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 B

Explanation

Choice A reason: Constipation is not an adverse effect of tamoxifen. Tamoxifen does not affect the gastrointestinal motility or function. Constipation may be caused by other factors such as dehydration, low-fiber diet, or lack of exercise.

Choice B reason: Clotting is an adverse effect of tamoxifen. Tamoxifen can increase the risk of thromboembolic events such as deep vein thrombosis, pulmonary embolism, or stroke. Clotting can cause serious complications such as pain, swelling, shortness of breath, chest pain, or neurological deficits.

Choice C reason: Tinnitus is not an adverse effect of tamoxifen. Tamoxifen does not affect the auditory system or cause hearing loss. Tinnitus may be caused by other factors such as noise exposure, ear infection, or medication toxicity.

Choice D reason: Urinary retention is not an adverse effect of tamoxifen. Tamoxifen does not affect the urinary system or cause bladder dysfunction. Urinary retention may be caused by other factors such as prostate enlargement, nerve damage, or medication side effects.

A. The patient needs to be warned that alopecia is a common adverse effect. B. It is given by deep intramuscular injection to avoid tissue irritation. C. It must not be handled by pregnant women. D. It must be taken on an empty stomach.

Correct Answer is C

Explanation

Choice A reason: This is incorrect because alopecia is not a common or serious adverse effect of finasteride. However, the patient should be informed that finasteride may cause decreased hair growth or loss of hair in some cases.

Choice B reason: This is incorrect because finasteride is not given by injection, but by oral route. The patient should take one tablet daily with or without food.

Choice C reason: This is correct because finasteride can cause birth defects in male fetuses if it is absorbed through the skin or ingested by pregnant women. The patient should wear gloves when handling the tablets and avoid contact with crushed or broken tablets.

Choice D reason: This is incorrect because finasteride can be taken with or without food. However, the patient should take it at the same time each day and follow the provider's instructions.

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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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Naxlex Comprehensive Predictor Exams

A nurse is teaching a client who is to begin taking tamoxifen to treat breast cancer. The nurse should instruct the client to expect which of the following findings as an adverse effect of the medication?

Correct Answer is B

Explanation

During the administration of finasteride, the nurse must remember which important precaution?

Correct Answer is C

Explanation

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