioning and visual cues, which enhance understanding before repetition is needed.
C. “I will speak in a loud voice when addressing the client.": Speaking louder does not necessarily improve comprehension and can distort speech. Many clients with hearing loss benefit more from clear, normal-volume speech and lip-reading rather than increased volume.
D. “I will face the client when speaking": Facing the client allows them to use visual cues, such as lip reading and facial expressions, which significantly improves understanding. This technique is the primary and most effective communication strategy for clients with hearing loss.
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}
Explanation
Rationale:
• Deep tendon patellar reflex: The client’s patellar reflex decreased from 4+ on day 1 to 2+ on day 2, indicating reduced hyperreflexia. This suggests a positive response to antihypertensive and preeclampsia management, lowering the risk for complications such as eclampsia or seizures.
• Heart rate: The client’s heart rate increased slightly from 84/min on day 1 to 90/min on day 2, which falls within a normal physiologic range and does not indicate significant improvement or deterioration. This shows that cardiovascular status has remained relatively stable.
• Blood pressure: Blood pressure decreased from severely elevated readings (162/112 mm Hg and 166/110 mm Hg) to 152/90 mm Hg, reflecting a partial response to antihypertensive therapy. Although still above normal, the downward trend indicates some improvement in maternal hemodynamic status.
• Edema: The client continues to have +3 pitting edema in bilateral lower extremities, which has not improved since the previous day. Persistent edema suggests that fluid balance and vascular permeability issues related to preeclampsia remain a concern and require ongoing monitoring.
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