A nurse is providing discharge teaching to a client who has diabetes mellitus and a new prescription for regular and NPH insulin. Which of the following statements by the client indicates an understanding of the teaching?
"I will inject air into both vials before pulling up the insulins into the syringe."
"I will shake the insulin vials vigorously before drawing up the medication."
"I will draw up the NPH insulin first and then the regular insulin."
"I will insert the needle into my abdomen at a 15° angle."
The Correct Answer is A
Insulin therapy management involves the precise coordination of short-acting and intermediate-acting agents to mimic physiological glucose regulation. Regular insulin acts rapidly, whereas NPH insulin contains protamine to delay absorption and extend the duration of action. Proper mixing technique is vital to maintain the integrity of each medication and ensure accurate glycaemic control without causing cross-contamination.
Rationale:
A. Injecting air into both vials is the correct first step when mixing insulins to prevent the creation of a vacuum. The nurse must teach the client to inject air equal to the dose into the NPH vial first, followed by air into the regular vial. This equalization of pressure allows for the smooth withdrawal of the liquid medication without contaminating the regular insulin with NPH.
B. Shaking insulin vials vigorously is contraindicated as it creates air bubbles that interfere with accurate dose measurement and can denature the protein molecules. Instead, NPH insulin, which is a suspension, should be gently rolled between the palms to redistribute the particles. Regular insulin is a clear solution and does not require any agitation or rolling before withdrawal from the vial.
C. Drawing up NPH insulin first is an incorrect technique that risks contaminating the clear regular insulin vial with the cloudy protamine from the NPH. The standard protocol is to draw the "clear before cloudy" (regular before NPH) to ensure the fast-acting insulin remains pure. Contamination of the regular vial with NPH would inadvertently alter the onset and peak characteristics of the short-acting dose.
D. Inserting the needle at a 15° angle is incorrect for subcutaneous insulin administration and is more appropriate for intradermal injections. Insulin must be deposited into the fatty subcutaneous tissue, typically at a 45° to 90° angle depending on the patient's body mass and needle length. A 15° angle would likely result in an ineffective intradermal delivery, leading to unpredictable absorption rates.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Insulin therapy management involves the precise coordination of short-actingand intermediate-actingagents to mimic physiological glucose regulation. Regular insulinacts rapidly, whereas NPH insulincontains protamine to delay absorption and extend the duration of action. Proper mixing technique is vital to maintain the integrity of each medication and ensure accurate glycaemic control without causing cross-contamination.
Rationale:
A.Injecting air into both vials is the correct first step when mixing insulins to prevent the creation of a vacuum. The nurse must teach the client to inject air equal to the dose into the NPH vial first, followed by air into the regular vial. This equalization of pressure allows for the smooth withdrawal of the liquid medication without contaminating the regular insulin with NPH.
B.Shaking insulin vials vigorously is contraindicated as it creates air bubbles that interfere with accurate dose measurement and can denature the protein molecules. Instead, NPH insulin, which is a suspension, should be gently rolled between the palms to redistribute the particles. Regular insulin is a clear solution and does not require any agitation or rolling before withdrawal from the vial.
C.Drawing up NPH insulin first is an incorrect technique that risks contaminating the clear regular insulin vial with the cloudy protamine from the NPH. The standard protocol is to draw the "clear before cloudy" (regular before NPH) to ensure the fast-acting insulin remains pure. Contamination of the regular vial with NPH would inadvertently alter the onset and peak characteristics of the short-acting dose.
D.Inserting the needle at a 15° angle is incorrect for subcutaneous insulin administration and is more appropriate for intradermal injections. Insulin must be deposited into the fatty subcutaneous tissue, typically at a 45° to 90° angle depending on the patient's body mass and needle length. A 15° angle would likely result in an ineffective intradermal delivery, leading to unpredictable absorption rates.
Correct Answer is ["0.75"]
Explanation
Step 1 is to identify the ordered dose and the available dosage strength
Ordered Dose: 60 mg
Available Strength: 80 mg / 1 mL
Step 2 is to calculate the number of milliliters to administer
Volume to administer = (Ordered Dose ÷ Available Dose) × Available Volume
Volume to administer = (60 ÷ 80) × 1
60 ÷ 80 = 0.75
0.75 × 1 = 0.75
Volume to administer = 0.75 mL
Step 3 is to round to the nearest hundredth
0.75 = 0.75
Answer: 0.75 mL
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.