A nurse is teaching a client how to draw up regular insulin and NPH insulin in the same syringe. Which of the following instructions should the nurse include?

Inject air into the regular insulin first.

Shake the NPH insulin until it is well mixed.

Draw up the NPH insulin into the syringe first.

Discard regular insulin that appears cloudy.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is incorrect. When mixing regular (clear) and NPH (cloudy) insulin, air should be injected into the NPH vial first, then into the regular insulin vial. This prevents contamination of the regular insulin with NPH insulin.

Choice B reason: This is incorrect because the nurse should not shake the NPH insulin vial, but rather roll it gently between the palms to mix it. Shaking can cause bubbles and affect the accuracy of the dose.

Choice C reason: This is incorrect because the nurse should draw up the regular insulin into the syringe first, then the NPH insulin. This prevents mixing of the NPH insulin with the regular insulin in the vial.

Choice D reason: This is correct. Regular insulin should always be clear. If it appears cloudy, it may be contaminated or expired and should be discarded.

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Correct Answer is C

Explanation

Choice A reason: This is incorrect because the dosage is given in the prescription as 500 mg, which indicates the amount of the drug to be administered.

Choice B reason: This is incorrect because the route is given in the prescription as PO, which stands for per os or by mouth, which indicates how the drug is to be administered.

Choice C reason: This is correct because the medication is not given in the prescription, which is the name of the drug to be administered. The nurse should ask the provider to clarify the medication name and spell it out if necessary.

Choice D reason: This is incorrect because the time/frequency is given in the prescription as BID, which stands for bis in die or twice a day, which indicates when and how often the drug is to be administered.

A. The hypoxia caused by the COPD causes an increased need for insulin. B. The corticosteroids may cause an increase in glucose levels. C. The antibiotics may cause an increase in glucose levels. D. His type 2 diabetes has converted to type 1.

Correct Answer is B

Explanation

Choice A reason: This is incorrect because hypoxia does not cause an increased need for insulin, but rather a decreased utilization of glucose by the cells. Hypoxia can also impair the secretion of insulin by the pancreas.

Choice B reason: This is correct because corticosteroids are known to cause hyperglycemia by stimulating gluconeogenesis, inhibiting glucose uptake, and increasing insulin resistance. The patient may need to adjust his insulin dose or switch to oral antidiabetic agents while on corticosteroid therapy.

Choice C reason: This is incorrect because antibiotics do not cause an increase in glucose levels, unless they are combined with other drugs that affect glucose metabolism, such as sulfonamides or fluoroquinolones.

Choice D reason: This is incorrect because type 2 diabetes does not convert to type 1 diabetes, as they are different types of diabetes with different causes and mechanisms. Type 1 diabetes is caused by autoimmune destruction of the beta cells of the pancreas, resulting in absolute insulin deficiency. Type 2 diabetes is caused by insulin resistance and relative insulin deficiency.

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A nurse is teaching a client how to draw up regular insulin and NPH insulin in the same syringe. Which of the following instructions should the nurse include?

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