A nurse is providing teaching for a client who has diabetes mellitus about the self-administration of insulin. The client has prescriptions for regular and NPH insulins. Which of the following statements by the client indicates an understanding of the teaching?
"I will draw the regular insulin into the syringe first."
"I will store prefilled syringes in the refrigerator with the needle pointed upward."
"I will gently roll the NPH vial between my hands before drawing up the insulin."
"I will insert the needle at a 90-degree angle."
The Correct Answer is A
Choice A reason: Drawing the regular insulin into the syringe first is correct. When mixing two types of insulin, the clear (regular) insulin should be drawn up before the cloudy (NPH) insulin to prevent contamination.
Choice B reason: Storing prefilled syringes with the needle pointed upward can cause air bubbles to move into the insulin, which can alter the dose when injected. The needle should be pointed downward.
Choice C reason: Shaking the NPH vial vigorously is not recommended as it can create air bubbles and affect the insulin dose. Instead, the vial should be gently rolled between the hands to mix the insulin.
Choice D reason: Inserting the needle at a 15-degree angle is incorrect for subcutaneous injections. A 90-degree angle is typically used unless the patient is very thin, in which case a 45-degree angle may be used.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The fluctuation of fluid in the water-seal chamber does not necessarily mean that the lung is fully re-expanded. The water-seal chamber's fluid level fluctuates with the client's breathing because it reflects the changes in intrathoracic pressure.
Choice B reason: The statement "Your breathing pattern causes this" is correct. The fluctuation, also known as tidaling, in the water-seal chamber is normal and occurs in response to the client's breathing. When the client inhales, negative pressure in the chest cavity causes the fluid level to rise, and when the client exhales, the pressure becomes positive, causing the fluid level to fall.
Choice C reason: Suction pressure that is too high can cause continuous bubbling in the suction control chamber but does not directly cause the fluid in the water-seal chamber to rise and fall. The suction control chamber's bubbling should be steady and gentle when the suction is set correctly.
Choice D reason: Continuous bubbling in the water-seal chamber may indicate an air leak, which is a problem that needs to be addressed. However, normal fluctuation with breathing is not indicative of an air leak.
Correct Answer is B
Explanation
Choice A reason: The Mantoux skin test, also known as the tuberculin skin test, measures the immune response to the tuberculin purified protein derivative (PPD) injected under the skin. An induration of less than 1 mm is not necessarily an indication of non-infectiousness; it may indicate a lack of infection or an inadequate immune response. This test does not reflect the current infectious status as it measures a delayed hypersensitivity reaction and can remain positive for life once someone has been exposed to TB or has received the BCG vaccine.
Choice B reason: Negative sputum cultures for acid-fast bacillus are a strong indication that the client is no longer infectious. Pulmonary tuberculosis is diagnosed and monitored through sputum cultures to detect the presence of Mycobacterium tuberculosis. A series of negative cultures typically indicates that the client is not excreting the bacteria and is, therefore, not contagious.
Choice C reason: While the cessation of coughing up blood-tinged sputum is a positive sign of clinical improvement, it does not conclusively indicate that the client is no longer infectious. The absence of blood in the sputum may simply mean that the damage to lung tissues is healing, but the client could still be harboring and potentially spreading TB bacteria.
Choice D reason: The Quantiferon-TB Gold test is a blood test that measures the immune system's response to TB bacteria. A positive result indicates TB infection, but it does not distinguish between latent infection and active disease, nor does it provide information on infectiousness. The parenthetical "negative" is confusing and should be clarified in the context of the test results.
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