A nurse is teaching a client who is newly diagnosed with type 2 diabetes mellitus about insulin therapy. Which of the following insulin combinations should the nurse instruct the client to mix?

Insulin aspart and NPH insulin

Insulin degludec and NPH insulin.

Insulin glargine and insulin detemir

Insulin lispro and regular insulin

Answer and Explanation

The Correct Answer is A

A. Insulin aspart and NPH insulin: Insulin aspart is a rapid-acting insulin, and NPH is an intermediate-acting insulin. These can be mixed in the same syringe to provide both immediate and prolonged glucose control, with aspart covering postprandial spikes and NPH maintaining basal levels.

B. Insulin degludec and NPH insulin: Insulin degludec is an ultra-long-acting insulin and should not be mixed with any other insulin, as mixing can alter its absorption and effectiveness.

C. Insulin glargine and insulin detemir: Both glargine and detemir are long-acting insulins and should not be mixed with any other insulin, as this can interfere with their mechanism of providing a steady release.

D. Insulin lispro and regular insulin: Insulin lispro is a rapid-acting insulin, and regular insulin is short-acting. These insulins should not be mixed because they have different onset and peak times, which can lead to unpredictable glucose control.

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

The first action the nurse should take is assess for dizziness when standing followed by increase dietary iron intake.

Rationale:

Assess for dizziness when standing: The client’s orthostatic hypotension (BP drops from 132/60 to 102/50 mmHg upon standing) and tachycardia (HR 108/min) suggest possible symptomatic anemia. Evaluating for dizziness ensures client safety and helps determine the severity of anemia-related hypoxia.

Increase dietary iron intake: The client has iron deficiency anemia (low hemoglobin, hematocrit, RBC count, and ferritin). Since they follow a vegan diet, increasing plant-based iron sources (e.g., leafy greens, legumes, fortified cereals) and vitamin C intake can improve iron absorption.

Incorrect:

Administer IV fluids: While anemia can cause orthostatic hypotension, fluid resuscitation is not the first-line intervention unless dehydration is present.

Check for signs of bleeding: The client reports no pain or discomfort, and there is no evidence of active bleeding. Anemia is more likely due to chronic dietary deficiency rather than acute blood loss.

Administer vitamin B12 supplements: The client’s vitamin B12 level is slightly low but not critically deficient. The primary issue is iron deficiency, not pernicious anemia.

A. "The surgeon will make a small incision in your abdomen." B. "You may experience referred shoulder pain." C. "Your procedure will be scheduled during menstruation." D. "Warm saline will be instilled via the cervix."

Correct Answer is B

Explanation

A. "The surgeon will make a small incision in your abdomen.": A hysterosalpingography is a fluoroscopic imaging procedure that does not require surgical incisions. Contrast dye is injected through the cervix to visualize the uterus and fallopian tubes.

B. "You may experience referred shoulder pain.": Referred shoulder pain is a common side effect due to peritoneal irritation caused by the contrast dye if it spills into the peritoneal cavity, particularly when the fallopian tubes are patent. This discomfort is temporary and resolves on its own.

C. "Your procedure will be scheduled during menstruation.": The test is typically scheduled after menstruation but before ovulation (days 7-10 of the cycle) to ensure the uterus is clear of blood and to avoid disrupting an early pregnancy.

D. "Warm saline will be instilled via the cervix.": Hysterosalpingography uses iodine-based contrast dye for X-ray imaging, not warm saline. Saline infusion is used in sonohysterography, which is an ultrasound-based procedure.

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A nurse is teaching a client who is newly diagnosed with type 2 diabetes mellitus about insulin therapy. Which of the following insulin combinations should the nurse instruct the client to mix?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is caring for a client. Complete the following sentence by using the lists of options. The first action the nurse should take is ____ followed by _____ .

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

A nurse is providing teaching to a client about an upcoming hysterosalpingography. Which of the following statements should the nurse include?

Correct Answer is B

Explanation

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