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.
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Dextromethorphan is a cough suppressant that does not affect blood glucose levels. It is safe to use for clients with diabetes.
Choice B reason: Prednisone is a corticosteroid that can cause glucose intolerance by increasing glucose production and decreasing insulin sensitivity. It can worsen hyperglycemia and increase the risk of diabetic complications.
Choice C reason: Atorvastatin is a statin that lowers cholesterol levels and reduces the risk of cardiovascular disease. It does not cause glucose intolerance and may have a beneficial effect on glycemic control.
Choice D reason: Cimetidine is a histamine-2 receptor antagonist that reduces stomach acid production and treats ulcers and gastroesophageal reflux disease. It does not cause glucose intolerance and has no significant interaction with diabetes medications.
Correct Answer is B
Explanation
Choice A reason: This is incorrect because NPH insulin is normally cloudy and should be gently mixed before use. However, the nurse should discard the solution if it has clumps, flakes, or crystals.
Choice B reason: This is correct because NPH insulin is an intermediate-acting insulin that has a slower onset and longer duration than short-acting or rapid-acting insulins. The nurse should explain to the client that NPH insulin provides basal coverage and may need to be combined with other types of insulin to control blood glucose levels.
Choice C reason: This is incorrect because freezing insulin can damage its potency and effectiveness. The nurse should instruct the client to store unopened insulin vials in the refrigerator and opened vials at room temperature.
Choice D reason: This is incorrect because shaking insulin can cause air bubbles and frothing, which can affect the accuracy of the dose. The nurse should instruct the client to roll the insulin vial between the palms of the hands to mix it gently.
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