A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Discard the NPH solution if it appears cloudy.

NPH is an intermediate-acting insulin.

Freeze unopened insulin vials.

Shake the insulin vigorously before loading the syringe.

Answer and Explanation

The Correct Answer is B

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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Correct Answer is A

Explanation

Choice A reason: This is correct because medroxyprogesterone is available as a depot injection that is given intramuscularly every three months. This provides a long-acting and effective contraception for women who do not want to take oral pills or use other methods.

Choice B reason: This is incorrect because medroxyprogesterone is not available as a vaginal form. However, there are other contraceptive options that can be inserted vaginally, such as rings, diaphragms, or caps.

Choice C reason: This is incorrect because medroxyprogesterone is not available as a transdermal form. However, there are other contraceptive options that can be applied to the skin, such as patches.

Choice D reason: This is incorrect because medroxyprogesterone is not available as a subcutaneous form. However, there are other contraceptive options that can be injected under the skin, such as implants.

A. "I should rotate the injection sites within the same location for a week." B. "I should store the unopened vials of insulin in the freezer." C. "I should draw up the regular insulin before the NPH insulin." D. "I should inject the insulin into the muscle for faster absorption."

Correct Answer is C

Explanation

Choice A reason: Rotating the injection sites within the same location for a week is not correct. The client should rotate the injection sites within the same location each day to prevent lipodystrophy and ensure consistent absorption.

Choice B reason: Storing the unopened vials of insulin in the freezer is not correct. The client should store the unopened vials of insulin in the refrigerator, not the freezer, to prevent damage to the insulin.

Choice C reason: Drawing up the regular insulin before the NPH insulin is correct. The client should draw up the clear (regular) insulin before the cloudy (NPH) insulin to prevent contamination of the regular insulin with the NPH insulin.

Choice D reason: Injecting the insulin into the muscle for faster absorption is not correct. The client should inject the insulin into the subcutaneous tissue, not the muscle, to ensure appropriate absorption and prevent hypoglycemia.

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A nurse is teaching a client who has diabetes mellitus and receives 25 units of NPH insulin every morning if their blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

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