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A nurse is mixing NPH insulin and regular insulin prior to administration. Which of the following actions should the nurse take first?

Inject air into the vial with regular insulin in it.

Draw up the NPH insulin dose.

Inject air into the vial with NPH insulin in it.

Draw up the regular insulin dose.

Answer and Explanation

The Correct Answer is C

Answer: C

Rationale:

A) Inject air into the vial with regular insulin in it:

Injecting air into the vial of regular insulin is part of the correct procedure but not the initial step. This action is typically performed after the NPH insulin vial has been handled, as part of the process to prevent contamination and maintain the correct insulin types.

B) Draw up the NPH insulin dose:

Drawing up the NPH insulin dose should follow the initial steps of air injection. It is important to manage the insulin types in the correct sequence to ensure that the regular insulin remains uncontaminated by the NPH insulin.

C) Inject air into the vial with NPH insulin in it:

Injecting air into the NPH insulin vial first helps to equalize the pressure and avoid contamination when drawing up the insulin. This step is crucial to ensure that the NPH insulin is not inadvertently mixed with the regular insulin, maintaining the integrity of each type.

D) Draw up the regular insulin dose:

Drawing up the regular insulin dose should occur after air has been injected into both vials. This ensures that the NPH insulin is not drawn into the regular insulin syringe, which could affect the medication's efficacy.

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Correct Answer is B

Explanation

A) Dry cough:
Dry cough is not a common adverse effect of metoclopramide. It is more commonly associated with medications such as angiotensin-converting enzyme (ACE) inhibitors.

B) Tardive dyskinesia:
Tardive dyskinesia is a serious adverse effect associated with long-term use of metoclopramide, especially at high doses or with prolonged therapy. It manifests as involuntary, repetitive movements of the face, tongue, or extremities and can be irreversible.

C) Black stools:
Black stools may indicate gastrointestinal bleeding, which can occur as a result of various factors, including peptic ulcer disease or gastrointestinal irritation. While gastrointestinal adverse effects can occur with metoclopramide, they typically present as diarrhea rather than black stools.

D) Oral candidiasis:
Oral candidiasis, or oral thrush, is a fungal infection of the mouth caused by Candida species. It is not a direct adverse effect of metoclopramide.

A. "Take a tablet every 10 minutes until the pain subsides." B. "Place the tablet under the tongue until dissolved." C. "Store the tablets in a refrigerator in a plastic container." D. "Call 911 if pain persists 30 minutes after taking one tablet."

Correct Answer is B

Explanation

A. “Take a tablet every 10 minutes until the pain subsides.”: This is not correct. Nitroglycerin tablets are typically taken at the first sign of an angina attack. If the pain is not relieved within 5 minutes, a second tablet may be taken. If the pain still persists after another 5 minutes, a third tablet may be taken. However, if the pain continues after a total of 3 tablets in 15 minutes, emergency medical help should be sought.

B. “Place the tablet under the tongue until dissolved.”: This is the correct answer. Nitroglycerin sublingual tablets should be placed under the tongue and allowed to dissolve. This allows for rapid absorption of the medication into the bloodstream through the mucous membranes of the mouth.

C. “Store the tablets in a refrigerator in a plastic container.”: This is not correct. Nitroglycerin tablets should be stored at room temperature, away from light and moisture. They should not be stored in a refrigerator or a plastic container as this can cause the tablets to lose their effectiveness.

D. “Call 911 if pain persists 30 minutes after taking one tablet.”: This is not correct. If chest pain is not relieved within 5 minutes after taking a nitroglycerin tablet, a second tablet should be taken. If the pain still persists after another 5 minutes, a third tablet may be taken. However, if the pain continues after a total of 3 tablets in 15 minutes, emergency medical help should be sought. Waiting 30 minutes could delay necessary medical treatment.

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A nurse is mixing NPH insulin and regular insulin prior to administration. Which of the following actions should the nurse take first?

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