Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

Pull up 30 units from the 70/30 vial, but only administer one third.

Withdraw ten units regular insulin from the 70/30 vial.

Withhold the dose until insulin regular is available on the unit.

Obtain a new vial of regular insulin and withdraw ten units.

Answer and Explanation

The Correct Answer is C

A) Pull up 30 units from the 70/30 vial, but only administer one third: The 70/30 insulin vial contains a mixture of 70% isophane (NPH) insulin and 30% regular insulin. If 30 units of this mixture are drawn, the actual amount of regular insulin would be 30% of 30 units, which equals 9 units. This does not equate to the 10 units of regular insulin required, making this option inaccurate for precise dosing.
B) Withdraw ten units regular insulin from the 70/30 vial: The 70/30 vial provides a fixed ratio of regular to NPH insulin. Extracting 10 units from this vial would not yield exactly 10 units of regular insulin; instead, it would include both types in the specified ratio, leading to an incorrect dosage of regular insulin.
C) Withhold the dose until insulin regular is available on the unit: Since the 70/30 vial contains a mixture and not solely regular insulin, it is necessary to withhold the dose until a vial of regular insulin is available. This ensures that the precise amount of regular insulin needed is administered, avoiding the imprecision and potential errors that could arise from using a mixed insulin vial.
D) Obtain a new vial of regular insulin and withdraw ten units: While obtaining a new vial of regular insulin is the correct approach for ensuring accurate dosing, the option of withdrawing ten units directly from a vial of regular insulin is not feasible if the current medication available is a mixture. This option assumes that the correct type of insulin is already available for use.

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Correct Answer is C

Explanation

A. Frequently assess the client’s blood pressure: While monitoring blood pressure is important, it is not as critical as monitoring the ECG in cases of diltiazem overdose. Diltiazem is a calcium channel blocker that can lead to significant cardiac effects.
B. Observe the client for signs of gastric irritation: This is relevant for some medications, but in the case of diltiazem overdose, the primary concern is the potential for severe cardiac effects rather than gastric irritation.
C. Monitor electrocardiogram (ECG) continuously: Diltiazem overdose can lead to serious cardiac arrhythmias, such as bradycardia, AV block, or other conduction disturbances. Continuous ECG monitoring is crucial to detect these potentially life-threatening complications.
D. Assess for changes in level of consciousness: While important, changes in level of consciousness are secondary to the immediate need to monitor cardiac function closely in the context of diltiazem overdose.

A. Avoid the intake of dairy products while using the medication. B. Take the medication one hour after meals and other medications. C. Remain upright for thirty minutes following drug administration. D. Follow medication administration with an additional glass of water.

Correct Answer is D

Explanation

A) Avoid the intake of dairy products while using the medication: There is no specific requirement to avoid dairy products when using bulk-forming laxatives. The primary concern with bulk-forming laxatives is to ensure they are taken with adequate fluids.
B) Take the medication one hour after meals and other medications: Bulk-forming laxatives should be taken with a meal or at a different time from other medications to prevent interactions, but the key aspect is to follow the medication with sufficient fluids rather than timing relative to meals.
C) Remain upright for thirty minutes following drug administration: While remaining upright can help prevent potential esophageal irritation, it is not the primary instruction for bulk-forming laxatives. The more critical instruction is related to fluid intake to ensure effectiveness and prevent complications.
D) Follow medication administration with an additional glass of water: Bulk-forming laxatives require adequate fluid intake to function properly. Following the medication with an additional glass of water helps the laxative form a gel-like substance in the intestines, which aids in bowel movement and prevents potential complications like obstruction.

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Based on the capillary glucose measurement, a client is to receive 10 units of regular insulin. The client's medication drawer contains one vial of a 70/30 mixture of regular Insulin and Isophane insulin How should the nurse prepare the prescribed dose?

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Naxlex Comprehensive Predictor Exams

A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

Correct Answer is C

Explanation

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

Correct Answer is D

Explanation

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